Blazin' around Baltimore/Passing thru Philly/Drivin' from Denver with aStop in Salt Lake/Settle back in Sebastopol

Warning: from here until I get bored with it or run out of ideas (which will probably come first), all titles will be witty (fingers crossed) alliterations.  :)

What a whirlwind the past 6 weeks have been!  At the end of August I flew out to Baltimore to spend time with my Amazin' Amy!  She is studying Cellular and Molecular Medicine at Johns Hopkins (aka she's super smart).  While there reminiscing about our childhood, I did some simple math and figured out that Amy is my oldest school friend.  We started Kindergarten together and 20 years later we're still going strong!  During high school we would talk about how she would be this awesome PhD doing all this research and I would be her clinical physician to carry it out in trial.  It's pretty weird now to realize that we are both doing exactly what we said we would.  Anyway, she's fabulous and I had tons of fun with her and her BF.

Our reunion improved greatly with the additions of more great friends, Rockin' Rachel and Dandy Dan.  They are in Occupational therapy (OT) grad school in Charleston, SC (aka they too are super smart) and just happened to already be in Washington DC.  While Amy abandoned us for her lab rats (aka she had to go to work since it was a weekday), the three of us explored Baltimore.  It was great not having any agenda and just enjoying the day with each other.  I'm so glad that even with the long distance and the busy schedules that these childhood friendships have not only remained strong but have grown and deepened over the years.  It was good for me to be with non medical school friends the night before my physical board exam.  They forced me not to over study and made sure I had everything I needed to succeed.  It was a much needed quick trip with wonderful people.

From Baltimore I took the train to Philly.  Every osteopathic medical student in the country travels here for this one day exam.  This is basically a full day of being a doctor with standardized patients in clinical settings.  You see the patient, take a history, do your exam and treatment and then immediately document it all in the computer.  What makes this the most stressful are the time restraints.  But I survived and just found out that I passed!

After 15 hours in Philly, I jumped on a flight to Denver where I was met by my Mom who flew in earlier that day.  From there we packed up my car with some essentials and road tripped it home.  First leg of the journey was to Salt Lake City where I met up with my "first adult friend" Katie and her new husband Jesse.  They were super nice and let us stay with them for the night; Jesse even cooked a delicious dinner for us.  It was great to see them after so long!  The next day was a big push from Salt Lake all the way home.

Alex's Birthday Dinner

The next was month was spent home taking an online pediatric radiology course.  It was nice to be able to relax a little and keep my own schedule.  I got to catch up with family and friends.  I was able to participate in several things while I was home.  One of those things is harvesting the hops.  This was my first harvest and it was a real interesting process.  I was also able to attend some wedding planning things with my wonderful bride-to-be-bestie Leah.  It was fun to join in.  During this time I also submitted all my residency applications.  Now I am just trying to plan the interview offers as they come in.  This month I travel down to Fresno for pediatric plastic surgery...I'll be sure to let you all know how it goes!          

Wedding Expo

Harvesting the Hops

Trailing through Tucson

I have spent these last few weeks in Tucson, Arizona on a pediatric cardiology rotation at Diamond Children's Hospital and I can honestly say I have loved every minute of it.  The people here at this residency program are awesome!  They have been so friendly and welcoming.  Being attached to a university does have it's pros and cons.  During the past year, I have worked mostly one-on-one with attendings.  I was use to having individual and private teaching.  I was not competing with other students or residents for attention or procedures.  Most of my rotations were great mostly because my attendings were great.  Some though left something to be desired and I felt like I wasn't challenged enough or I didn't learn enough.  Being at a university with residency programs in pediatrics, internal medicine, ER, surgery, and family practice is very different.  There are 3rd and 4th year medical students all over the hospital.  Because of this, every attending is use to teaching and really knows what is important for the students to learn.  Also, the pediatric residents have all been so patient with me.  It might just be the peds environment, but no one in this program is fighting for procedures.  They share taking the lead in patient care and take turns doing the hands on stuff.  They seem to really believe in the statement "sharing is caring".  They also enjoy teaching med students and sharing advice from their med school days (which were more recent than the attendings).  I am constantly being challenged and pushed to think things through to the next step and beyond.

Children's hospitals always have the best decor

I have been exposed to so many kinds of congential heart disease and conduction disorders during this rotation.  I have learned how to read EKGs (which is very different in children than adults) and ECHOs.  I even got to see some fetal ECHOs were the babies' heart defect was diagnosed at 20 weeks while still in mom's tummy.  This helps the doctors prepare appropriately for when the baby is born and some bigger hospitals are researching ways to fix these defects before the baby is born.  I scrubbed in on cardiac catheterization and ablations.  My ears have gotten much better at detecting innocent murmurs verses pathological ones.  I met kids who are thriving with only one ventricle due to modern interventions.  I met adults who had open heart surgery as children who are still followed by a pediatric cardiologist because adult docs aren't trained how to care for them.  The cath lab is one of my favorite places.  It just blows my mind that we can close holes in the heart, redirect blood flow, repair blood vessels and even replace valves all through vessels in the groin!  Most patients can go home the same day as the procedure.  My least favorite part is wearing the lead.  Because xray is used, all people in the room have to wear a lead vest and skirt plus a thyroid guard.  By the end of the case it is so heavy and hot!

Desert Museum trails

Now Tucson, Arizona is pretty cool in its own way.  All the houses are so flat and short.  It's weird to me to see box houses everywhere with rocks and cacti instead of lawns.  The downtown buildings are also pretty short.  There are no skyscrapers of any kind.  But it does have a big university so the college part of town is pretty fun.   I spent one afternoon at the Arizona-Sonora Desert Museum where I learned all about the animals and plants for Arizona.  The desert is somewhat pretty at times though I believe the things that live in the desert have an unfair advantage in life.  They all prick or bite or string or fly.  Totally not cool.  I received my first introduction to cockroaches and I am not a fan.  Turns out they live in bathroom drains...yuck.  You have to pour bleach down the drains every now and then to kill them.  I swear they know when they've been spotted and then they plan their attack.  They hold real still and then fly right at your face when you go to kill them.  Just thinking about them makes my skin crawl.

Halfway up Mt. Lemmon

The area around Tucson is really diverse.  Desert surrounds the city but mountain ranges are only a short drive away.  I hiked with some residents on Mt. Lemmon which is at 9,000 feet.  It was like being back in Colorado with aspen trees and pines all around.  Rumor is they even get snow there in the winter.    

Top of Mt. Lemmon

Overall I really enjoyed my time in Tucson.  I honestly think I would be happy completing my residency here.  This is my first away rotation so it's too soon to know for sure but it's definitely on my list.  Hopefully I won't have the same problem that I did last year with loving every specialty.  Now it's off to Baltimore to spend the weekend with my friend from home who is getting her PhD at John Hopkins.  While there we will be joined by other hometown friends who are in Charlestons in OT grad school.  So a mini Sebastopol Reunion will take place in Baltimore!  Then I take the train to Philly to take my clinical skills board exam.  On to the next adventure :)

Nicest Resident Ever

         

Where Has The Time Gone?

Oh my goodness has it really been since February since my last post?!?!?!  Where has the time gone?  So much has happened since then.  So let's take a quick trip back in time for an overview of the past 5 months.  March was spent in my second month of Family Practice.  My doctor was known in town as being the family doc that delivered babies.  He probably delivered over half of Pueblo.  He also spent one day a week in the OR doing OB/GYN procedures and surgeries.  I had a lot of fun with him.  He was an older doc who liked to joke around and tease.  He was very professional with his patients but totally not PC every other time.  It made coming to work really entertaining.  He was really easy going and let me participate as much as I wanted to.

April was a challenging month for me.  I worked with an Internal Medicine Residency team.  This was very different from all my other rotations.  I was use to it being just me and my attending everyday.  Now, I only saw the attending during rounds and spent all the other time with residents.  It was challenging switching between the residents from day to day because they had such different teaching styles and expectations of my role.  For whatever reason, no matter how hard I tried some of the residents could just not be pleased.  At times it felt very much like high school with all the drama.  I admit to struggling through this rotation mostly due to the social issues.  Luckily the majority of the residents I worked with were awesome and nice.  The hours were long (5:30am - 7:00pm) and the work was constant.  There were no breaks or downtime.  Even the lunch hour was spent in a noon lecture.  It seemed more difficult than even my surgery rotation at times.  But in the end I survived and learned a lot about myself.  It was a good experience for me because I'm sure there will be times in the future where I won't be completely happy with my work environment.

May was just an awesome month!  I got to do a month of adult Heme/Onc!  There is only one group in Pueblo with 4 doctors.  I rotated between them all.  It was great seeing the different approaches to patient care.  It was amazing!  I loved the patients and office staff.  Everyday I got to meet and work with incredible people who taught me so much about life!  I loved every minute of it, the highs and the lows.  But I do feel the need to step onto a soap box for a minute here...consider yourself forewarned.  Please please please get your colonoscopy at age 50!  Colon cancer is called the silent killer for a reason.  Is it fun? - No.  Could it save your life? - Most definitely.  I don't know about you but I would trade one day of discomfort and misery for 10 more years.  Also, mammograms!  Again, not fun but necessary.  Alright, I'm done and stepping off my soap box now.

At the end of May, my daily routine was thrown for a loop.  As many of you know, I gave myself a pretty nasty concussion.  It was a fluke event.  For unclear reasons, I passed out one night in my kitchen and hit my head on the granite counter-top.  My post-concussion symptoms were more extreme than I would have liked and unfortunately decided to hang around for several weeks.  Because of this, I had to postpone my board exams since I was unable to study.  I was able to go home for a few weeks to heal.  It took some time, but I finally started to feel like myself again after 6 weeks of struggling with headaches, vision changes, dizziness, fatigue, cognitive slowness, and emotional instability.  Really I was probably not much fun to be around.  But my friends and family were saintlike and took care of me through it all.  I'm over the bitterness and anger now and can see the good that has come from this experience.  I was able to go home and see my family which is always nice.  Also, I believe it has made me be a more compassionate person/doctor towards people with head injuries.

So that took up most of June and early July.  I went back to Pueblo for some intense broad prep, took my exams, and then popped on an overnight flight to Tucson, Arizona.  So I'm here now doing a rotation in Pediatric Cardiology at the University of Arizona.  And I'll let you know all about it in a few weeks :)                      
  

No Offense But I Really Can't Stand Adult Patients

I consider myself a good person....most of the time.  But I really dislike dealing with adult patients.  I'm sure you're wondering "Why did it take you so long to figure that out?  Haven't you been dealing with adults in all your other rotations besides Peds?"  The answer to this question is yes, I have been dealing with adults but I was either cutting them open in surgery or caring for pregnant ladies (who come with infant included so have already earned a few points in my book) or they were crazy (which if you read my early posts crazy people can be quite entertaining).  I mean really think about it...I've done general and orthopedic surgery, ob/gyn, psych and peds.  I'm not sure what this really says about me...that I only like you as a patient if you are anesthetized, are carrying a child, or are amusing me with your hallucinations?  I'm choosing not to dwell much more on that...

This month I entered family practice.  And it's just not my favorite thing.  I'm use to working at a fast pace and being go go go all day long.  I mean I pulled over 80 hour weeks during surgery.  And even in my general peds rotation I was seeing at least 18 patients a day.  This last rotation a really full day had 10 patients.  I should be happy for the break and feel less stressed but instead I feel bored.  I know I shouldn't be complaining, but it's my blog so I'm going to.

Most of my patients are older with multiple chronic diseases.  It's all about managing medications and logging blood pressures and blood sugars.  I have a hard time telling the 82 year old woman who is already on 15 different medications that we have to add another one.  It is also difficult and very frustrating dealing with non-compliant patients all day long.  I don't know how many times someone comes in for a high blood pressure check and they don't bring any logs from home.  A very typical encounter:

Me: "Have you been checking your blood pressure at home?"

Patient: "No, not really."

Me: "Are you following a low salt diet?"

Patient: "No."

Me: "Do you have an exercise routine?"

Patient: "No."  

Me: "Are you taking your meds?"

Patient: "Sometimes."  

I then walk out of the encounter throwing my hands up thinking 'why do I even bother?  What's the point when they don't listen?  Why should I care about their health when they clearly don't?'  I get that you can only do so much and that whole 'you can lead a horse to water but you can't force them to drink' but job satisfaction is very low with this mindset.  I'm just not cut out for family practice and that's ok.  There are people out there who are and I for one am grateful for them.  God bless those who enter family medicine!  But it for sure won't be me.   My calling is pediatrics.  I have endless patience for children and their ridiculous behavior.  I have less patience for adults acting like children.  The highlights of my day are when there are kids in the office.  Every now and then there is a well child check or an acute complaint.  It quickly became known around the office that I like working with kids and so all of them were funneled to me.  I called those encounters my little moments of happiness.  I also got to deliver a few more babies and unlike with Ob/Gyn, I was allowed to follow the infant to the nursery for the newborn exam.

So now that I'm done whining, it has to be said that overall I had a really good experience this past month.  My attending was really smart and very nice.  She taught me a lot and let me do a lot.  I got to perform many procedures by myself.  She really took the time to teach me.  And we share an Alma mater!  She graduated from DU the year after my mom did.  One of those 'it's a small world' moments.  Everyone in the office was nice and I enjoyed my time there.  They even surprised me with having lunch and cupcakes brought in on my birthday.  It was really sweet.

Pretty flowers!

Speaking of my birthday, I am now 25 years old.  Half way to 50...  It was a good day.  There were many small surprises throughout the day.  It also happened to be my last day of this rotation.  It was like all the patients knew it was my birthday and they behaved.  As I already said, the office had a small lunch celebration for me.  My parents had flowers delivered to me at the office.  I had no plans for the night since most of my med school friends had an exam the next day.  Around dinnertime a grade school friend who was transferred to Fort Carson up in Colorado Springs a few weeks ago called me up.  She insisted we do dinner together.  So I drove up to the Springs and we went to the Melting Pot with two of her housemates.  I was very surprised when we were shown to our table and there was a gorgeous bouquet of roses and a Happy Birthday balloon waiting there for me.  It was so sweet of her!  And totally unexpected!  We had an amazing dinner and had our first sleep over together since high school.  It was fun reminiscing about the "old days" together.  It was a perfect day.  A big thank you to everyone who helped to make it a special day!    

 

The Best Rotation Ever (aka CLARITY!)

So it's official....I want to be a pediatrician!!!!  Now I know some of you are rolling your eyes right now just thinking to yourself "Well of course you do Danelle.  You have only been telling us this since you were six years old."  But some of you know how hard I struggled with this decision.  Though I come across as calm, cool, and collected, for the past few months I was panicking inside.  I fell in love with Ob/Gyn in October and for a while there I could really see myself doing that forever.  Then my pediatric rotation in Texas just confused me more because I didn't absolutely love every moment of it.  I was disappointed that my first day walking into the Children's Hospital a choir of angels didn't light up in the sky singing "Alleluia".  I mean I thought my life calling would come with some sort of grand sign.  But alas, it didn't.  So I spent the last few months making lists, thinking about what I really wanted and how I pictured my life in the future, and doing some serious soul searching.  And then I finally had that moment of clarity where a choir of angels dropped from the sky singing.  Ok in reality giant stuffed animals dropped off of shelves to the melody of screaming babies.  But it was just the sign I was waiting for.  And it all happened at a pediatric clinic at home...

I was extremely lucky to complete an elective rotation at home.  I lived with my parents for the month of January and worked in Santa Rosa at a general pediatric clinic.  Back in October I thought I had a rotation all set up but then it unfortunately fell through due to legality reasons.  The amazing doctor I was coordinating with for that rotation then took it upon himself to find me something else in Santa Rosa.  He felt that it was unfair for legal reasons to hold me back.  That's how I ended up at the best clinic ever.  The director there took a chance on me and I will forever be grateful for that.  It was there that I fell in love with pediatrics.  I never saw myself doing general peds, but I loved everyday in clinic.  I have to work with children.  They are just amazing little creatures.  They are candid and funny and speak whatever is on their mind.  You can't help but smile working with them.  And they are so smart!  I learned so much from the munchkins.  One of my favorite interactions was with a little four year old girl who needed her Kindergarten shots.  I start every encounter with "So tell me why you're here."  She just sighed and said with a very serious and brave face "I need shots."  She then continued "I'm ready.  I'm prepared."  She looked shyly up at me and asked "Do I still get a sticker if I cry?  I'm going to try really hard not to but I might cry."  I wanted to give her all the stickers at that moment.      

I got into a nice routine while home.  Every morning at 5 am my parents and I would go to Boot Camp together.  After sweating for an hour and questioning "why am I doing this?", we'd come home.  It seemed so much easier when I was in high school getting up for 5 am ice time at the rink.  Now that I'm all old and stuff my body protests getting up before the sun.  But I pushed through telling myself that if my parents could do it without complaint then so could I.  Once home, Dad and I would get ready for work while mom made breakfast and packed our lunches.  It was like being in school again.  I was spoiled for sure.  Then dad and I would carpool into work.  He would drop me off at the clinic and pick me up to head home.  Mom would have dinner ready and then the evening was spent studying with an early bedtime to do it all over again.

This pediatric clinic mostly treats the under-served community and is open until 9 pm five days a week and then until 3 pm on Saturdays.  The majority of the families are Spanish speaking only.  Challenge number one - learn Spanish, fast.  I got this app on my phone to teach me.  My dad and I would practice together on our way into work.  My favorite was to try speaking with the 5-8 year olds because they thought I sounded funny but would correct me and teach me.  The parents were too polite to tell me I was saying things wrong.  So I now know many medical words and can ask very personal questions in Spanish like "How long have you had diarrhea?" (cuanto tiempo ha tenido la diarrea?) and "Does it hurt when you pee?" (le duele al orinar?).  Wonderful everyday conversation, right?  All the providers and MAs were bilingual.  The MAs were also super helpful in teaching me Spanish.  The key to a successful clinic operation most definitely starts with good MAs.  They work hard for very little praise.  They were always there to assist the doctors with whatever they needed.  The MAs at this clinic totally rocked and were really nice to me.  They helped me out several times without making me feel like a complete idiot.  

Everyday I would work with a different provider.  This clinic has 8 providers but only 4 working at a time and all are ladies.  (Girl Power!)  And from the moment the doors opened in the morning it was busy!  On my busiest day I saw 28 patients!  A "light" day had about 20 patients.  The rule of the clinic was no walk in was ever turned away.  I learned a lot and got to see many different doctoring styles working with the different providers.  All the providers are amazing ladies and great doctors and nurse practitioners.  After shadowing my first day, I was put to work the next seeing patients by myself and creating a plan.  I documented everything I did in the computer.  I learned how to prescribe medication and write school notes and send referrals.  I almost always felt behind but I loved being that busy.  The more I saw the more I learned.  All the providers were super friendly and they have connections with pediatric residencies in California so it was a great networking opportunity for me.
They treated me like one of the team and I am super grateful to have met them all.  On my last day they even got me a cake and sang "For She's a Jolly Good Fellow".  It was so sweet and really touched me that they would go to the trouble!  And for the record, it was a delicious cake!  (Almond cake with apricot filling and white chocolate butter cream - Yum!)  As you can see they also gave a nod to my newly acquired Spanish skills.

Overall this has been my favorite rotation so far.  I think it meant just a little bit more to me because I was working in the community that I grew up in.  I can't express in words what this rotation meant to me.  It made me realize not only my love for pediatrics but my love for my community.  I haven't lived in Sonoma County for 7 years now but it will always be my home.  And who really knows what the future will hold but as of now I would be very content and honored to come home and work in the community that raised me.  It was very special all around.  And the best bonus was being able to spend time with my family and friends.  The older I get the more I realize how awesome my parents and older brother are.  I love them all so much and I cherish this new "adult" relationship we have.  And my grade school friends.  It was wonderful being able to spend time with them again.  It's been so long with all of us leaving for college and now work and grad school.  Even though we have spent more time apart than together these last 7 years, our friendship is as strong as ever.  The month went by too fast but I am so thankful for everything I experienced!

  

         

Holiday Special

I have decided that since every music artist and TV show have a holiday special, I get one too.  And fair warning - this post has nothing to do with medical school.  So if that is the only reason you keep reading, I'm sorry to disappoint.  You can stop reading now, or not....  As Captain Planet says, "The power is yours!"  But let's not kid ourselves, I really just wanted to share all my fun pictures with everyone.  The words are not that important.

Anyways, my family got the pleasure of my company for the holidays!  They were extremely happy.  Especially my parents, for we all know that without me their lives have no purpose (love you mom and dad!)

The holiday season started with a gift exchange party among my college friends in Denver.  I met these five amazing people my freshman year of college.  I am very fortunate that they have remained friends with me through my crazy moods and schedules of medical school.  For the past two years we have had a rotating Sunday night dinner.  We take turns hosting and cooking.  It's been great having them as a consistent support group.  And they know me so well!  I got a lunch box that says Human Organ for Transplant and a doctor nutcracker.  The next week I took my exam and hopped on a plane home.

We of course had the annual Wilson Holiday Party.  Mom and I baked up a storm the day after I got back.  I was extremely pleased with our Christmas tree made out of rice crispy treats.  It was great seeing family and friends again after being away from so long.  And the weather was perfect unlike last year when our party got rained on.  This year the Wilson Family had a Holiday staycation.  We went to a fabulous Christmas Eve party, had a lazy Christmas morning, enjoyed dinner with the extended family.
The next few days were spent doing things local that we haven't done before, like exploring point Reyes and taking CJ to the beach for the first time.  I was even home for my mom's birthday.  We went to the Melting Pot and ate tons of melting cheese and chocolate.  Overall it was perfect.

Christmas Morning

I was real lucky to be able to catch up with some high school friends I haven't seen in years.  My bestie recently got engaged so my other bestie and me threw her and her fiance a surprise engagement party.  We made a pretty good party planning team.  Fall back job for sure if this whole doctor thing doesn't work out.  Boy was she surprised!  The timing just worked out perfectly with everyone being home for the holidays.  It couldn't have gone better and was really fun play 'what have you been up to these last 3 years' with everyone.

The Party Planners

New Years was pretty laid back.  I hung out with friends and played board games.  I learned this new intense game that involved aliens with special powers trying to colonize other people's galaxies...it was confusing, but fun!.  Though that might sound lame to some of you, that's my idea of a rockin' night.

Well, that was my Holiday Special!  Hope you enjoyed it even though it is a month and a half late.    

Psych Psych Psych

Finally, a rotation that is not wooing me in any way!  I absolutely have no desire to pursue psychiatry!  Yay!  One specialty is for sure crossed off my list!  My first week was spent in the Adolescent Psych Unit.  This is an inpatient psych treatment center for children ranging from 6 to 17.  I found this week challenging.  I like working with kids, but I had a really hard time finding common ground with these children.  They were dealing with messed up home lives and issues that I have never had to face.  I just can't relate.  Now the argument can be made that I can't relate to women who are pregnant since I have never been pregnant or children in kidney failure since I have never had kidney failure, but those are situations I can at least imagine.  The kids in the psych ward come from situations that I can not even fathom.  I never was a 15 year old dealing with a meth addiction and bipolar disease and I have a hard time imagining it.  It was also difficult working with such a wide range of ages and problems.  A 7 year old with behavioral issues sits in the same group therapy session with a 17 year old dealing with alcoholic addiction.  And it was frustrating since most of the issues stemmed from the home life and the parents.  A lot of these kids were having problems because their parents were having a hard time actually being parents.  I think some parents had their children committed looking for a quick fix with a wonder drug.  Well unfortunately no such drug exists.  Now this may sound harsh and I admit fully that these opinions are created with the limited view of a 24 year old childless med student, but really how hard it is to love a child and provide them a safe place to grow and explore the world?  But enough with my frustrations.

There were definitely some fun times with the kids.  A typical day started with group session after breakfast were the kids set a goal for the day and how they mean to accomplish that goal.  The psychiatrist would pull the kids out for short individual sessions with each kid during the morning.  This was mostly to discuss the medications being used and looking for side effects.  The psychiatrist at this facility didn't do any psychotherapy and left it all to the councilors or behavior specialists.  Each kid had a family session everyday as well, whether in person or by phone.  These seemed to be the make it or break it moments of treatment depending on how receptive the parents were to change.  The kids had many group sessions during the day and even recreational therapy (aka play time).  I met some pretty special kids that week.

Next I went to the Chemical Dependency Unit. This unit is an in patient treatment for drugs and alcohol.  Some stay just for 3 days for detox while others are there to complete a 30 day program.  Again a wide variety of life stories.  I never really felt like I fit in or that I was qualified to be leading group sessions.  Most of the councilors there were recovering addicts themselves so they had more of a connection to the patients.

My last two weeks was spent on a in patient psych ward.  The focus there was on treating schizophrenia, major depressive disorder, bipolar, any form of suicide attempt and delusions and hallucinations.  These two weeks were more to my liking.  My day was more structured and I was working one on one again with my attending.  Also, this might sound insensitive but I want to be really honest.  Sometimes the patients are just very entertaining.  They talk about the world of their delusions and some are really quite creative.  Also, you never know what they are going to say or do next.  One time a patient just stripped all his clothes off while continuing to answer my questions as if nothing out of the ordinary was going on.  Because the patients were unpredictable, everyone on the ward wore a panic button which I can say from experience works.  This button causes a hospital wide alarm to go off, almost like a Code Blue that you see so much on TV.  Security, nurses, and doctors have to respond until the alert is called off.  There is a tracking devise on each alert so that they know where to find you.  So all the doors on the psych floor lock automatically.  One time I was working in an office with the door open when a patient walked in and shut the door behind him.  Earlier that week this patient had written me into one of his delusions.  He claimed that I was the one hurting him in his sleep.  My attending told me that this was a bad sign and that I needed to avoid this patient until his anti-psychotic medication kicked in.  Well, my avoidance strategy didn't really work once I became locked in a room with him.  I didn't even hesitate with pressing my panic button.  The alert went through the entire hospital and the response time was very impressive.  While it only took less than a minute for help to come, it was one of the longest minutes of my life.  I think for the first time ever I felt in direct danger.  Luckily there was only enough time for this patient to push me into a chair before he was restrained.  Yay for panic buttons!  Overall, this was the only scary thing that happened during my rotation.

While I understand the importance of locked doors on this floor, they can really hinder things at times.  Like when you think you're being a good person and take the stairs up the one floor to the cafeteria.  For some reason you can get into the stairwell but then can't get out.  So I may have had to call my attending from the stairwell on my cell phone to come let me out.  Good news is that there is no way a patient could escape via the stairs!  I tested every door before calling for a rescue.  My attending was really awesome to work with.  I personally think that being a woman in the psych field gives her an advantage.  That, and being a mom.  She didn't put up with all the nonsense and called the patients out when they were making excuses or just weren't listening.  She also stood up for herself and her staff when the patients got rowdy.  She was the attending this month that taught me the most.  Well, anyway, that's psych...and now home for the holidays!  (I know this post is overdue and that the holidays have already happened, but I'm keeping a timeline here.  Up next - Danelle's Holiday Special!)