The longest suspended pedestrian skybridge in North America
by fiona
"The 660-foot-long enclosed skybridge, which allows direct transportation of patients and supplies between OHSU and VAMC, is the longest suspended pedestrian skybridge in North America."
I walk across the skybridge several times a day. This trek is often the only sunlight exposure that I get during the course of the day. With a daily routine that involves getting to the hospital before 7 and leaving after 6 (on early nights), I spend a depressing amount of time basking in the forlorn glow of flourescent lights. I am well on my way down the exciting path that is vitamin D deficiency. But this does mean that every glimpse of the outside world is something to relish, to savor in silence. To absorb through every pore. And walking across the skybridge - which not only transports patients and supplies, but has one of the most amazing views of downtown portland and the Willammette valley - allows for a few brief moments of calm. It takes like 5 minutes to walk across. Well, maybe more like 2 - but its a long walk. And usually its filled with people, a little bustling medical highway. I almost always see someone I know on the skybridge.
The other night I walked across at 3 in the morning. I was the only person on the bridge. My footsteps were echoing in the 660 feet of silence. The portland skyline was glowing around me. I paused to try to see the river, look down at the trees, and have the obligatory "I wonder what would happened if this bridge collapsed right now" thought. I had this odd sense of connectedness to my future self - I will always be able to look back and remember this exact moment, I thought.
My next thought was of closing my eyes, and how nice that would feel. I was on my way to the pediatrics resident lounge again, where I was hoping for a couple hours of sleep. I found my way there, expecting my previous comfortable and suprisingly refreshing window seat experience.... only to find that some dude was lying there! In my spot! In the window seat! How he could be so bold, I will never understand. My next realization was that the pillows and sheets that were there 5 days ago had disappeared, leaving me with only my velour sweatshirt to keep me warm. Left without any other conceivable option, I laid down on a different window seat, wrapped my sweatshirt around me, and had another uncomfortable realization:
The lights in this room are on a timer. And they are motion-sensitive. I pulled the sweatshirt over my eyes, and proceded to have a rather chilly sleep that was punctuated by the lights turning on every time I moved. Every. single. time. I really commend the makers of that motion-detection system. I applaud you. Your lights are excrutiatingly sensitive.
I realized that it was that moment - the lying on a cold well-lit window seat trying to get 2 hours of sleep moment - that my future self will look back on. Non the i-am-one-with-the-night-sky experience of a few minutes prior.
Or also perhaps the moment when I realized that I had stayed up late the night before, researching things like Guillan-Bare syndrome and chronic inflammatory demyelinating polyradiculopathy because I thought my patient was immunocompromised, only to find out the next morning that she wasn't. Sweet.
( I'm listening to a 80's rock mix that I made for my brother a couple years ago. I still maintain, no matter what they may say, that Bon Jovi's "I'll Be There For You" is one of the best songs ever written. And I don't care who knows it.)
Posted on February 26, 2006 | Comments (7)
Rocky Balboa vs. Clubber Lang
by fiona
My new life is a strange one. It consists of frantically bustling around the hospital for 6 days a week, and then having one day where everything stops and i am left spinning, exhausted, not being able to think of what to do. What do normal people do when they have a day off? What did I used to do when I had a day off? Is there something I should be reading?
Today is my day off. Today is also President's Day. Is it a day for all presidents? Are we celebrating Bill Clinton and William Taft and that one guy with the giant mutton chops today? Or just Washington? Perhaps we only celebrate the presidents we like. I have never paid much attention to this holiday.
But today it has my attention because I got to not go to the hospital, for the first time in 7 days. Today i awoke in my nice bed, with The Admiral curled next to me, and I had the beautious wonderful luxury of looking at the clock and going back to sleep.
Yesterday morning I awoke on a cushioned window seat in the pediatric resident's lounge in Dornbecher hospital. It was 6:45. I had overslept. I was sleeping on a window seat in a lounge because there is no call room for medical students. There are no beds for us on this rotation. For that reason, we have been instructed by the clerkship director to go home at 10 pm. But that never happens. There is too much work to do. On my first night on call (my fist night of this rotation) i did go home. I left the hospital at 3:15 in the morning, slept for one hour, and then came back by 6:30. Riding my scooter through the freezing darkness that night, tears of exhaustion drying on my face, I decided that I would from then on scavenge for a place to sleep in the hospital instead of going home.
These experiences make me very grateful for little things, like not waking up to an alarm, like being outside when it is light out, like putting on jeans, like going for a walk in the woods, like watching Rocky III with my friend laresa late last night, and not worrying about having to get up the next day.
Rocky III, for those that are wondering, is not nearly as good as Rocky I or Rocky II. It is the first downward step in the precipitous decline that is the Rocky series. But you do get to see Sylvester Stallone and Mr. T punch eachother in the face, which is always a rewarding experience.
Rocky VI began filming in December. Does this make sense to anyone? Rocky VI?
Posted on February 20, 2006 | Comments (11)
The History and Physical
by fiona
Every so often, doctors like to pull medical students into patient rooms and force them to demonstrate their clinical skills in action. The love this. They relish it. Their favorite thing of all is to base your final grade on your performance in this contrived student-patient interaction that is known affectionately as The History and Physical. Or "H and P" for short.
Yesterday i had my observed H and P. My attending, who evaluates me but does not work with me on a daily basis, met me outside of the room of a patient who i had never met before and knew nothing about. She then observed me as I took a full medical history from this poor unsuspecting patient and then submitted them to a complete physical exam. I then gave a 10 minute presentation on the patient I had just seen, including the relevant portions of the history and exam, complete with my assessment of their various medical problems and my plans for addressing them.
This, needless to say, was a little bit nerve-wracking.
It did go pretty well, though, and by now I'm used to these sort of interactions with patients so it wasn't all that stressful once it got rolling. My attending had a lot of positive feedback, which was nice. But she also, as expected, had some constructive criticism, which i will share with you now.
1. "When you go in to talk with a patient, turn their TV off." I was well into my exam when i realized that throughout my entire interaction with this patient she had been watching the soap opera Passions on mute. I thought she was just concentrating on my astute questions.
2. "Always examine from the patient's right side." If you are right-handed, this allows for the best maneuverability. Good to know.
3. "Streamline your exam technique." I honestly took the patient's socks off three times during my exam. Three different times! I'm going to look at your feet now... oooh now I think I will check sensation... wait, maybe i should just check a Babinski reflex real quick, sorry... It was pretty bad.
4. "When you are asking a patient with emphysema to take lots of deep breaths, maybe you could stop and make sure they are breathing ok." Hmmm. Good point.
There were also tons of obvious questions I forgot to ask, and tons of little things that I forgot to do. Moral is, when people are watching you, and especially if the people who are watching you are also grading you, you will inevitably do dumb things. It is statistically impossible for something to not go wrong in such a situation.
Tomorrow is the last day of this 5-week internal medicine rotation. I have my final evaluation session with my attending at 9:15. And then i just hold my breath until the next 5-week internal medicine rotation starts. I would be lying if I said this wasn't getting a little old.
Posted on February 2, 2006 | Comments (6)