A new pet introduced itself to our family tonight. I had just finished tucking the Sweet Breads into their beds when I came downstairs and saw a little creature scuttling across our wall just beneath the chore charts. It was the size of a large bug, and the way it moved looked like one of those really disturbing (though apparently harmless) house centipede things (I found this website called what's that bug? to help me name those shaggy-legged crawlies accurately). Sadly - maybe for lack of time - I am no longer the devout bug humanitarian I once was. It was heading for behind some furniture, so I reflexively grabbed for a shoe to squish it. But (thank goodness) I looked a little closer and realized it wasn't a bug at all! It was some sort of little lizard! I called for Richie, and he came bounding down the steps with Mazie and Vivian on his heels. As it turned out, we needed Mazie's speed and skill to capture it because it was so fast and, truth be told, we're just not as fearless and nimble as our 8-year-old. She had gently captured it in no time flat.
We put it in a tupperware and began speculating about what manner of lizard this was. It's about an inch and a half long from nose to tail tip. Its body is mottled and its tail is banded. The most striking things about it are the way it moves - more articulated then a normal old lizard - and how transparent its body and head are. If you hold it between you and the light, you can see the outline of its digestive tract! I had held a gecko back in college, and of course had oggled geckos in pet stores. The shape of its head and feet...is just so gecko! It turns out this is a House Gecko - Mediterranean or Asian or whatever, now they're pretty much everywhere warm - including the southern US, according to Dr. Wikipedia.
The whole family (except Cindy and Skiplo) is super excited. We put it in a bug box with a damp clod of grass and furnished it with a mosquito and a moth for snacking. I don't know if we'll keep this thing or what (it depends on whether crickets and their stinky selves fit into our budget), but it sure is cool! It makes me glad I saved the aquarium we got for free back in Williamsburg.
Surgery followed by Internal Medicine was a slog. It wouldn't have been so hard if it were JUST 80-hour weeks. But on top of that, there was studying to get done in the interstices of time, which barely existed - especially on my last 3 weeks of medicine. There are a number of factors that go into making your schedule, and it is very team-dependent. I worked more than any person I knew during internal medicine...it was just the luck of the draw. My team was wonderful at patient care (hence the long hours) but worked super late compared to other teams. No time to study makes for a feeling of being stuck between a rock and a hard place at all times. I was realistic from the beginning about not being able to see much of my family for this chunk of time, and Richie was fully on board. But being brain-dead at the end of a 14-hour day is something I found if I tried to fight, I just ended up wasting time staring at a book and going nowhere mentally. It was tough - I hate being under prepared. In this case I had no choice but to get through the best I could, make the most of my days off (all of which I spent trying to catch up with my studying). My anxiety has ratcheted way way up in the past month due to this hours-in-the-day issue. I find myself clenching my hands in normal conversation, having a hard time sleeping at night, and with racing heartbeat intermittently throughout the day. I am glad for a break.
After surgery and medicine, this whole doctor thing feels different to me. These rotations are very difficult but very empowering. You begin not just to practice your physical exam skills but to use them to gather data and fit your mind around how a patient is doing...based on your own ascertainment. I had patients whose physical exams (which is to say how their body was faring as can be perceived from the outside) I knew better than anyone else. I could trust that I knew because I did the physical exam over and over again day after day. I went from "I think I may have heard a split S2" to "There is a late-peaking high-pitched systolic murmur heard best at lower left sternal border, grade 3 / possibly 2." Confidently. I can see a retina pretty well now, even non-dilated and with a normal (as opposed to pan-optic which magically gives you an eye-max view of the retina) ophthalmoscope - which is a good thing because it's what I have. Dr. Hardison has taught us to look at hands very carefully, and I will never forget that lesson. You can see an amazing amount of stuff on hands alone. Diabetes, chronic hypoxia, endocarditis, connective tissue diseases, arthridities, anemia, vitamin deficiencies, certain cancers, and lots of other stuff. Dr. Hardison's so full of physical exam pearls and so experienced (I think he's in his late seventies) that looking at a hand is like literal palm-reading for him.
The light was beautiful tonight after a heavy rain and just before dark. Things are beginning to feel normal-ish again. Once more, it doesn't take long to get back to normal-ish. We all went to church together this morning. I made meals for my family and cleaned up after. I read a chapter (The Bell and the Hammer) from The Magician's Nephew to the girls. I got to listen while Richie coached Vivian through her first at-home writing assignment (How she got her name). We worked together on adjusting our budget. Very nice.
Just in case you don't know, we really wrestled to find the right fit for Vivian's middle name. Vivian was first named "Vivian Augustine Gunn." But she was so little and new...and that name sounded so heavy and old...we switched the middle name to Faye, and we're so glad we did! It fits her just right!
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