We’re suspended for a moment on this spinning blue pearl,
here together and alive right now, conscious, though no
one knows why. It is a question of caring. When one of us
considers the experiences of another, all the failings
and the achievements in someone else’s life, we are
seeing from this common place, knowing that it’s all
taking place in doubt and the absolute solitude and
terror of being human, and knowing that it’s all
temporary.
“Tell me about your patient.”
“I, uh, well. She’s here to get #30 out. Uhh. She has hypertension and is taking medication for it.”
“Like?”
“Hydrochlorothiazide.”
“Which is?”
“Err… a loop diuretic.”
“Nope.”
“A potassium sparing diuretic.”
I was wrong the second time, too. HCTZ can be paired with a potassium-sparing diuretic, but it’s only a calcium-sparing diuretic. It’s really really not a loop-diuretic. Anyhow, that dialog is from today, up in oral surgery: our current surgery doc loves to pop quiz us… hard… in front of the patient. If you get it right, he may just keep asking things until you get it wrong. I simply am not quick enough on the draw — so, I can’t remember what I DO know, and I can’t even put forth a good guess when I do NOT know. I get flustered when these things happen:
I don’t have enough time to think (3-4 seconds would be nice).
I see a patient for the first time.
I anticipate doing something I’ve never done before.
I’m intimidated by a dominant personality in a position of absolute authority.
Oral surgery puts all these together, and I turn into a wreck. For every question like this:
“Patient is on Celecoxib.”
“Which inhibits COX-1 or 2?”
“COX-2.”
Or this:
“You didn’t ask your patient if they smoke, but I would guess they do.”
“I… I’ll add that to the history.”
“Which automatically makes them ASA what?”
“ASAII.”
I get things like this:
“And what’s the name of the position when you raise the patient’s feet above their head to help them recover from vasovagal syncope or orthostatic hypotension?”
“I… well, I just… I mean, I was studying it in the… it has this name which”
“The Trendelenburg position.”
Or this:
“Good. You remembered that Coumadin is a Vitamin-K dependent coagulation inhibitor. Which factors does act on?”
“Umm. IX and…”
“Nope.”
Interestingly enough, I would have SWORN I said IX, which on further investigation appears to be correct. But that doesn’t matter. This surgeon really seems enthusiastic about helping us; I appreciate this. I really do. Also, his expectations are high. Very high. Thing is, I absolutely can NOT get a read on whether he thinks we’re all total screw-ups (what are they teaching the kids these days), or if he thinks I’m a screw-up and need remedial education.
I can’t tell if I bother him or if I’m giving myself too much credit, and I’m simply like a fly buzzing around the head of a hiker, only deserving of a reflexive swat to clear the field of view for more interesting things ahead.
I really suspect it’s the latter.
I’m way too easily crushed by doctors like this — I’m not looking to be coddled, but I can’t help but seek out affirmation. I know it’s not a good way to learn, but I can’t help it. Somehow, some way, I just have to forget that I might bother this surgeon, and that he’s going to make me look foolish in front of patients (justified or not, in search of education or a reminder of seniority). After figuring out how to ignore these distractors, I need to learn.
After all, you have to look down at rapidly rising pool of blood in an empty tooth socket, the surface of the deep red liquid pulsing with a heartbeat due to the size of the vessel that was injured, and think clearly enough to figure out how you are going to achieve hemostasis, close, and get on with it all. I’m sure all of my colleagues aren’t even phased by this, and simply go on with their lives when they get home.
As for me, I’m a little bit shaken up.
I still wonder where I stand with the attending surgeon. I know it doesn’t matter, the surgeon absolutely couldn’t care less about me, and that this over-thinking just gets in the way, but it all makes me worry.
“Don’t worry about missing that class,” our teacher said
when we sheepishly relayed the reason for our breathless
arrival. “You can’t learn ethics or compassion. You
either have it or you don’t.”
14 hours are left until day one of my two-day hell-test sponsored by the Joint Commission on National Dental Examinations. And when I say “sponsored” I actually mean “questions written to mess with me” because I still had to pay $360 for the privilege of taking this thing. My wife has made every food (all the foods) in the kitchen for a delicious dinner tonight:
Yesterday, I reviewed 1000 flashcards in 3.8 hours. The day before, around 900 in 4.1 hours. I’m to the point where, as I’m going about my day (especially when I awake), random words and phrases pop into my head. I’m not kidding, here are some examples: Sturge-Weber angiomatosis. LD50 for fluoride is 5mg/kg. Necrotizing sialometaplasia. Canalicular adenoma.
Last night, I told Mykala that I can’t tell if this non-stop fact review-fest is doing any good anymore. My brain is just stuffed with facts; some I have straight, and some I might second-guess when confronted with a novel questions, 9 hours into testing. On top of that, I can’t tell if I’m getting too specific, not specific enough, or if I’ve memorized a fact backwards because I transcribed it from the dental decks incorrectly.
Ellie Goulding’s ‘Home’ is a song with a tide. It washes out to low tide, and you are left with stripped down melody: guitars, vocals. It rises to high tide, and you get powerful crashes of synthesizers and hip-hop inspired backbeats. Her voice has no sharp edges, just round corners.
The use of that last phrase, “style over substance” has
always been, as Oscar Wilde observed, a marvellous and
instant indicator of a fool. For those who perceive a
separation between the two have either not lived,
thought, read or experienced the world with any degree of
insight, imagination or connective intelligence.
If you’re looking for a succinct, mind-bendingly well-written piece in tribute to Jobs, you must read John Gruber’s Universe Dented, Grass Underfoot.
Despite its ungainly title, “Saussure, Predictive Text, Cycling Awake and the word ‘Book’” is an interesting article. Here’s the thesis: two unrelated books on your bookshelf can become associated in your memory, simply because they are next to one another. Similarly, two unrelated words on your phone can become associated in your memory, simply because T9 predictive text puts them next to one another. As a result, language grows in richness, because new associations are made on the bookshelves of our phones. It’s a really neat idea, one that has produced real-world results. For example, the word “Zonino” is “text misprediction” for “WooHoo!”
I have to close, just like the author of the article did: Zonino!
Nike+ has this “Power Song”; it’s what you play during your run when you need instant motivation. This is that song: “Part Of Me (Original Mix)” by Solar Stone from “Rain Stars Eternal”.