Birthday dinner, ice cream and pus.. what a great day!

Today is my birthday and though I am far from home ( well not actually that far only 480 miles, but still) I had a pretty darn good B-day. My loving and considerate mother got in her car at 3am Sunday morning to drive up here to see me for my birthday. I drove her around the city and attempted to show her downtown without realizing it was the day of the Iron Man competition up here (which made the city chaos) so that was'nt happening. Instead we had a picnic in the local park, layed in the warm sun, looked for shapes in the clouds and talked for hours. Then I introduced my sheltered mother to Cold Stone ice cream, mmmmm deliciousness in a creamy, decadent, tummy acheingly, good cup from heaven! This morning she wished me Happy Birthday and sent me off to work.
Today I got to do my fist I & D (incision and drainage) on a wicked awesome abcess! I've been waiting 6 weeks to get something with a little gore to it and how coincidental it finally happen on my birthday! I did learn that when pressing on the abcess be sure to stand diagonal to the hole you've made otherwise you get sprayed with chunks of sebum and a beige colored stream of puss. I know I'm a freak show and I get a not-so-secret pleasure from really gross stuff like watching a mountain of red flesh with a flow of yellowy, cream colored ooze out from an incision I just made. And I understand that it's odd I get a giddy enjoyment from rupturing the pockets of fluid and squeezing the surrounding tissue so a shower of a chunky mixture of blood and exudate comes exploding out of the hole. I get it. But I look a it this way... If it were me I would rather have someone who was excited to see my infected mound and enjoyed relieving my suffering than someone who was grossed out and disgusted by what they were being forced to do because it is unfortunately thier job. So yes I'm a freak but you should be glad I am!
So after my exhilerating day at the office I came home to decide how I should spend my birthday evening all alone. I was all set to have a nice sushi dinner by myself when Travis the son of my landlord/roommate Rich invited me upstairs for dinner. It was a nice surprise to enjoy a bbq dinner on the patio on a warm summer evening with some much welcomed company. Now I'll settle in for an evening of red wine and movie time. So today turned out to be a very good birthday, considering I'm away from everyone I love.

Meeting the Elks

So today after work I headed over to Spokane to visit Blair, Sammy and the Elks for Taco Tuesday! After hearing Blair's description of life in the trailer park I had to go and experience it for myself. As I pulled into the lot Blair and her massive Mastiff Sammy came out to great me! I was given the grand tour of the their "Home Sweet Trailer" which was actually not a bad set up, it was much more spacious than I had imagined. We then headed into the lodge for those famous 1$ Tacos and a cold Budweiser. We were warmly greeted and Blair introduced me to all her new friends, who were happy to share their table and some stories. As we dined on our tasty tacos 4-5 older gentlemen strapped on guitars, electric, acoustic, and one with a harmonica and began to play and sing some old country songs I was completely unfamiliar with (except for a few Johnny Cash classics). It was really one of the most fun and entertaining meals I've had since I've been here. After dinner we bellied up to the bar where the fabulous bartender made us one of the stiffest White Russians I've ever had and Blair and I played a handful of "pull-tabs" which according to our friend Emily are all the rage in the Midwest. (they're kinda like scratch-it lottery games, but without the scratching). I had never heard of them, neither had Blair so of course we had to try our hand at it. Alas the "Ice queen" struck again and no big winners for us. Half way through my mostly vodka white russian I realized it was 7 o'clock on a Tuesday and I was drunk! Blair and I retired to her trailer where she made me some toast and we chatted for a few hours while I sobered up. As my evening with Blair and the Elks came to a close I can tell she's in good company and I am very happy she's well taken care of by some very friendly and kind hearted people. I'm super glad we have a least few weeks to hang out together before the next leg of our clinical journey begins. So raise a glass for the Elks of Spokane and cheers to cheap food, stiff drinks and good friends!

Best Weekend Yet!

It was sooo nice to have girl friends from school come visit this weekend. Em came over from Moses Lake Friday night and the moment she pulled up I was grinning ear to ear. After sitting next to her 5 days a week, 8 hours a day for an entire year, not to mention late night freak out phone calls before a test, cram quizzing the morning of the test and margaritas after it, sharing stories of frustration with school, boyfriends, husbands, roommates and parents, tears of sadness leaving for break, tears of shear joy from laughing so hard you nearly pee your pants, she's hands down one of my two closest friends from school. And I can hardly describe how good it was to spend some quality time with her.
We headed to downtown Coeur d'Alene and strolled up and down the main street, Sherman Ave, which was teaming with activity. With the Coeur d'Alene resort only blocks away the ave had your mix of middle aged tourists with fanny packs and "Coeur d'Alene" T-shirts, young sex-pot women and men dressed to the nines scoping each other out, teens out on summer break in their freshly washed/waxed cars cruising the strip cat calling as they roll by at 2mph.
We popped in and out of art galleries with wine tasting, eclectic little shops with a variety of huckleberry flavored everything, and boutiques with jewelry, clothing and crafts from local artist's. By the time we decided on dinner at "Scratch" I already had a buzz from all the free wine. We sat outside on the patio/sidewalk and enjoyed the warm evening air, the food was fantastic the wine was delicious the entertainment was... entertaining? We were "treated" with a performance by a street musician playing the guitar and singing across the street. Unfortunately he seemed to know only one melody and simply adapted every song to it. Imagine the creativity it takes to conform the lyrics of "Hey ya" by OutKast to the melody of "jumper" by Third Eye Blind... it's impossible yet he somehow found a way.
The next day we took a hike around Tubb's Hill a short mellow hike with a nice view and a cool breeze coming off the lake. Followed by a stroll down the boardwalk type area adjacent to Independence Point park. That evening we were joined by another awesome friend from PA school, one of the most genuinely nice people I've met in my entire lifetime. Blair, who's working in Spokane stopped in for dinner, some wine and a little shop talk. She's an amazing girl, I don't know how she deals with some of the situations she's been confronted with and what's even more inspiring... she does it with a smile (although I've learned she can definitely be a hard ass when she needs to!!)
Today Em and I went on another hike near Wolf Lodge Bay the "Mineral Ridge" trail which was more wooded but the view from the top was impressive. It gives a pretty good perspective of just how big Lake Coeur d'Alene really is. We stopped at Crickets bar/restaurant in downtown on our way home for some lunch. We should have split something cause the portions where HUGE and the drinks were tasty!
Finally the time came to say goodbye for Em has a long drive ahead of her. Saying goodbye to her this time around wasn't as bad because I know I'll be seeing her again in a few weeks for Professional Practice Seminar (PPS week) in August. It was just so nice to have someone to talk to who really and truly understands what your going through and share your new experiences with. That's really the best thing about school, all the wonderful friends I've made. So THANK YOU Em! THANK YOU Blair! I had the BEST weekend yet and it's all because of you!

YES.... I am a student

NO.. I don't know EVERYTHING yet, that's why I'm doing rotations, and how do you expect any Doctor, PA, NP, RN ect... to learn anything if everyone is to good to be seen by a student! Don't get me wrong I totally understand when people are dealing with something uncomfortable and would prefer to have their regular physician see them or do probing exams, believe me I UNDERSTAND! But when I can see and hear the disdain they have for me as a student it bothers me. Why on earth would you snear at someone who's sitting in front of you with empathy and desire to help in anyway they can??

Me: Ok, no problem I'll go and get my preceptor to do the exam/history, would you mind if I sat in and learned during the exam
Patient: Well if he's the one doing the exam and making the decisions I don't see why you need to be here.

Really? Seriously?, did you not hear me say TO LEARN? do you not understand what a students job is?? Luckily this is an extreme minority of the patients, in fact out of the 4 weeks I've been here there have only been 1-2/wk that prefer I either not do the exam or step out for part of it, which I don't mind at all.

The Air-mattress Debacle

So after my fabulous long Memorial day weekend at home I returned Monday evening to find my air-mattress half deflated which is kinda odd since I haven't had to re-inflate it since I got here 2 weeks ago. Regardless I chalked it up to being cold down here in the basement ect... so I filled it up and began unpacking, chatted with Ryan on Skype looked over and realized roughly three hours later the air-mattress was again deflated. WTF! So I strip my bed, inflate it again but this time I go hunting for a leak. I eventually find a small roughly 1 cm rip on a seem, I figure it's 11pm not much I can do about it I'll just fill it up and go to sleep. So during the night every 2hours I would wake up in a different position the first time I awoke at 2am and was falling off the head of the bead because I was sleeping to close to the top, I shifted and fell asleep only to wake up at 3ish to find my legs had somehow migrated to the left and I was diagonal across the bed and I was being suffocated by the sides of the bed like a sandwich. Finally at 6am I awoke due to pain in my hip as I was now firmly resting on the floor. My 2ft high Air-mattress was almost completely flat... Awesome. So the next day I go to the store find myself a vinyl patch (seeing as how my cheap-O one didn't come with a patch) Patch up the mattress and attempt to sleep on it the next night. This goes fairly well the patch mostly holds, it's only half deflated in the morning I figure I'll do the water test on the weekend when I have an entire day to deal with the sucker. I've been sleeping on it through the week and it's not bad. This morning I wake up at my normal time 6am out of conditioning but decide I'd like to sleep in a bit so I get out of bed to fill up the mattress so I can sleep a little longer. About 20 seconds in I hear a loud noise and see part of the covers jump and there goes the bed... rapidly deflating. I pull back the covers to discover the small hole along the seem just completely blew out. All I can say is at least it happened on a Saturday.

Patients are interesting..

even the ones that just have a lame cough and runny nose you've already seen a hundred times. It's amazing what you can learn from people if only we had the time to listen. As a student I get extra time with patients cause I'm still a little slow. I ask a lot more questions and do a much more though job than other practitioner's which is good and bad at the same time for everyone involved. Good for me cause I need to practice honing my skills at decision making, which answers to follow up on which one's are a rabbit trail and the stuff that is just random bits of information that I don't even know why their mentioning it to me. It's those random bits that sometimes are the most interesting and occasionally yield a pearl. I'm liking Family practice in part because now that I've been here 3weeks I'm starting to see some of the regular patients for a second time and getting to know these people is a wonderful part of the experience. Some of the elderly patients are a bit feisty but I'm amazed at the good humor most of them share with you. There are a few people my supervising PA has mentioned "I remember when that one was only a week old... now look at 'em all grown up and having one of their own" I think one of the greatest assets health care can have is investing in Family Physician's. Some one who knows you, is invested in making sure your treated with the care that everyone deserves... (even if they are a pain in the tookus) Keeping people healthy should be the goal not waiting until their sick and then spending a ton of money to just manage what could have been prevented or pull them back from the grave. I'll probably end up saying this about every rotation but I'm thinkin' Family Med looks like it's pretty rewarding... might this be it for me?

Where I live in Coeur d'Alene