Monday, November 29, 2010

Grace in small things #1

1. Chicago in February!
2. Christmas is coming! let the festivities begin
3. My best friend is coming to visit this weekend
4. Cups of tea on a cold wet day
5. My fabulous new cook book, Stephanie Alexander's Kitchen Garden Companion

Friday, November 19, 2010

New day

It's raining outside but it's going to be a great day. I'm so grateful for such a satisfying job... even though there's a lot of paperwork and a fair amount of hassle getting things done... and an absolutely INORDINATE amount of faxing! Who knew?!

I was sick yesterday and spent the afternoon on the couch, alternately sleeping and eating chicken soup, and watching Grey's Anatomy. Sick is so much better with good soup and bad TV. But today I am great!

It's going to be a good day.

Wednesday, November 17, 2010

Cohabitant

We moved in! Amid 31 degree heat, lots of dust, sore backs... and now here we are living together in our beautiful little cubby house in the sky! So far, so good. I know my lover was nervous, and to be honest I was too. It really is a big step! I think we were ready to make it though.

Anyway yesterday was a wonderful day. I'm working in toxicology, drug and alcohol, and general medicine this week, and these three hats are keeping me very very busy! Toxicology is fascinating though. I have to say that it's apparent that there are lots of people in pain right now. I'm sure it's probably always been true; maybe I'm only just now paying attention. My patients at the moment include a single mother who ate three handfuls of herbicide pellets, a 21 year old who took an overdose of his antipsychotic and washed it down with a bottle of Scotch, and a 26 year old divorced mum whose new partner recently cheated on her took two packets of cold and flu tablets.

I know this sounds tragic, and it is. We see a lot of suffering. But what is really wonderful about this work is that we can do things to help these people. All of the people I mentioned above are doing very well, and here they can access psychiatric help and community support too. In my very small way, I really feel as though I can be part of the solution in this job. Maybe a very small part. But it's good work and I'm so very lucky to do it.

Tuesday, November 9, 2010

Trivial

I ended up going with the chili plant for my friend's birthday, not that it was even one of the options... There's no time these days to construct the perfect gift, to put the amount of thought into things that I'd like. I'm getting used to the idea that rather than organic homemade muesli bars, like the ones I'd imagined, I'll be throwing together packet cakes for my family, if I even have time to have a family.

How on earth do you reconcile the desire to excel in your work, to be a wonderful partner, a best friend, a lover, a daughter, sister, citizen, musician, baker, person who spreads happiness? Who can tell a joke, bring a smile to a room, heal the sick, or at least not make them worse?

I'm a long way from any of those things.

Today I made a medication error. Actually, the error was made yesterday, but I found it today. I accidentally gave a patient a drug that they did not need, that could have harmed them. All drugs have side effects. I accidentally gave a small dose of mirtazapine, a commonly used antidepressant.

It happened like this. The nurse looking after these two patients was pushy and persistent. I had stated in the morning meeting that we would start a low dose antidepressant at night for our psychotic and demented 75 year old patient. She had been keeping the whole ward up on a nightly basis and was requiring sedation and mechanical restraints in the form of a Posey jacket to keep her from wandering the ward and disturbing the other patients.

Anyway, the nurse was chasing me to chart the medication. I said that I would do it when I recharted all that patient's medications; I didn't want to make a mistake. Later that day she came up to me and put the medications chart under my nose and said 'Can you please do it now!'

This is in no way the fault of the nurse - she was pushy, sure, but lots of people are. She was just doing her job, and being herself. The issue of nurse and doctor dynamics is neither here nor there, although I'll address it at some stage.

The point is that I wrote the prescription in the chart, and gave it back to the nurse. Today I was reviewing the medications, and saw that the wrong patient had received mirtazapine.

I felt hot and cold. Sure, the patient is fine, absolutely fine. As medical errors go, this one is minor and almost consequence-free. But it's a mistake, it shouldn't happen, and it must never happen again.

As my consultant said - this is something to learn from. At least it won't ever happen again.

Friday, November 5, 2010

It works!

I really do think that you can plan to be happy. For me that means a certain level of organisation, a feeling that I am making progress, and a sense of achievement. Yesterday I ticked several things off the long list I have accrued since arriving back in town. Most of the items are bills to pay and research to progress.

Anyway, things did go well with the boy - his mood was different yesterday after spending the previous night in doing his administrivia. It is really astounding how much of a difference that makes!
So the upshot of all the angst is that he does want to move in, he's just a bit nervous. Understandable, no?

I, being the understanding nurturing type, do get that. So anyway we are on! In t-8 days! We will be cohabiting. I will have a 'de facto'. Eek. That is a bit full-on!

Bring it on! I like to make a decision, then dive right on in. It is hard to understand how others struggle with that - I've always found it difficult to empathise with. What was I saying about being understanding again?

I have to get a birthday present for a dear friend this afternoon.
Ideas:
1/ Tomato seedlings inside a colourful watering can
2/ Cook book
3/ Beautiful bottle of wine
4/ Gorgeous handmade pottery tea cups

Off to work!

Thursday, November 4, 2010

Happiness

Ways in which to be happy on Thursday, 4th November, 2011

1/ Be grateful for great friends
2/ Have a really, really good latte from the guy at the coffee cart
3/ Enjoy the patients - this is the best work in the world
4/ Pay some bills! you'll feel better!
5/ Do some research
6/ Be committed
7/ Wear a dress with spots
8/ Smile at everyone
9/ Laugh!
10/ Look forward to the weekend!
11/ Have a glass of champagne with friends finishing med school tonight!
12/ Celebrate

Town

Life goes on... the boy and I are happy, ish... Well, he may be chronically dysthymic and we both might be hyper-analytical. But he loves me and I love him and we are moving in together in 10 days!

If that sounds confusing, well, it is.

Anyway I am also:
1/ Running every afternoon in preparation for the big 10K on Sunday
2/ Drinking a glass of merlot at 11.50pm - unwise?
3/ Nesting like a mofo
4/ PMSing
5/ Watching Gray's Anatomy
6/ Digesting a delicious meal had tonight with friends.

So it's all good really.