What did the number 0 say to the number 8?

"I like your belt."

*giggle* I kinda liked that. :-)

So things have been good, and when I say 'good', I mean to say that they've been... well... a little insane. But good. Insanely good. Goodly insane. You know. That old chestnut.

Anyhoo...... where do I start? First of all, I started my internal medicine rotation at Loyola. It's been pretty fantastic so far, albeit exhausting. You'd be amazed how tiring it is to simply THINK all day long. I know, I know, you're skeptical. But next time you have a day off, print out the NYTimes Saturday cross word puzzle and go to town. I bet you by 7 o'clock that evening, you'll know what I mean. I'm not just thinking; I'm straining my brain to process, integrate and assess information from each patient in order to learn how to NOT kill people (so, ya know, no pressure).

Despite my bitching, however, I love it. I mean, I LOVE it. Internal medicine is by far and away the most intellectually challenging rotation I've had to date (and I think likely it will stay that way the remainder of the year). Adults just take such awful care of themselves that by the time they're older, several systems shit the bed at once. Almost every patient I've taken care of has a myriad of co-morbidities: heart failure, renal failure, liver cirrhosis, diabetes, coronary artery disease, hypertension, ect. Alone, each of these conditions have a set of criteria to follow for management. But when one patient has 3 or 4 problems, management, whether medical or surgical can get muddied. And I LOVE it. The more challenging it is, the more excited I get, the more motivated I am to study and learn, and the closer I feel like I get to becoming someone who can be trusted with peoples' lives. It's pretty great. I mean, not that these people are so sick... just the medicine. I'm not cold and heartless. I swear. Eek.

I'm on my inpatient month at the VA. In addition to simply enjoying the medicine, I LOVE the patient population at the VA. The Vets are just about the cutest, most respectful and interesting old men I've ever met. One of my patients last week was AT the Battle of the Bulge. I actually SPOKE with someone at one of the most pivotal battles of American history. Amazing. There's also a certain satisfaction to be had in caring for patients who've made a significant contribution to American society. Who deserves to be taken care of well more than those who've taken care of us?

I'm also coming to realize how much I enjoy procedures. I did my first ABG (blood draw from an artery rather than a vein) a few days ago and NAILED it on the first try! I jump to do venous draws at every opportunity, and have been taught how to do a paracentesis with the promise that if we have another patient who needs a diagnostic tap, I get to do it (see one, do one, teach one! :-)). I even jumped to put in an ANAL TAMPON yesterday, to my never ending horror. For the sake of your stomachs, I won't go into details. Even as I volunteered, I heard my voice as if an out of body experience and thought, "What is WRONG with me?" LOL. But I'm finding that I enjoy procedures almost as much as I enjoy talking to patients, which is definitely going to be an important factor in deciding my future career. For a while now I've been leaning towards a career in pulmonary medicine/ critical care medicine. It would mean some additional years of training, but I think it would be worth it to have a long, stimulating and rewarding career. Of course, I may change my mind a dozen times over the next few years. We'll see, I suppose. :-)

In other news, Shane found out a few weeks ago that he'll be deploying to Afghanistan in January. I know, I know what you're thinking, but its actually a good thing. He's deploying to an area of Afghanistan that is about as far away from the front lines as one can get, and will mostly be doing his duty within the well fortified confines of Bagram Air Force base. So, outside going somewhere like Germany, its about as safe as he could be. It will be an incredible experience for him, something he'll look back on with pride, which is more than enough motivation for me to support him 100% on it. Never mind the fact that it will be a huge resume builder, AND its only six months, during a time I'm going to be eye-ball deep in my surgery rotation anyway. Honestly, this is as good time for a deployment as any. I'm already brainstorming for ideas for kick-ass care packages (if you can offer up suggestions, I'd love to hear them!). While he's gone, I'll also be making some trips to Washington state and hopefully a few other places in our beautiful country. Maybe getting a dog, taking up pogo-stick-ing. LOL I don't know. We'll see what I'll do to pass the time.

Lots and lots and lots of other things to comment on, but I'll probably save them for another time. I have a hair appointment in like half an hour; my treat to myself on my first day off in fifteen days. I deserve some pampering, don't you think?? :-)

Have a good one, kids. :-)