Saturday, July 31, 2010

The Gall!

First of all, please write a comment to my last post here. Post as anonymous if you so choose.
Now, to the meat of this post. Yesterday (Friday), a girl in my class sent me a Facebook message. This is what it read:


I am going to make the appointment to have my car repainted on Tuesday morning and was wondering if you could pay me this weekend. The total will be $396, including tax. You can put the check under my door (apartment XXX)


My reply:
Hi G,

I would like to clarify a couple things:

First, while I empathize with your situation, I do not feel it is fair for me to pay for the scratches on your car. I was not in my car, my car was not in your space, and you could have asked me to move prior to you incurring the scratches if you had any doubts about getting into your own spot. Furthermore, both my car and the pillar were stationary; thus, it was the driver’s responsibility to avoid them and I am not at fault.

Second, I'm not sure why you are asking me to pay for damages when I didn't incur them on your car. I had always been within the lines of my spot. It's true that on occasion the car to my left was slightly over the line into my spot, causing me to park closer to my right line (but still within my lines). If you had any doubts about getting into your own spot safely, you could have talked to me and asked me to preemptively move my car, which I would've gladly complied. In this way, this current situation would never have happened.

I hope you can understand my perspective on this issue.

Seriously?! A message like that via Facebook?! The gall! That's not classy at all. The supposed incident as described above happened about 2 weeks ago. Last week she confronted me in the parking garage under our apartment complex about this. She thought it was fair for me to pay for 75-100% of the cost of the scratches that she made on her car. I wasn't going to negotiate right there and then because her step-mom was also present next to her.

Now, I've consulted numerous friends and all of them, without fail, have told me that I shouldn't pay. Even one of my friend's dad, a lawyer, tells me that I should only pay 10-15% at most to keep the peace if I felt compelled to pay something. But after that Facebook message - and what read to me as a sense of entitlement to the payment - I won't give over even a cent.

The aftermath of all this has been pretty calm. She hasn't responded to my reply and she hasn't otherwise confronted me yet. Hopefully she sees my point and how ridiculous it is for her to ask for payment concerning something I didn't do. And I hope she leaves me alone. But I'm bracing myself for the imminent hatred that'll now radiate from her towards me. Whatever.
Lastly, please post a comment to my last post here!! Thanks! :-)

Friday, July 30, 2010

I Need Your Help

Hi all, a quick question for all of ya.

Prompt: Medical interviewer from hell

Could you please tell me about a few bad experiences you've had with health care workers (e.g. nurses, doctors, etc)? Is there anything you wished that health care workers would do/address?

Please leave your answers as a comment to this post (or you may email me). Your answer need not be very personal/specific. Anonymous comments are encouraged.


P.S. I'm gathering bad experiences from people to give to a dinner speaker of an event I'm organizing. Hopefully, this will help med students become better and more empathic when interacting with any and all patients.

Tuesday, July 27, 2010

Popping In

Hey all,

Just popping in here for a bit. It's been a busy few days. Last week was one of the most frustrating weeks I've had in a long time. The corner of my left eye still intermittently twitches uncontrollably from time to time, even now. I won't go into all my frustrations, for there are many. And the moment's passed anyhow.

But, this week has been better thus far. I won't say much more than that right now. One thing I've learned is that I should never proclaim good things, because I jinx myself and things don't turn out as wonderful as I predict, lol.

Also, Inception, amazing movie. Go see it!! I couldn't stop thinking about it after seeing it on Sunday, and that might be why I didn't sleep too well that night, lol.

Alright, last week of peds rheum. And I have to give a 10-minute presentation on something on Thursday. That PowerPoint is almost done . . .

Sunday, July 18, 2010

Learning to Smile

When I was little, I was told that I had a goofy smile, that it looked a bit weird, and that I showed my teeth in an odd way. I was told to smile better but I didn't know how. So for years I avoided smiling on demand when asked - the only smiles I had were those spontaneous one that you couldn't control, the ones that weren't taken in photos. For years I refused to show my teeth. I had to learn to smile, learn to be comfortable with it. I feel like I've finally reached a point where I could be comfortable smiling.

And because it took me so long to learn how to smile, I also had to learn how to hug. I avoided contact and gave people their space. It was weird and awkward for someone to invade my personal space or for me to invade theirs, wanted or unwanted. Even now, hugs feel strange though I crave the feeling. Even now, touching another person is somewhat awkward. But I'm learning how to hug and I think I'll get it soon.

And because I'm still in the process of becoming comfortable hugging, I have yet to learn how to dance and be comfortable within myself. And so dancing is incredibly awkward for me. It makes my heart race, it makes me sweat, it makes me nervous - for who would be the one to notice and laugh and send me back to square one? It may be a while yet before I learn how to dance.

And because I have yet to learn how to dance - to feel comfortable with my own limbs - it may be too early for me to be involved in a relationship. To first feel comfortable enough to smile, then comfortable enough to allow contact, then comfortable enough with one's limbs, and finally comfortable enough to be vulnerable to another - this is a long road that I started way too late. What have I been doing all those teen years?
Last Friday I went to a wedding, one of my labmate's from anatomy lab. Two other labmates went with me, and they each brought their significant others. I was alone because the final labmate bailed on me.

He looked so happy getting married. He's usually someone who's calm and level, who doesn't let his emotions shine through. He had a great poker face. But there were no poker faces that night, and his smile was the brightest in the room. He was marrying his best friend whom he had known since they were both 4-years-old. And during the reception, as he gave a toast, he almost let himself cry - his shell broken for a brief moment. And it was endearing.

And throughout the entire day, we all had to smile, and hug, and dance. While I was okay with the first two, dancing was rather rough the couple of times I was dragged on the dance floor. It was a lovely wedding and I am truly happy for the both of them.

The last few weddings have left me with mixed emotions. Happiness for the bride and groom, sadness for myself. Optimistic that there are such things as happy endings, pessimistic that I'd be so blessed to enjoy one.

I have a ways to go. To learn how to dance, to love, and to be vulnerable. To find my best friend with whom I'd gladly spend eternity. The question is a trial of time. This is one future that I can't even predict. How many long years will it be before I reach the edge of where so many already are?

Though I think that at the end of the road, I'll come full circle and learn to be a little kid again - to smile, to hug, to dance, and to love as they do. Because they are uninhibited. Perhaps society makes us unlearn that which is innate, and it's only through struggle that we re-learn that which we've forgotten . . .

Wednesday, July 14, 2010

The Rheumatological Posse

So, I meant to write this a while ago. Alas, that didn't happen since I've been unusually busy and things have been rather hectic. My peds externship is already more than half over! Wow how time has flown.

I'm on my pediatric rheumatology (peds rheum) placement for the remainder of this month. And while I don't think I'll go into peds rheum, it's pretty interesting. All the people I've been working with the last week and a half have been great as well.

Last Tuesday I met with Dr. N, the attending who's responsible for me, and two of the fellows, Dr. K (1st-year fellow) and Dr. C (2nd-year fellow). Peds rheum is a 3-year fellowship that one does after a 3-year pediatrics residency. I must say, Dr. C was adorable! He's this cute little Asian dude who has an adorable smile and voice. Yes, I may have a tiny crush on him. Alas, he kept pimping me last week.

What is pimping you might ask? Well, pimping is where a senior medical person asks a series of questions on medical facts to a younger medical person to test the limits of their knowledge. Often it's done in a way to embarrass the younger person and "put them in their place." Earlier, Dr. N and Dr. C had discussed an article that came out called The Art of Pimping. In there is a section on how to defend oneself from being pimped; I particularly like The Muffin, lol. Anyway, Dr. C pimped me on shingles, which I hadn't formally learned about but because I know a little bit about it in the past, I got all but one of his questions correct. Later in the week he pimped me on how aspirin works in the body. I blanked and couldn't remember, but I finally gave the correct biochemical pathway (whew!) after he kept pressing me for an answer. If only he weren't so nice otherwise and adorable . . .

Anyway, my peds rheum placement is quite amusing. There are so many of us on this month! There's me (representing M1 and M2), a M3 who's in clinic once a week, a M4, 2 interns (1st-year residents or PGY1s), 1 second-year resident (PGY2), 1 first-year fellow (Dr. K), 1 second-year fellow (Dr. C), and 1 third-year fellow (Dr. S) in addition to the 5 attendings. I spent a lot of time with the M4 and she's been great in explaining things to me and how rotations work during M3 and M4 years. The residents and fellows were all great to get along with as well.

So my time in peds rheum is devoted between 2 primary things: clinic, and inpatient wards. Of those 2, the majority of my time is spent in clinic. On the first day I had no idea what peds rheum was all about, except childhood arthritis. By the end of the week, through clinic, I learned that peds rheum covers a lot of diseases, such as: juvenile idiopathic arthritic (JIA), psoriatic arthritis, spondyloarthropathies, Raynaud's phenomenon, and lupus amongst many others. By the end of the week, I had seen at least one kid with each of those. Since there are lot of us, often 2-3 of us would go in with a fellow or attending to see the patient. I'm sure many (if not most) of those kids felt overwhelmed when 3-4 people walk into a room together.

Inpatient wards generally aren't busy because peds rheum don't get many consults. Last week we only had one kid that we were consulted on. I'm going to call this kid "Kid of the Week" or KotW. So we, the 8-person rheum posse, see this kid on Tuesday. He presents with some minor neurological symptoms, and we don't really suspect anything rheumatological going on with him. So we leave a note suggesting it might be CNS vasculitis or something and leave it at that. The thing was that the areas of his brain that're affected made it practically impossible to confirm CNS vasculitis without destroying brain matter along the way to finding out.

By the following morning, the kid had several mini-strokes and his neurological symptoms had worsened, so they sent him down to the PICU (pedatric ICU). When we arrived we encountered a very irritated critical care attending. Shortly after we arrived, the neuro consult team arrived. The critical care and the neuro attendings started arguing in the hallway about how to care for this kid who's rapidly deteriorating in front of us. After the critical care guy calmed down a bit, we talked to the neuro team and see if they also agreed that it was CNS vasculitis. Neuro sent KotW down for an angiography of the brain while we started his treatment, even though we didn't have a definitive diagnosis (but to not treat him was less risky than the possibility of him worsening, so we decided to treat what was most likely the problem).

The following day, the results of the angiography seem to "confirm" our diagnosis. Of course, the fellows and the attending on service were skeptical because CNS vasculitis is very difficult to "prove," and it technically couldn't be proven in this case since it was so atypical (apparently). Also, none of us could interpret the films, so the rheum posse trekked down to radiology so we could find someone to interpret it for us. I do not want to be a radiologist. The room they were in looked and felt kind of like a bat cave. It was very dim so that the radiologists could see their computer screens more clearly. The only other source of light were desk lamps pointed away from the screens, which gave an odd ambient glow. Also, the radiologists were talking in low voices into their microphones to dictate their findings and notes; it kind of sounded like a low constant drone or perhaps chanting . . . as if they were all in a cult or something.

Well anyway, it seemed that the radiologists couldn't help us, so they directed us to interventional radiological neurology (I didn't even know one could specialize that much). So, someone there explained the films to us, and we mostly nodded in agreement because we had no clue what we were looking at (I'm sure even the attending with us had no clue - all those tiny tiny blood vessels just look like squiggly messes to me). So long story short, we think our diagnosis is correct and that KotW was getting better. They decided to keep him over the weekend to monitor him and see how he did.

Monday, July 5, 2010

5-Day Weekend

I'm now done with primary care pediatrics in the inner city, and I'll be starting pediatric rheumatology tomorrow. No idea what it's going to be like, so this'll be interesting to say the least.

Because the primary care pediatrician I've been with the last 2 weeks only works Mondays, Tuesdays, and Wednesdays (albeit, from 8am to 8pm), I got Thursday and Friday off. I also got today - Monday, July 5th - off as well. So all this translated to a 5-day weekend for the 4th of July. :-D

I've been taking it easy the last few days - hanging out, cleaning a little bit, and working out a little. I don't remember if I talked about this, but apparently I lost about 6lbs during my 2 weeks in pediatric infectious disease, and then gained 3lbs in primary care pediatrics, and now lost those 3lbs again (until I gorged myself during lunch today, alas). Curious. Since I'll be in the hospital for 4 weeks, I'll probably lose more weight (here's hoping?).

Anyway, on Saturday, I saw the new The Karate Kid movie with a friend. I actually thought it was a pretty good movie - I thought that the acting was great and the music was good; Jackie Chan did a really good job. It would've made more sense and been more aptly titled The Kung Fu Kid, but I read somewhere they changed it to The Karate Kid later on. According to my friend, they apparently call it The Kung Fu Kid in China, or something like that. And today, I watched the original The Karate Kid with some friends, just for comparison because it's been years since I last saw the original, and didn't remember it well. Honestly, I thought that the new remake wasn't bad and didn't do a disservice to the original - other than karate having absolutely no role in the remake. Ah well. It's still a movie I think that's worth watching.

Later on Saturday, I went to a outdoor live music festival by the lake with a friend to watch the city fire off fireworks. I've rarely been close to seeing fireworks, so it was really nice to see them go off by/on the lake. :-) The local fireworks were today, so a few of us got a good view of them. However, there were also LOTS of mosquitoes out, so we were all pretty much doing our mosquito-be-gone dance. I really like fireworks.

Yesterday, I watched Infernal Affairs and The Departed with a friend at his apartment. The Departed is an American remake of the Chinese Infernal Affairs. There were certain scenes, plot elements, and even lines that were almost verbatim translations. That was amusing. I personally liked Infernal Affairs better because the exposition at the beginning is shorter, the good guy/bad guy distinction is a bit more nebulous at first (adding to the mystery), and the two main characters were easier to sympathize with. Also, in seemingly classic Asian style, the movie was a bit more psychological and there was more display of high-tech/using wit scenes (if that makes sense at all). The movie had English subtitles, and it took me a little while to get used to them while hearing Chinese. I translate Chinese differently in my head, so the English subs messed with my head a little for a few minutes, haha.

Lastly, Jake (my best friend from undergrad), is now in Beijing. I meant to call him before he left, because I needed his counsel. Alas, I missed my window of opportunity. However, he told me that about a week ago he proposed to his girlfriend and now they're engaged!! Their wedding is about 1 year from this Saturday. I'm so happy for them!! And I'm soooo not missing their wedding, even if it means a lower grade on a rotation (though, I "shouldn't" be on service over a weekend . . . maybe on call? I really need to somehow figure all that out . . .).

Thursday, July 1, 2010

I'm Tired . . .

. . . of pushing my APAMSA co-president along. He's pretty lazy and only gets things done when I demand them to be. It's been a while since I last checked up on him, I wonder if he completed the goals we set out for ourselves back in early June.

. . . of pushing my LGBTPM secretary along. He's very hesitant about taking responsibility. He keeps trying to get away with doing less. That's not acceptable because he barely does anything to being with compared to the rest of us.

. . . of reassuring my LGBTPM community chair that we're okay, that even if we've over-extended ourselves, we'll still be fine. She's constantly worried that we're too busy with our ambitions for the groups, but she's only chiefly responsible for 2-3 events.

. . . of making sure my LGBTPM treasurer doesn't explode on me and quit. Apparently, she hates that I send out emails so frequently (not once a day, like she claims). She's a pretty high-strung person, and I always tread carefully around her. She's been really stressed lately, but she has the advantage that most of her events are in the Spring semester - so she has more of a time-buffer than some of us.

. . . of being guilted into doing more work by my FMSA Patient Education co-chair. She is way overburdened this summer with many things, but she hasn't held up her end entirely. She feels that she's doing disproportionately more work than me for this program. In our last email volley summing up our latest meeting together, this appears true on the surface. But, it's her own fault. She keeps adding things to her to-do list that we hadn't originally agreed to deal with; and I keep asking her to tone it down - to deal with our top priorities first and leave her "extras" alone. Does she listen? Not really.

. . . of being responsible for my brothers. I was engaged in a long phone call with my mom last night. My brother in Hong Kong is miserable.

It's hot, humid, and rainy there; he's working 6 days a week, from early morning (I'm guessing 8am or 9am) until 7pm or so; he doesn't know what he's doing at work because he's the only person working on the programming assigned to him; he has no friends there; our relatives eat a lot of veggies and little meat, no juice, and no milk (cuz those things are expensive); and he's clearly homesick. Sending him to Hong Kong for 3 months was a HUGE mistake. And I told my mom this. He's been there for 2 months already. Had our parents sent me or my other brother, we would've been okay - we would've adapted and toughed it out. But my youngest brother, he wasn't ready for this. So my mom begged me to call him in Hong Kong to lift his spirits, to make sure he's eating right, to make sure he drinks enough water, to make sure he survives. So my mom tells me that I'm the only one he really listens to and that only I can help him now.

Knowing my brother, knowing that he'd rather starve himself than eat things he dislikes, knowing that he's miserable, it was a call I was fully prepared to make. Thank God my prayers were answered and he got on an early flight back to the US some time either today or tomorrow. He'll spend a few days/weeks in California with our relatives there - and I know he likes it there almost as much as I do (even if he doesn't show it).
This wasn't the summer I intended to have. I'm tired of being responsible for others when there's no one giving me the kind of support I need.

Every day while driving back from work, I wish there were someone waiting for me when I returned, or someone's door I could just show up on to hang out. Instead I return to an empty apartment. Instead I return to loneliness.

The long days at work I actually enjoy. At least while I'm working my mind's preoccupied. But how I envy all the people working there who have people to return to at the end of the day. And just like that, I've let myself become my work to distract me from my loneliness. And just like that I keep myself busy to hide the fact that there's no one here for me. And just like that I hate myself a little more.

I can't deal with this right now. I'm not sure I can even deal with this in the morning. I think it's time for an "emergency" call to my best friend before he leaves for Beijing for the rest of the summer on July 4th (what a terrible day to leave the country).