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Wednesday, March 31, 2010

"So you're an EKG technician?"

She says, peering at my work ID as I hand over a few dollars for the bottle of Guinness I've set on the gas station counter.
"Do you just do EKGs, or do you read EKGs?"
"Well..the-"
"Do you know what PVCs are?"
"Premature ventricular contractions -- or sometimes people say complexes. They're early beats originating from ventricles, the bottom chambers of your heart"
"Are they really bad? I went to the emergency department and they said I had PVCs," says the clerk.
"Usually they're not a very big deal unless you're having a ton of them. It's not uncommon for healthy people to have a few.."
"Hang on a sec.."

She then proceeds to pull out her cell phone and show me a picture that she took of her EKG. I'm amazed that she actually took a picture of a chunk of her EKG. I have no idea how she would have been able to do that.
"Yup. That's a PVC," I confirm.

"They told me that I might have already had a heart attack and that I'll need to have an echo and see a cardiologist."
I look at the EKG again. Only a few leads are visible, but my eyes settle on Q-waves.
"Sometimes people can have 'silent heart attacks' without even knowing it. You'll probably need to have more testing to figure out what's going on."

She toys with her cell phone for a few seconds, and shows it to me again. This time she brings up a video clip of her heart monitor in the ED. It shows ventricular bigeminy.

She tells me that her family has a cardiac history, that she's overweight (obese), that she's only in her thirties, and that she's scared. We talk for a few more minutes, about different kinds of cardiac testing, her cardiologist, and that she's working to change her lifestyle.

This entire situation was bizarre for me. I've never had a stranger stop and question me like this. Is this what happens to doctors?

And what about the whole cell phone thing? I don't know about you, but it makes me sort of uneasy. I am all for keeping patients informed, but it seems like there's a high likelihood of the patient misunderstanding these data. And from a medicolegal standpoint, it seems sketchy.

Monday, March 29, 2010

Getting to know people...

I just read Old MD Girl's post on how, as a post-bac student independently taking pre-med requirements, she managed to obtain some research experience.

It seems like the same advice continues to ring true across disciplines: get to know people.

Easier said than done. At least for me.

You would think that after years of performing for big and small audiences, that I would have escaped some level of social awkwardness. And in comparison to me before college, and me after college, I probably have. It's still a constant effort to be outgoing, though. I find this less of an issue with patients, and more of an issue with the physicians I work with. I constantly feel as if every time I interact with a physician, I am wasting his or her time. As a result, I'm incredibly meek. I typically avoid any form of interaction in person or on the phone, unless it's really necessary. My favorite methods of interaction are e-mail, arch (text) paging, and leaving notes. If we actually speak about anything, especially on a personal level, especially academic plans, it's like I'm on a date with someone completely out of my league. I start sweating (and regretting that I wore my minimally effective all-natural hippie deodorant). My face feels like it's on fire, I get all shaky, and start blundering my sentences. I don't think I've ever been so nervous in any other kind of situation.

When I become a physician, I intend to be nice to people who cannot control their odd physiological reactions around me, and to break the ice instead of reinforcing their awkwardness by acting like they are awkward AND wasting my time. Then again, I could be over analyzing all of this..

So now I have to come up with a plan. I have to figure out how I'll be social and get to know people who I will be tempted to be mute around. Here is my proposed plan:

I will pretend to be someone else.

I did this when I was employed for the summer season at Cincinnati Opera. It was my first contract to sing professionally. I moved to Cincinnati for the summer, and I knew no one. I pretended I was outgoing, confident, and sexy E. Greene. I always wore make up, and my hair always looked nice. Dresses and heels became a staple. I got to know people, sometimes too well and too quickly! And since I was surrounded by people that didn't know me, how were they to suspect that I had previously had a different personality?

And although this outgoing version of me wasn't how I normally acted, it wasn't a total facade. I think when I got back to Oberlin, I think I was some combination of pre-and post-Cincinnati E. Greene. But the change, this rapid evolution of myself, was evident.

So, maybe it's time to evolve a little again. This should be easy to do, since at my next educational institute of choice, I will know absolutely no one! I'll pretend to be someone more outgoing, to be a little more openly geeky and hardworking, and to talk to professors and physicians without worrying about passing out.

Sunday, March 28, 2010

Follow the path of least pain?

I've decided that I'm going to try to curtail my desire for hermitage and actually attempt to post regularly in this blog. As a result, there will probably be fewer stories and more thoughts.

I recently submitted a long-winded and probably overly personal question to www.mothersinmedicine.com, about how to go about taking my pre-med courses. I needed some outside opinions; I had over analyzed my situation to the point of going batshit. I got some great responses, and I think maybe more importantly, some reassurance. I think my mantra may be something along the lines of "follow the path of least pain." This is wimpy, but I'm all for attainable goals with the benefit of ultimately enduring.

It seems like since I've had a baby, I've made so many changes. After a perfect and uncomplicated pregnancy, it still seemed like I was giving up everything: school, sleep, breasts, being able to listen to NPR without regularly crying, and at least one arm (I became adept at doing everything with one hand: typing, buttering toast, chopping vegetables, pulling down my pants to use the toilet). I was socially and geographically isolated from all my friends (who had waited to have children, which made me paranoid that things were awkward), but I was never actually alone, due to baby at my side. It became a strange and unusual pleasure to take a shower alone, blow dry my hair, cook a meal with two hands, or go for a run.

My priorities have shifted. I remember initially being so uptight about schools, about names and reputations, unwilling to even consider state schools. When I took a statistics course through SUNY Upstate for $181 a credit, it was this bizarre and empowering revelation. Now that I have to deal with bankrupting my husband in addition to myself, it makes me think twice. Or thrice. Or really, about a hundred times.

I think I'm going to try to take Chemistry I and II over the summer at Binghamton University (state school), and go from there. We'll see how well I can coordinate that with working overnights. It will be a commute -- this is like an hour and a half away from me, but I think it will be okay.

I'll have to think of some way to effectively use all my time stuck in the car. Maybe I can record lectures or something. I used to practice singing in the car, until the day a turkey flew out of NOWHERE into my car and destroyed my windshield. It's possible I may have been distracted, but really, I'm convinced the bird was on a suicide mission.