“On Call” Is Not Like It Sounds

More often than not (or at least it seems), I am “on call” for the weekend.

I have been advised by friends to change my terminology when talking to them from “on call” to “working.”

Apparently, “on call” sounds like I’m sitting around with a pager.

When you’re an OB/GYN resident, that is usually far from the case.

Yesterday’s 24 hour call proved to be the greatest HIIT workout ever.

The day was a constant trickle of this, that, and the other. Managing labor. Antepartum concern from pre-term labor. Consult here or there. Some post partum issues. A delivery.

And, then the obstetrics Gods wanted to throw my team a new one around 2 am.

Around 2 am, three sections needed to happen. We can only do one at a time as we need to keep one room open for a “stat.” We were trying really hard to deliver one vaginally, to no avail.

So, between 2 and 7 we did three back to back to back C-sections. Naturally, during the first the ER calls with a “rule out ectopic.”

Let me explain to you the whole “rule out ectopic” situation, for those of you who don’t see these on the regular.

To keep it brief, let’s just say there’s a whole issue between pregnancy tests being able to detect the “hormone of pregnancy” (beta-hCG) and an ultrasound being able to see said pregnancy. So, there exists the whole entity of “pregnancy of unknown location,” meaning we know you are pregnant but we can’t see it. Mysterious, right? I’m surprised Mary Higgins Clark hasn’t picked up on this for a mystery novel, yet.

Anyways, so the ER calls with one of the consults that “they think has rebound and some free fluid in the pelvis,” which, to me, means this cannot wait until even though I have two patients in labor I need to watch closely. Her BhCG is also a level at which you should see a pregnancy in the uterus, which the ER doesn’t (the usually never do, however, when its a very early pregnancy) so I need to bring her up so I can examine and scan her. And somewhere in there a multip (i.e. this ain’t her first rodeo having a baby) rolls up in active labor. And someone had to round on all the patients, too. Thankfully, there is always a midwife there, too! She so kindly helped us.

We divided up the work. The other two residents did the 3 sections and delivery stuff (which is a MOUNTAIN of work) while I ran from one place to the next with delivery boots on (just in case), a scrub hat (so I could run into OR to give updates), and a heart rate above a 100.

I slept very, very well today.


Yes, that is a pelvis in the background. Casual pelvis.

Anyways, the nicest part of the whole night (besides the fact that everything turned out well) was how well the whole team worked to keep the ship from sinking, to go back to that whole sailor analogy. When the tide turns, everyone in our residency really rises to the occasion. I’m lucky to work with people like that.

What is that saying? “It is amazing what you can accomplish if you do not care who gets the credit?” – Harry S. Truman.

Guys from the 1940s knew stuff, ya’ll.

Anyways, on another completely unrelated note, I’d like to talk about bar soap.

To me, the sterility of bar soap in a soap dish is questionable. Is not that puddle of water that the bar of soap sits in a nidus from bacteria, viruses, and infection? Or maybe the suds from the soap keeps it away.

I guess no one died, yet, from using bar soap. However, I am very grateful to the inventor of liquid soap.

Although I do kind of like some bar soaps. The suds forming the micelles really gets the skin clean, don’t you think?

Truth be told….my favorite soap? DR. BRONNER’S!!!

Ok, I will stop talking about soap.

That’s all for now.

Night night.

Until next time…

24 hr coffee tally: I think 4 but I can’t remember

On being like a “real person…”

I got to go into work today at 9.



Usually I’m on like coffee #2 by then.

We have a few rotations where we get to come in at 9. And, it is glorious. You feel like you can actually do something in the morning besides wake up, roll out of bed and dress in essentially blue pajamas, shove some food and a coffee down your face, and go to work for 13-14 hours.

Literally, nothing made me happier this morning than being to go to CVS and get coffee after boxing class ALL BEFORE GETTING TO WORK.

It felt criminal almost. Like I was being a bad resident by, God forbid, doing something for my personal life.

I could’ve even sworn there were birds chirping today.

Birch coffee and CVS will do that for you. And sunshine.

Also, the labor floor was bananas this week so a few minutes of usual chaos on a NYC street seemed, actually, quite peaceful.

I am on call 24 hours tomorrow which means working 24 hours. I have been told I need to change what I tell people because on call sounds like I’m resting at home with a pager. It is the opposite of that.

Where will I be getting my stethoscope for rounds? Nurses! #nursesunite . I mean, I would’ve crawled in a whole and died if it were not for the nurses on, say, the Tisch Labor Floor my intern year.

Anyways, that’s all for now…

Until next time..

Daily coffee tally: 2

BOB, You Outdid Yourself

Yes, Jim Bob — 19 children is enough.

Just kidding, not that Bob. BOB. Bellevue OB. Refer to last night’s post if you are confused.

BOB, you really outdid yourself today. 6 deliveries from 7 am to 6 pm. This is a new record for me at Bellevue.

The one checkbox I do really love checking with all of those deliveries is “the log.”

In addition to sending telegrams and using fax machines, we still use a written delivery log. In order. Of every delivery at Bellevue.

Of all of the delivery stuff, the log is my favorite. I don’t know why. I like filling out forms, I guess. And, its cool to see all the information about a delivery written out.

Or something like that.

BOB wore me out so much today that I didn’t even exercise. I know, I’m really letting myself go.

I did run around all day though. Up and down and up and down and up and down that labor floor. That’s like interval training, right?

In other news, I learned to put contacts in over vacation.

So far, I have managed to a void incurring a raging eye infection seeing as I have to basically manhandle my own eye lids and eye to get the contact in and out. I’m sure I’m colonized with some crazy multi-drug resistant bacteria. Thankfully, careful hand washing has thus far worked in preventing me from having some wicked infection.

Further, I have yet to abrade a cornea. I was legitimately concerned about this after taking my contacts out, seeing as I basically pinch my eye ball to find it and take it out.

One benefit of going to medical school is that you end up with friends in many fields. So, when I was worried by cornea was at risk, I texted one of my friends, “So can you give yourself a corneal abrasion getting  contact out?” He said probably not… that it would be hard to do.

Let’s hope I keep that trend alive.

In even other news, while I was at home, I read a book that had nothing to do with OB/GYN. It was wonderful. I read “Girl On The Train” and am now in the middle of “Big Little Lies,” which probably won’t be finished until my next vacation.

That is all for now.

I am tired.

Night night.

Until next time..

Daily Coffee Tally: 3-ish (2 half drunk because #notime)

“What Are You Doing Now?”

If you’ve ever worked on the Bellevue labor floor, you know the frequency of the phrase, “What are you doing now?”

I like to think of the Bellevue OB (“BOB”) as a ship that we, the team of 3 (a 1st, 3rd, and 4th year), keep driving forward.

On BOB, there are always 600 different checkboxes. For a delivery alone, there are at least 10. For one patient.


And, nightmare.

The “seniors” (3rd and 4th year) are sort of like the captain and skipper whereas the intern (1st year) is like…first mate? I don’t know, I gotta catch up on my sailor terminology.

Anyways, the first mate is, technically, supposed to do most of the “stuff,” depending on the volume, to learn and such.

So, your captain and skipper are always asking you, “What are you doing now.”

Often, they will then tell you “oh wait, but I wanted you to do this.”

And, 5 minutes later, another person will tell you “oh wait, actually just do this instead, not that.”

You stay perpetually confused, frustrated, and just wanting to check one damn box.

You can also feel that way when you’re a senior. Not as much. But, there is always so much to do that learning what should happen now versus later versus possibly simultaneously is the new trick for the old dog to learn.

I’m using a lot of metaphors tonight.

The way I used to circumvent the question of “what are you doing now” question was to theatrically announce frequently exactly what I was doing now, in 5 min, in 10 min, and thereafter. I learned this from Spencer. Thank you, Spencer.

For instance, “I am now going to use the bathroom. I’m then going to scan triage 20B. After that I’m going to go check room 2 and do her labor note. After that, I will come back and give you update. Aye aye, captain.”

Just kidding on the last part.

But, maybe we should adopt the whole sailor thing on BOB. Might spice it up a little bit.

I’m getting distracted.

Its easy to do that when you’re on OB.

There are so many checkboxes and things to do you can literally jump from one thing to the next in 0.2 seconds.

Like this blog.

Has this made any sense?

Anyways, the gist of BOB: sailors, checkboxes, “what are you doing now.”

Final note: one night at sign out, I made everyone in the room (nurses, anesthesia, peds, OB) say their favorite ice cream flavor as an introduction. All of the nurses said rum raisin. I have never had rum raisin. Maybe I should try it.

That’s all for now.

Night night

Until next time…

Daily coffee tally: 3 [thanks to midwife extraordinaire, Kelly]

The “We Did It!” Moment

If today were an episode of Sesame Street, it would have been brought to you by the phrase “You/we did it!”

In the OR today, during my total abdominal hysterectomy, I, apparently, did a better job at skeletonizing the uterines than last week. And, my attending kept going, “There you go! You did it!”

I think she actually said this with every step. As well as, “ok, now keeping going already…”

The OR is like a dance, they say – you should always be moving. Fluid. Seamless. Efficient.

Later in the afternoon, we had a family meeting for a patient. These usually involve multiple teams to discuss a patient’s care and course.

Come to find out, the attending on another service caring for my patient was one of my fellow med students.

[We started in the same class, then I took a research year between 3rd and 4th years, and he did a 3 year residency…if you were trying to do the math on that one!]

It was really interesting to hear him talk, very eloquently, about fluid shifts, electrolytes, optimizing the status of the patient to handle treatment.

It was weird to think back to being in the same hospital as 3rd year medical students and, even further back, in anatomy lab.

I had this secret thought to myself during the meeting. Like “OMG, we actually did this. This doctor thing.”

I don’t think you ever question that you’re going to become a doctor once you enter medical school. But, like they say, the days are long the years are short. I can still see one of my other co-med students, who is now a chief resident, in the library with a huge pile of notecards and me with 16 different colored pens and highlighters rewriting notes after notes after notes (I liked to go through each lecture three times to distill details notes to less detailed notes to bare minimum to then review before the test). And now we like…know things. Its weird. But cool. And empowering. Its also a very expensive process. Beware.

By the way, if you want to know the real secret to learning something….write it down. Over and over and over again.

There is something really powerful about putting pen to paper. It engrains it in your brain.

At least, that is my experience.

Finally, a thought for you people out there — do you think its bad, at a certain age, to have dreams that you know won’t come true, but are cool to think about anyway.

I mean, 29 isn’t old — but it’s not 18.

Secret dream (or not so secret): be a doctor part time and teach high school chemistry part time (is that a thing). I love teaching. I’m not good at many things (do not ask me to cook for you, use your can opener, put something together…), but I think I’m a good teacher. My forte is making good analogies — like the time I compared culturing and identifying bacteria to Facebook stalking guys. Different stains to use? Its like an Instagram filter! Duh…

Anyways, enough about me…

You can tell me your secret dreams. In the comments. Share away!

Speaking of, I’m off to dream world.

Night night…

Until next time…

Daily Coffee Tally: 3 (the 4:15 pm coffee was CLUTCH. I’m going to write that down. I think its going to be a game changer)

Thought Bubbles From The Day

Here are some, but not all:

[with some context for some of them]

*4 am texts from night team regarding admissions* –> “This day is off to an auspicious start – two patients went to OR overnight and another admission…should I start the caffeine drip now?”

*when you’re struggling with a new to you instrument* –> “My hand is not big enough for this! That’s it! Its not me. Its the manufacturer of this instrument.” [After thought — definitely wasn’t holding it right.]

“Is Surgical Solutions a Bellevue thing only? Or is that a company?”

“The OR is like a 3 ring circus sometimes — anesthesia, scrubs, surgeons.”

“Thank God Dr. Lerner knows how to work everything in here.”

“Am I sweating from stress or is the Bair Hugger blowing on me?” (Combination of both)

“Can’t JK Rowling write just one more Harry Potter book?”

“I want more coffee” <– this is on repeat

“I feel like Lupe Fiasco really understands the life of a resident.” (Listen to “The Show Goes On” and “Battle Scars”)

On doing my first total laparoscopic hysterectomy (TLH — THANKS DR LERNER!!!) –> “Seriously, if I can do this, anyone can be a surgeon. Can openers are still hard for me. And, look at me now!!!”

“Written cards really need to make a comeback. Snail mail. Its vintage. Let’s get on board. And cursive writing.”

That’s all.

And, finally, you should read this article that I got from my former favorite fellow (now attending) regarding talking to a patient who is dying. –> Link –> http://m.jco.ascopubs.org/content/early/2015/08/06/JCO.2015.63.4105.full

Night Night.

Until next time..

Daily Coffee Tally: 2

[PS – super looking forward to grand rounds tomorrow – coffee!]


The US Open started today.

Possibly forgotten fact – once upon a time, I played tennis.

I had an extensive collection of visors. I'll prove it to you….

I had an extensive collection of visors. I’ll prove it to you….

Another visor

Another visor

Another one....

Another one….

I really liked visors… (why? because you can still have a high ponytail!)

I really liked visors… (why? because you can still have a high ponytail!)

Beyond collecting an extensive repertoire of dri-fit gear, one reason you should put your child into tennis, or any sport, for that matter, that you learn how to fight.

In a tennis match, you are alone. There is no coaching. No phone a friend. In addition, unfortunately, in junior tennis, there is also a lot of cheating.

Suffice it to say, you have to learn to stand up for yourself. You have to go and get a lines judge if you think you’re being cheated. You have to learn to fight back when you’re down 4-0 and can’t hit the side of a barn. You learn to fight for yourself because no one else can.

I’m thankful my parents put me in every sport imaginable and that my mom, ever the fighter, taught me, as well, not to back down.

Like, in the 9th grade, when apparently I didn’t score high enough on my 8th grade TCAP or PCAP or Redcap or whatever the Tennessee standardized test is called to qualify for honors English or honors Biology. My sub-par test scores were likely two fold: partially because my middle school was more of a holding pen than place of higher education (although if you could make it at Bearden Middle, you can make it anyway; its tougher than New York) and partially because in the 8th grade I was more concerned with when the GAP was going to get a new shipment in (did I call the store often? Yes…I’ve always been persistent).

I fought to get myself into those classes because I thought I could handle them. I think I got As (if my memory serves me correctly). And, I think I ended up doing ok for myself, academically speaking.

Or, like today, when I got wind of the fact that some of my surgeries I scheduled might be cancelled by SCC. I stormed (literally stormed) up from clinic to SCC (“YOU WILL NOT CANCEL THESE CASES I FOUGHT SO HARD FOR!) prepared to raise some hell to get my cases to the OR.

[Side note: In my head, I was also crafting an email to the head of HHC and, of course, straight to the top – Mayor De Blasio – regarding my frustrations. Don’t go down without a real fight, right?]

[Side note: Also cue Lupe Fiasco’s “The Show Goes On” as the background to my storming up to SCC.]

Sometimes you just have to fight.

Prove you can’t be easily tossed aside. That you’re not disposable.

Ok, that’s all I have to say for today.

Don your Serena cat suits and get your rackets swinging, folks.

You do remember the 2002 US Open Serena cat suit right?

Night night…

Until next time..

Daily coffee tally: 2.5