The safe house….

Today I went to the peds surgery conference. Because yes I admit I wanted FREE LUNCH.

Well there is no such thing as a free lunch at least not when you are me.

The lecture was crowded. All the peds surgeons were there, all the residents more than half the peds residents and all the peds medical students and the entire Peds ED staff. It was so crowded there were people on the floor…

The topic was led by a Sr surgery resident and was on Peds tramua. It was well done. I was sitting there eating my potato salad and turkey sandwhich when all of the sudden JKP my peds surgery attending (FROM LAST APRIL FOR CRYING OUT LOUD) stops the resident looks around the room and say A. L. (my name), what are the five Ps of compartment syndrome.  THere are like 50 people (no lie) in the room including surely some of JKP’s current residents and students for him to torture.   I had a big bite of my free lunch in my mouth and half mouth half cough “Me??” like an idiot. “Yes you!” he says with his big grin, “you can phone a friend if you want.”  “Um how many Ps are there again?.. ” I am racking my brain I know all about compartment syndrome but I don’t know if I can describe with only P words.  I know the symptoms the treatment, the causes.
“UM umm.. pain, pulseless, pallor…”  Coldness, coldness I think but I can think of a P word for coldness.  “Um someone can get the other two. ” I mumble. Here I am a fourth year and am being pimped by an attending in front 50 people and I get it wrong…how humiliating.  Of course an eager third year gets the last two…”polikothermia (coldness) and parasthesia” some kid who probably knows endless acronyms and couldn’t actually talk to a real human being or even treat compartment syndrome… but as I began to think about it more I took the compliment.

As I left and wandered back to Peds Cards Clinic I realized something scary…

JKP likes me which may seem terribly contradictory because I really was a terrible surgery student not because I couldn’t suture quickly to save my life but because I lacked confidence. But the reason he likes me is because I wrote an essay about my last day as his student( http://wakeelf.livejournal.com/2008/09/23 ) . And because I spent time with little girl who was very, very terrified one Friday pre-operatively after I left the service (long story). He found out about this after a Mom told him on a follow up appt three months later.  He e-mailed me a thank you note.

For those of you outside of the profession if you get pimped (asked a question) in a room full of 50 other people by an attending currently not your own one of two things is true. 9/10 (in places not cut-throat) that attending thinks you are awesome (he might think this see above) or really smart (not true). For that attending to be in another specialty far, far from  yours of interest means he really, really  likes you if he actually knows your name. Or occasionally an attending will do it TRULY because he/she doesn’t like a student but its rare. So yes we humiliate people we like, as a weird medical compliment.. and you wonder why doctors are so messed up…

Here is the thing at my current academic home of 8 years.  Everyone knows my name. Not just JKP. But all the Deans, the head of my dept, the program directors.  I am never that kid they had on the service three years ago.  Its not because I am so great, its because I have been here forever and I am only the med studednt ever to go all four years here with a disability.  Generally I am well liked, well supported and safe. So safe, no one doubts rather I should be here, no one thinks twice about a doctor in a wheelchair or amplified stephscope in the peds cards clinic.

I have been scheduling interviews and dreaming of  moving on.  In my heart I know this is right. But today I realized its going to hurt. More than I realize. Because the outside is not safe.  Everyone does not know my name. Everyone does not respect me or my existence.  Out there there is no JKP or Dr. O or Dr. J to fight on my behalf or even cheer me on.

Outside I am still a questionable admission….outside I am chronically ill, pre-existing condition, idealist, non-conformist who came into medicine knowing who she was and had little interest in fitting into some medicine mold.

Am I ready for that? Am I ready to leave this safe harbor I have sailed in for 8 years?

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Why my life will never be reality TV worthy…

I have had a relapse of the more severe anemia. My concentration at work is lagging and I am tired all the time. Its way worse than the hip issues.  Sometimes though all this makes me laugh. Maybe I laugh so I won’t cry.

Yesterday I came home during my roommate’s bible study. It was 9:30 time for my little anemic self to get ready for bed. Getting dressed and undressed on hip precautions (no bending past 90 degrees) takes twice as long and is mind-numbingly frustrating at times. I went to remove my socks with my good foot and in the process I pulled the scab off a bug bite. I am on Asprin to prevent blood clots post-surgery so I bleed from small cuts like I have stepped on nails. So here I am sitting there with blood running down my ankle. My house is full of strangers who block my way between my room and the bathroom. I am wearing only underwear on the bottom and a loose shirt on the top. I can’t put my PJ pants on because I don’t want blood all over them and all over my legs. I can’t wipe the ankle clean because I can’t reach it on hip precautions.  Finally I grab a blanket pool cover up thing from St Croix, wrap it around my waist, hop over to my flip flops (so not easy on a new hip) so I don’t drag blood all the way to the bathroom. Then I try to run fast  (as if I can run at all ever much less right now) through the hallway in hopes no will notice me running in a tropical pool cover up and night shirt with blood gushing from my ankle.  They did and they sort of stared at me as if I had lost my mind.

I turn the bath water on and stand there with my sponge with the long handle (compliments of Mt Sinai Orthopedics) and wipe away the blood and clean the tiny, tiny, tiny sore on my ankle. All that drama for a mm break in the skin. I walk back to my room, pull on my pants and laugh as I got into bed.  Then before I could read two pages I fell into the deep, desperate sleep of anemia.

so long and thanks for all the fish…

8 years of academic work.

7 days a week. 24 hours a day for most of that eight years (minus college summers)…

Speaking of summer..4 summers of medical volunteer work in the developing world

10-12 academic honor societies and two or three service ones. And one for professionalism and humanism in medicine.

88 page honor thesis.

45 different papers reviewed for a medical publication…that I first authored…

7 medical mission trips.

countless hours. countless cups of chai tea. countless effort.

and do you know how  my esteemed alma mater of 8 years summarized  my work in my Deans’ letter (hugely important document that is sent to all residency programs)

She excels in academics all the while overcoming challenging physical limitations.

….all grown up.

Its been a while. I should probably write about my surgery and I will some time. It went well, recovering in Roanoke was fantastic. Now I am back in Wisnton and life is very well difficult.

DO you remember what you wanted to be when you were five? eight? fourteen? twenty?  I do. Teacher, writer, doctor, missionary (/doctor).  In academic international medicine I will get to be all four.  In six months I will have achieved the three out of the four and the fourth halfway on a shorterm basis. I”m a lucky (blessed) young woman.  Its not that I found my niche in the world, although I did.  Its not that i have some high and mighty calling or endless ambition. Nope that is not why I am lucky.

This weekend I am helping lead a retreat for young adults with disabilities and chronic illnesses. I just got the schedule. The theme of the weekend is WHEN I GROW UP.  We are asked as staff and campers to bring a COSTUME of what we want to be when we grow up for a special banquet.  There  is only one other disabled staff person who I have ever met working at this camp. She is very nice, smart and pretty. She lives in her parents’ basement and volunteers at the hospital where I learn medicine. So its the two of us plus 40-60 other 20 somethings/late teenagers with disabilities in a room dressed as our greatest ambition.   I am sure most everyone will bring something or make it at camp. I am sure nearly everyone will dress up for the big banquet.  I just have one question…one thing that makes me put my face in my hands and feel very alone and yet very lucky.  I won’t be wearing costume and honestly I might be the only one.

Today I went to my first physical therapist appt in Winston. It was a nightmare. They were unprepared, lost my transfer paperwork from Virginia, had not processed my insurance correctly. But what really got me was they did not understand how I could possibly have a full time job and be recovering from a hip replacement at 25.  They didn’t understand that I have to be in clinic at certain times.   It was odd to them I was not on medicaid and had complicated out of state insurance (because the blessed school’s policy will not cover birth defects). They looked at me like I had seven heads when I told them no I can’t be there at 10 in the morning or 1 in the afternoon I have a job.  and yes a disability.

You know for the last three weeks I lived like I am supposed to live according to my society. …in my parents’ basement.  I didn’t cook a single meal, my Mom did my laundry, my Mom picked up stuff I dropped so I would not have to struggle to not break hip precautions, my Mom or my friends drove me around for the first two weeks.  This is how most of my friends live (NOT ALL). Oddly enough we never had a single problem with my insurance, I got therapy for proper amt of time each week and everyone talked about how freaking inspirational I was.  Funny how well everyone plays around when you play the part they expect you to play.

Being the only one in a room full of disabled people ….its awkward.  I didn’t wake up one day and decide I am going to be the one disabled kid who moves out of their parents’ basement. I just grew up, went away to college, chose the career of my choice and lived my life.  I’m not a freak, I’m not a pioneer, I’m not anything particularly amazing. I am just a 25 yo almost doctor who happened to be born missing a few nucleotides.  My parents aren’t superheros, my doctors aren’t brilliant, we all just missed the memo about the whole disability checks, medicaid basement thing.

My life is difficult but it only compounded by a society that just can’t get over the fact that I became who i wanted to be when I grew up.  And not despite of my disability or because of my disability. But because that’s what I wanted and that’s what I worked for.

Today I heard the sound of a heart that was born backwards (transposition of the great vessels) but corrected almost normal state by human hands. Doctors’ hands.  Today I finally began to master heart murmurs and laughed with a little kindergarter and teased a young man with Downs’ Syndrome about his girl friend.  And I loved it.

so on Sunday I will put on my scrubs and my stethoscope and my white coat and my hospital ID badge with my name and date of graduation there in small block letters.  And no I don’t know what corny, inspirational thing I will tell these young adults this weekend other than this: I am so happy being a pediatrician, I don’t think I could ever do anything else.  And our social norms suck…ignore them.