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Tuesday, December 21, 2004
Happy Birthday to Me!

Today's birthday (December 21). When you narrow your focus to one big goal, instead of being restricted, you feel your life broadening! Use what you're learning to up your income! Passionate encounters in the new year lead quickly to a commitment. Just be sure you're really ready! Friends have excellent tips in financial and romantic realms. Virgo and Pisces are love signs. Your lucky numbers are: 9, 20, 41, 12 and 15.
~Sara~
1:30 PM


Monday, December 20, 2004
It's ON

Well, here it is. Somebody has finally pissed me off enough that I'm going to post a serious post on my blog. The whole point of Just Say Oh is for it to be fluffy. I didn't want to write about the tragedies in my life, or even anything that makes me sad. It's bad enough I have it all rattling around in my own skull. I don't need to give it to you to think about. So here it is because somebody pissed me off.

I'm a third year medical student. I just got done with my internal medicine rotation. I worked harder during my month at St. V's than I have all year long. We were allowed to participate in patient care, so it made me want to really work. I took overnight call. I pre-rounded on my patients every morning the way we're supposed to. I studied every night so that I could answer my attending's questions. I basically did the things you're supposed to do. Maybe it doesn't seem like it was anything special, but all of that is hard to maintain when you're working 14 hour days 6 days per week. Anyway, I thought my attending and I had a good rapport. I was able to answer 95% of his questions (which is pretty darn good). I was always on time for rounds. I knew the little things about my patients that only the nurses know. I was a dutiful medical student. In contrast, one of my classmates missed about 10 days of the rotation, often showed up for rounds at eleven, and tried to stay out of the attending's way so he wouldn't get pimped. This didn't bother me because it didn't add to my work at all, and I assumed there was something going on in his life that he was having a hard time coping with. I covered up for him when I could because we're friends. Dr. K. said he didn't give people bad evaluations, so this other student was safe.

I learned that it didn't matter how hard I worked when I got my evaluation from Dr. K., and it said that I was "more interested in being political (sic) correct." I honestly do not remember saying anything that would make him think I'm always trying to be "political" correct. I treated the patients with respect. Maybe that was the problem. Maybe he's one of those that thinks that IV drug users don't deserve medical care. Maybe he believes that the smoker with COPD did it to herself and she is not worthy of mercy and medication to ease her panic when she's short of breath. I don't know. If it's a conflict of ideology, I guess I'm willing to take my lumps.

The thing that really burns me is that the no-show student got a really good evaluation from this guy. The other girl on the rotation got a so-so one. So this makes me think that it might have something to do with the fact that I'm a girl who wants to be a doctor. I have heard over and over that some areas of medicine are still a "boy's club." I even kind of expect from the surgeons with all of their bravado. However, in all of the possible scenarios I imagined, I thought that the docs would be less enthusiastic about teaching me, but I didn't think they would stoop to slam me in my evaluation. I was shocked. Really!

All I can say is that I know myself, and I know that I did a good job on that rotation. If he wants to try to call me lazy, or whatever, I know it isn't true. It is not in my nature to sit here and take this from anybody. I'm going to talk to the dean of students about this. Dr. K. can't be allowed to treat women this way if that's his problem. He also isn't supposed to evaluate me based on whether or not he liked me personally. He is supposed to evaluate my skills. Am I good with patients? Do I have a good grasp of the concepts? Can I write a decent SOAP note? That's his job. Moreover, he is supposed to write comments that will allow me to improve myself, not comments that leave me wondering "what the fuck?!" If he thinks he will strike his blow against women in medicine using me, he's biting off more than he can chew. I will make sure the powers that be know about this, and I will let the female med students who will rotate after me know about this guy. I'm not worried about admitting that I got a bad evaluation from my attending because I know I did a good job. I also have 4 more evaluations from that rotation that attest to that fact. You would think that with everything that women have accomplished in the last 45 years, things like this wouldn't happen anymore. My friend, C., who is an intern now, says that sometimes the girls just get screwed on their evals. Well, I don't accept that.
~Sara~
2:38 PM


Sunday, December 19, 2004
1. WHAT COLOR ARE YOUR KITCHEN PLATES? white
2. WHAT BOOK ARE YOU READING NOW? Snow Falling on Cedars by David Gutterson
3. WHAT'S ON YOUR MOUSE PAD? Lightning
4. WHAT'S YOUR FAVORITE BOARD GAME? Scrabble
5. FAVORITE MAGAZINE? Cosmo or People. I like to read the smut while I work out.
6. FAVORITE SMELL? Coffee
7. LEAST FAVORITE SMELL? vomit
8. WHAT'S THE FIRST THING YOU THINK OF WHEN YOU WAKE UP IN THE MORNING? What can I wear to work that doesn't require ironing?
9. FAVORITE COLOR? midnight blue
10. LEAST FAVORITE COLOR? orange of any kind
11. HOW MANY RINGS BEFORE YOU ANSWER THE PHONE? 2 or 3
12. FUTURE CHILD'S NAMES? Aidan and Leah
13. WHAT IS MOST IMPORTANT IN LIFE? sex (ha ha)
14. CHOCOLATE OR VANILLA? Chocolate
15. DO YOU LIKE TO DRIVE FAST? no, I'm a wuss
16. DO YOU SLEEP WITH A STUFFED ANIMAL? no, I'm not that big of a wuss
17. STORMS-COOL OR SCARY? very cool
18. WHAT TYPE WAS YOUR FIRST CAR? '84 Fiero, the piddle mobile
19. IF YOU COULD MEET ONE PERSON DEAD OR ALIVE WHO WOULD IT Be? Do I even have to say it?
20. FAVORITE ALCOHOLIC DRINK? scotch
21. WHAT IS YOUR SIGN & BIRTHDAY? Sagittarius 12/21/77
22. DO YOU EAT THE STEMS OF BROCCOLI? yes
23. IF YOU COULD HAVE ANY JOB WHAT WOULD IT BE? doctor
24. IF YOU COULD HAVE ANY COLOR HAIR WHAT WOULD IT BE? red like my mom's
25. IS THE GLASS HALF FULL OR HALF EMPTY? It's just half. I'm a realist.
26. FAVORITE MOVIES? Oceans 11, Fight Club, (or any other Brad Pitt movie), the Emipre Strikes Back, Brigette Jones Diary
27. DO YOU TYPE WITH THE RIGHT FINGERS ON THE KEYS? yes
28. WHAT'S UNDER YOUR BED? a box of sweaters and my high black boots
29. WHAT IS YOUR FAVORITE NUMBER? 46
30. WHAT IS YOUR SINGLE BIGGEST FEAR? failure
32. WHAT IS YOUR DREAM CAR? BMW
33. FAVORITE Singer/group? Modest Mouse (I liked them before they were cool), The Smiths, The Cure, Social Distortion, Mary J. Blige, Smashing Pumpkins
34. FAVORITE TV SHOW? Scrubs
35. KETCHUP OR MUSTARD? Mustard
36. HAMBURGERS OR HOT DOGS? Cheeseburgers
37. FAVORITE SOFT DRINK? Diet Cherry Coke
38. THE BEST PLACE YOU HAVE EVER BEEN? Seattle
39. WHAT SCREEN SAVER IS ON YOUR COMPUTER RIGHT NOW? MCO stuff. I'm at school.
40. BURGER KING OR MCDONALDS? Mickey D's
41. FAVORITE PET: DOG OR CAT? both
42. DO YOU HAVE A CRUSH ON SOMEONE? yes
43. HOW WOULD YOUR FRIENDS DESCRIBE YOU? I'm sure they would say I'm outspoken.
44. DO YOU HAVE ANY BROTHERS OR SISTERS? yes. a sister, Missy, and a brother, Nick
45. WHAT'S YOUR FAVORITE SONG? At Last by Etta James
46. DO YOU STILL WISH ON STARS AND BIRTHDAY CANDLES? yes
~Sara~
2:47 PM


Saturday, December 18, 2004
Wild thing, I think I love you.

Well. I changed the template again. This time I learned about uploading pictures, and moving a may*star tag from one blog to another because I couldn't seem to upload the images for her links that were on the new template. I'm sitting here giving myself eye strain over it, but I love to screw around with my blog. I feel like some of the templates that blogger has to choose from are like dry toast.

I went out with my peeps for my birthday last night. It was awesome. We went to the Maumee Brewing Company, and then back to Stacey's house for cake. Yes, my friends got me a cake. I have never in my life had people (besides my family) throw a birthday party for me because my birthday is so close to Christmas. For those of you who don't know, it's December 21st. I'm turning 27. (Birthdays are still fun right now. Talk to me again when I'm turning 30.) I had a great time, and my friends got me a massage gift certificate! I can't wait. I've never had a massage before.

Thanks you guys. I love you.

~Sara~
5:37 PM


Friday, December 10, 2004
Court sent this to me over e-mail.


Unique Case of Aerial Sleigh-Borne Present-Deliverer's Syndrome
Source: North Pole Journal of Medicine, vol 1 no.1, December 1997
Author: Dr. Iman Elf, M.D.

On January 2, 1997, Mr. C, an obese, white caucasian male, who appeared approximately 65 years old, but who could not accurately state his age, presented to my family practice office with complaints of generalized aches and pains, sore red eyes, depression, and general malaise. The patient's face was erythematic, and he was in mild respiratory distress, although his demeanor was jolly. He attributed these symptoms to being "not as young as I used to be, HO! HO! HO!", but thought he should have them checked out. The patient's occupation is delivering presents once a year, on December 25th, to many people worldwide. He flies in a sleigh pulled by eight reindeer, and gains access to homes via chimneys. He has performed this work for as long as he can remember. Upon examination and ascertaining Mr. C's medical history, I have discovered what I believe to be a unique and heretofore undescribed medical syndrome related to this man's occupation and lifestyle, named Aerial Sleigh-Borne Present-Deliverer's Syndrome, or ASBPDS for short.
Medical History: Mr. C. admits to drinking only once a year, and only when someone puts rum in the eggnog left for him to consume during his working hours. However, I believe his bulbous nose and erythematic face may indicate long-term ethanol abuse. He has smoked pipe tobacco for many years, although workplace regulations at the North Pole have forced him to cut back to one or two pipes per day for the last 5 years. He has had no major illnesses or surgeries in the past. He has no known allergies. Travel history is extensive, as he visits nearly every location in the world annually. He has had all his immunizations, including all available vaccines for tropical diseases. He does little exercise and eats large meals with high sugar and cholesterol levels, and a high percentage of calories derived from fat (he subsists all year on food he collects on Dec. 25, which consists mainly of eggnog, Cola drinks, and cookies).
Family history was unavailable, as the patient could not name anyrelatives.
Physical Examination and Review of Systems, With Social/Occupational Correlates: The patient wears corrective lenses, and has 20/80 vision. His conjunctivae were hyperalgesic and erythematous, and Fluorescein staining revealed numerous randomly occurring corneal abrasions. This appears to be caused by dust, debris, and other particles which strike his eyes at high velocity during his flights. He has headaches nearly every day, usually starting half way through the day, and worsened by stress. He had extensive ecchymoses, abrasions, lacerations, and first-degree burns on his head, arms, legs, and back, which I believe to be caused mainly by trauma experienced during repeated chimney descents and falls from his sleigh. Collisions with birds during his flight, gunshot wounds (while flying over the Los Angles area) and bites consistent with reindeer teeth may also have contributed to these wounds. Patches of leukoderma and anesthesia on his nose, cheeks, penis, and distal digits are consistent with frostbite caused by periods of hypothermia during high-altitude flights. He had a blood pressure of 150/95, a heart rate of 90 beats/minute, and a respiratory rate of 40. He has had shortness of breath for several years, which worsens during exertion. He has no evidence of acute cardiac or pulmonary failure, but it was my opinion that he is quite unfit due to his mainly sedentary lifestyle and poor eating habits which, along with his stress, smoking, and male gender, place him at high risk for coronary heart disease, myocardial infarction, emphysema and other problems. Blood tests subsequently revealed higher-than-normal CO levels, which I attribute to smoke inhalation during chimney descent into non-extinguished fireplaces. He has experienced chronic back pain for several years. A neurological examination was consistent with a mild herniation of his L4-L5 or L5-S1 disk, which probably resulted from carrying a heavy sack of toys, enduring bumpy sleigh rides, and his jarring feet-first falls to the bottom of chimneys. Mr. C. had a swollen left scrotum, which, upon biopsy, was diagnosed as scrotal cancer, the likely etiology being the soot from chimneys.
Psychiatric Examination and Social/Occupational Correlates: Mr. C's depression has been chronic for several years. I do not believe it to be organic in nature-rather, he has a number of unresolved issues in his personal and professional life which cause him distress. He exhibits long-term amnesia, and cannot recall any events more than 5 years ago. This may be due to a repressed psychological trauma he experienced, head trauma, or, more likely, the mythical nature of his existence. Although the patient has a jolly demeanor, he expressesprofound unhappiness. He reports anger at not receiving royalties for the widespread commercial use of his likeness and name. Although he reports satisfaction with the sex he has with his wife, I sense he may feel erotic impulses when children sit on his lap, and I worry he may have pedophillic tendencies. This could be the subconscious reason he employs only vertically-challenged workers ("elfs"), but I believe his hiring practices are more likely a reaction formation due to body-image problems stemming from his obesity. The patient feels annoyed and worried when he is told many people do not believe he exists, and I feel this may develop into a serious identity crisis ifnot dealt with. He reports great stress over having to choose which gifts to give to children, and a feeling of guilt and inadequacy over the decisions he makes as to which children are "naughty" and "nice". Because he experiences total darkness lasting many months during winter at the North Pole, Seasonal Affective Disorder (SAD) may be a contributor to his depression.
Treatment and Counseling: All Mr. C's wounds were cleaned and dressed, and he was prescribed an antibiotic ointment for his eyes. A referral to a physiotherapist was made to ameliorate his disk problem On February 9, a bilateral orchidectomy was performed, and no further cancer has been detected as of this writing. He was counselled to wash soot from his body regularly, to avoid lit-fire chimney descents where practicable, and to consider switching to a closed-sleigh, heated, pressurized sleigh. He refused suggestions to add a helmet and protective accessories to his uniform. He was put on a high-fibre, low cholesterol diet, and advised to reduce his smoking and drinking. He has shown success with these lifestyle changes so far, although it remains to be seen whether he will be able to resist the treats left out for him next Christmas. He visits a psychiatrist weekly, and reports doing "Not too bad, HO! HO! HO!".
Conclusions: Physicians, when presented with aerial sleigh-borne present-deliverers exhibiting more than a few of these symptoms, should seriously consider ASBPDS as their differential diagnosis. I encourage other physicians with access to patients working in allied professions (e.g.Nightly Teeth-Purchasers or Annual Candied Egg Providers) to investigate whether analogous anatomical/ physiological/psychological syndromes exist. The happiness of children everywhere depend on effective management of these syndromes.
~Sara~
4:42 PM

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