Week 17/18: you are not here to work, you're here to learn!

Sorry for the delay everyone! I took off this past week to stay out of the hospital and study for the usmle step 2 coming up really soon (March 30th). The week before this one was my first week in the new hospital.

My mornings are quite different now. I still get up around 5:30am but then take the bus at 6:24 to the train station, take the train at 7:03 and arrive in Hildesheim around 7:33, walk about 15 minutes to the hospital and start work around 8. On Mondays, Wednesdays, and Thursdays we have lectures until 5pm which doesn't get me back to my apartment until about 6:30. Due to the over hours we accumulate with the lectures, we get off Tuesday or Friday every other week. 

I'm currently in my surgical rotation. On the first day, we spent most of the time running around the hospital getting our lab coats, having lockers assigned to us, picking up our I.d. and chip cards. One of the surgeons sat down with us to divide us up in the departments. The first week I was in thoracic surgery. Then it'll be as follows for varying amounts of time: pediatric surgery, vascular surgery, general surgery and lastly trauma surgery.

I have a few vacations planned in between as well. 

My first week in a new hospital and new department went well. I spent everyday in the OR. I'd never really been in contact with thoracic surgery before and in the few days there I assisted in removing a lung, taking lung samples, cleaning out an infected pleural space, thoracoscopy and tracheotomy placement. It was cool to feel a breathing lung and touch a beating heart. 

The department is way smaller compared to what I'm used to. Thoracic surgery in this hospital consists of three people: chief, attendant and resident. Huge contrast to what I'm used to. But the whole hospital is a smaller scale than the university setting I've been working in. It's seems much more small town-y. People will open the doors for you, ask if you'd like some coffee, have a conversation with you. The chief himself sat down with me and discussed x-ray pictures with me. He made sure that I saw a lot and helped where I could. He also said that I'd be much better off being a thoracic surgeon than God forbid an urologist! It's so funny, the last few months I've lived in my urology world and thought it was the most normal thing in the world to want to be a urologist, work in that setting and treat those patients. Ever since I've come to the new hospital, everyone is amazed at my decision, shocked almost and tries to convince me to do something else and teases me about wanting to be a urologist. The urologists in the hospital are all supposedly really nice though and seem to have a lot to do. The other doctors like the urologists, they just can't wrap their mind around the idea of me becoming one.

One of the first things that the doctor that greeted us told us was that we are not there to work but rather to learn. We are supposed to get insight into the different departments and be as hands on as possible. That is great news for us! I really do look forward to learning a lot. I'll even be more excited once this board exam is over so I can actually relax and enjoy the time in the hospital. If the other departments are anything like the thoracic surgeons, I will be learning a lot!

Monday I start in pediatric urology, super excited! There is one surgeon who does pediatric urology. I'll try to work with him as much as possible. This upcoming week will be quite stressful since it's the week before my exam and I'll try to focus on that as much as possible. I apologize in advance if there is another week delay on the next post. I'll try to fit it in in one of my study breaks but no promises. Who knows what state I'll be in two days before the exam. 

Quick update on my meeting with the pediatric surgeons. In a nutshell, I was introduced to a little boy with a urological condition who comes from Azerbaijan. His family is in Germany on a scholarship and came in the hopes of receiving better care for their son. Unfortunately the insurance doesn't cover preexisting conditions. I've presented his case to the pediatric surgeons and urologist and have asked administration to let me know what the diagnostic test and most likely surgery will cost since the money will have to be fundraised. My fundraising goal is now set at about $13,000. I've been meeting with some people and getting the ball rolling on things and as of right now, if everyone pulls through, it seems promising. Up first is the diagnostic test to see how extensive the condidition is and what the best treatment option would be. In the upcoming posts I'll share a little more about this little boys story and also share information on how you can help me help him and his family if you want! 

Stay healthy everyone!

V

Week 16: My last week in Urology for a while

The past 16 weeks seem to have flown by so quickly! I assume this is mostly do to the old saying "time flies when you're having fun" but also due to the fact that almost all my free time before and after work was spent studying.

I spent most of my last week trying to complete my internship log book and get all the signatures I needed from multiple doctors. I was called into the OR to hold hooks in a cystectomy (bladder removal). Typically one of the longest operations urologist preform and I spent 4.5 hours holding hooks in my last week in the department. Only seemed fitting to end this way (because if I remember correctly, a cystectomy was the first urological operation I saw a year and a half ago when I did an elective in the department).

I baked 60 banana bread muffins and a "Kalter Hund" (German dessert consisting mainly of coconut fat, cocoa and graham crackers) Thursday night to take to work with me on Friday. I am genuinely sad that I won't be going to work in that department on Monday. The department consists of some pretty great people. The work atmosphere is the best I've been in and it really is more of a family than a group of doctors. I am thankful to the whole staff (doctors, nurses, secretaries, etc.) who helped me out during the last few months and didn't make me feel like an idiot if I asked a question. 

I also genuinely think that they are a bit sad that I won't be around anymore either.

My highlight while in the department was probably the whole situation with patient X. But I also have to thank all the patients who were kind to me. They were all a crucial part in my training and I thank them for having faith in me. 

Tomorrow it's off to Hildesheim every weekday until mid October. I'm not the biggest fan of the transistion periods. I've never been to this hospital, let alone have I ever traveled there. I don't know a single soul that works there. I've heard good things but it's always so overwhelming the first few days trying to figure out your orientation in a new hospital, observe and understand the dynamic of the people working there and getting to know the basic procederes (do you have to call for a consultation, or send a fax, or is it on the computer?). It'll be an overwehlming few days. Luckily, I have a little break from work starting Friday and all of next week to concentrate on the USMLE primarily since that is right around the corner as well (March 30th).

Since I'll be in a smaller hospital, I hope to be way more hands on than I have been. We will be rotating through different departments so little transistion periods will always be taking place. I'll be doing my surgical rotation so I assume I'll see the likes of trauma surgery, general surgery, maybe anesthesia. I'll know more tomorrow. 

Still can't say much about my appointment with the pediatric surgeons but I hope to be able to by next week. 

I hope you all had a great week and stay healthy in this crazy world!

V

Week 12: Bitter tears and 24 hour shifts.....but now it'S VK time!

Hey y'all!

Just got out of my 24 hour on call shift and thought I'd update everyone quick before I head off!

I started working in the outpatient clinic this week. Depending on the doctor working the clinic on any given day, there is more or less for me to do with patients. Luckily, the consultants had their consultation hours running parallel.

Urology can now also be found on Level 02

We also had two new girls doing electives this week. I played mom a bit for one of them making sure she saw as much as possible while she was in our department for one week. My days were spent between jumping in on some consultations, showing the girl around and doing some translation work.

Wednesday was a bit of a tough day. I'm still getting up before work every morning to study. And while this isn't effecting my mood substantially and I am surprised at how happy I am in general, I am still constantly under a certain level of stress making me a bit more prone to decompensating. I went in with the doctor to see a patient. He talked to the man and his daughter, gave the man the shot he came for and then left to let me do the ultrasound (rather standard procedure). Well, then the daughter started asking me about what dimensions a kidney should have. When I tried to explain to her that we don't generally concern ourselves with the exact dimensions of the kidney but rather look at the kidney's structure, she interrupted telling me she was from the medical field and that she would know that already.....well then why the heck did you ask?! So she became increasing difficult and then sprung the question on me if her dad was getting his prostate checked. Now, I have no issue with checking prostates but I usually ask when it was last done because there are more or less intervals in which it should be done. Her basically deaf father and she talked concurrently about how the prostate should be checked and this doctor said this and that doctor said that. When I told her I didn't know her fathers complete history and that the intervals are a bit dependent of the patients history, she yelled at me that I should know her dad's complete history since its all in the files (You are absolutely right, for your fathers outpatient appointment for a shot, I certainly intensely reviewed his 20 year urological appointment history in our department. Would you like to know his blood pressure from March 10th 1986?). She continued to yell at me that every doctor said something else and that we should know what we are talking about...blah blah blah! At some point I interrupted her and told her that it was not feasible to fulfill her vision of knowledge and even less considering I've been in INTERN in the department for merely a few WEEKS and the she could use a substantially nicer tone! And then I walked out. I told the doctor about the situation and then went to the bathroom. I just made it in time to the last stall to bawl my eyes out. I couldn't believe how mean she was to me. I was just there to help and would have discussed everything in a calm manner had she approached me in such a way but to just let out all her frustration with life on me was too much. I stayed in the stall for about 15 minutes until I couldn't cry anymore and tried to freshen up and hide the evidence. I was paged and asked where I was since there was a patient for me to see. I washed my face with cold water, put on some lip gloss and headed back to the outpatient department. The rest of the day was fine but this lady's inhumane treatment really irked me for a few more hours.

Urologist also have our own exit (and apparently use too much Viagra)

My friend wasn't feeling well and came to the hospital. After getting her all worked up and checked, I left the hospital after 12 hours.

Nothing all to exciting happened Thursday and Friday.

Yesterday (Saturday), I started my 24 hour shift. We had quite a bit to do. There were patients on the ward that needed us, the emergency room called almost every hour with a different case for us (mostly renal colic or infections). We also had to place renal fistulas as an emergency again (luckily this time it wasn't in the middle of the night). I did get 5 hours of sleep in all though. It was busy but interesting.

Today I leave to Frankfurt so that I can fly away tomorrow morning! Where to? Cape Town, South Africa!!!!!!!! I haven't really had it sink in yet since I've been so extremely busy with other stuff but since a few hours, I've been getting more and more excited! Of course I'll report a bit about my time there next week!

And as a last little thing for you all to try out (because its yummy!). I've been making this ginger-lemon-honey drink daily the past week. I wasn't going to risk getting sick! And like I said, its delicious!

-cut slices of ginger and pour over with hot water and let it stand over night
-1 fresh pressed lemon
-1 tablespoon honey
-some mint or lemon balm leaves for color
-mix it all together and enjoy while your colleagues think you brought a mojito to work ;)

Enjoy and stay healthy!

V

Week 11: Urology congress in Heidelberg= the only place the mens restroom has a line and the womens doesn't!

Well, I'm officially a quarter of a century old! 1/4 of my minimum goal reached!

The week started off with two rather unspectacular work days.

Wednesday I had to present some of my research data to the lab. I thought it would take about 10 minutest to click through my pictures and then they would tell me how little I've found and that I am a complete failure as a doctorate student. Okay, I didn't actually think it was going to be that bad but I had no idea what to expect. I had nothing definitive to show them. I composed some of the electron microscopy pictures I had taken and wanted to discuss these with the group of histology and anatomy professors and researchers. And in reality, that is what happened. The whole thing took 1.5 hours because each slide was discussed to great lengths with everyone there. I got some great input and some more direction as to what it is I am looking for. The conclusion is also that my endless hours in front of the electron microscope are long from over.

Wednesday night, I drove out to my aunt and uncles place to celebrate into my birthday. I facetimed my parents and opened my package of presents they had sent me. So happy! Amongst other things, I got a lot of material on Stephen Hawking. I'm excited to read his "A Brief History of Time" book on vacation. My friend got me travel guides for two of my destinations this year!

The next morning, my aunt and I took the train to Heidelberg. Most people know Heidelberg. Its a rather famous city also in respect to its medical history. I'd never been and have always wanted to go. Having won the tickets to the Urology Semi-Live Congress there, I finally had a reason to. My aunt and I ran around the city (sadly with not so great weather) but it truly is a gorgeous city.

The funniest thing happened in the candy store. There is a candy store that isn't very big but packed from top to bottom with candy from Germany and around the world. Even crazier than the collection of candy was the guy working there! Crazy beard and hair-do and thick leopard print nerd glasses. He spent about 10 minutes with each costumer at the register. So, don't go if you are in a rush. If you complain, he'll kick you out. What a cool way of working. Once we were up, my aunt told him it was my birthday. Before I knew it, he brought a stool in front of the register, told me to stand on it, made my "mom" hold my hand, gathered all the customers in the store around me, turned the light and radio off and announced to everyone that it was my birthday and that deserved a celebration, lit up a sparkler and made everyone sing Happy Birthday to me! It was fabulous and I couldn't stop smiling! He makes everyone at the register roll dice and play a little game and then you'll get more candy as a present. Super fun experience! I recommend it to anyone who visits. The store is called "Heidelberger Zuckerladen", has been around since 1986 and is located at Plöck 52 in Heidelberg.

At night, my uncle came and joined us. We had dinner at Moghul Tandoori, an Indian restaurant (Brückenkopfstraße 1, 69120 Heidelberg, Germany). I can also recommend this place.

Earlier in the day we had coffee at Coffee Nerd (Rohrbacher Straße 9, 69115 Heidelberg, Germany) (recommendation from the candy store guy and TOTALLY worth it). The coffee is ridiculously good.

I spent Friday and Saturday at the Semi-Live Urology Congress. The concept was that every half an hour, a different surgeon who is exceptional at the procedure, presents important information and techniques. Each was followed by a question and discussion road. In between there would be lunch and coffee breaks.

A little DaVinci practice never hurts

Right off the bat I met a student from Heidelberg and we ended up spending most of the time at the congress together. The presentations were more or less all really good. With about 300 participants present....there were only about 8 women. This meant this was the only place were the men's bathroom has a line and the women's doesn't!

I saw some operations I had never seen before let alone knew were a possibility. Friday night, there was a big dinner at a really old restaurant in Heidelberg. There was no lack of food.....it was so much food.....

Early morning walk to the congress

I made a connection with an Egyptian urologist and was invited to check out the facilities. The chief of urology in Heidelberg told me to apply for his department next year. The only people I didn't get a chance to talk to and wanted to were the two speakers from the States. I'll get in contact with them though. Over all it was a lot of information but really cool.

Heidelberg at night

Today I had a birthday brunch with some of my girlfriends.

Over my birthday weekend I didn't allow myself to study.....not that that made my guilty feelings go away any.....Its back to it tomorrow morning!

Hope you all had a great week!

Stay healthy!

V

Week 10: "Well, you don't place tracheotomy tubes, now do you?"......how rude! Get over YOUR fear of the penis Sir.

This week seemed incredibly long. This was mostly due to my numerous little naps in between. I am really able to fall asleep almost anywhere and sometimes I'm refreshed after just sleeping a few minutes.

Monday through Friday I got up at 4:30am, studied for the USLME until 6:10am, slept until 6:30am and went to work. Consequently, I went to bed around 9:30pm to at least get 7 hours of continuous sleep. Studying and answering questions in the morning significantly increased the amount I was getting right. It's still not where I want it in the end but I still have until the end of March to get there. I looked through the questions and worked on flash cards after work.

I attended a lecture Monday night held by Prof. Dr. Harald Lesch. He is a German physicist, astronomer, natural philosopher, author, television presenter, professor of physics at the Ludwig Maximilian University of Munich and professor of natural philosophy at the Munich University of Philosophy. He held a lecture about the smallest and the largest components of the universe and how they fit together. It was really interesting and refreshing to learn something different and new!

Wednesday, I was called into the OR to assist with a hydrocele operation. The patients ascites (excess water in the abdomen) was so extensive that it had reopened the processus vaginalis (connection between abdomen and scrotal sac) that usually closes in early development. Basically, he had excessive amounts of fluid in his scrotal sack....and since there was a lot of pressure from the fluid in his abdomen, it was like turning on the water faucet once we opened the membrane in the scrotal sack.

Cucumber, Apple, Basil, Lime Juice for the OR

Wednesday was a long day. The day involved ward work, operation, pathological conference lecture, evening meeting which was then still followed by a short educational lecture by one of the attendings. Luckily I had my back turned towards everyone to face the screen.....because I totally fell asleep for a minute or so....good thing I didn't snore. I was just so tired!

Friday looked like a busy day from the get go. One of the three interns wasn't there and the other didn't show up. We had two huge operations and two wards that needed to be tended to by interns.....and there I stood! My ward doctor was afraid I wouldn't be around to draw all the blood and his fear came true. Directly after the morning meeting I was sent into the OR immediately. I grabbed a coca cola and a biscuit and hurried off to the OR. I usually don't drink Coke, I did while in Ghana because coffee or tea wasn't very accessible and I needed caffeine. Now I do sometimes when a big operation gets sprung on me unexpectedly and I wasn't able to have breakfast yet. Caffeine and sugar to keep me from passing out while standing for 5 hours. Luckily the other intern had just overslept and was able to assist in the other huge operation.

Sometimes I just have to...

I was operating with the chief and he is tall. Although it was a 5 hour operation, my back didn't hurt nearly as much as it does when I operate with shorter surgeons. It was really nice operating with chief because he kept asking me questions. Sometimes anatomical, sometimes surgical or just logical to get me to think like a surgeon. He is an examiner for the board exams so it felt like a mini board exam.

Saturday I decided to tag along for an 24 hour on call. We started Saturday morning at 8am and I went home this morning at 8:30am. I slept for 2 hours and then again for 3. During the day we had quite a bit to do. The wards had to be tended to, the emergency room would call every now and again and we'd go there to check out the patients. We had some postoperative patients that weren't very stable and had to be transferred to intensive care. I hardly sat throughout the day.

We were called by the ENT-ward because they had a patient that hadn't peed in a day and a half. We asked them if they had placed a trans-urethral catheter. The doctor retorted that we (urologists) didn't place tracheotomy tubes so why should they place a trans-urethral catheter......Um....because every nurse should know how to!!! The genital area seems to be a big Tabu for many of the other departments and some doctors don't even take the time to look at the patient when it comes to urogenital tract problems and proceed to just call the urologist on call. Get over it people! Look under the blanket! Its only a penis!
 

Middle of the night, glazy eyes.

Late evening we were informed that a patient was being brought to the hospital with horrific labs. The patient was placed on acute dialysis when they arrived and desperately needed the kidneys drained. We couldn't do that until the acute dialysis was over though....which was around 1:30am. The doctor and I slept for two hours before being called to the CT to check out the patient's pictures and get the attending and nursing staff on call to come to the hospital and coordinate the anesthesiologists for the procedure. We were back in bed by 4am and slept uninterrupted until 7am. It was a long on call but also really interesting and the doctor and I get along great so that was nice too.

Outta there and walking home in the snow!

I get three days off in the week for being on call over the weekend. I am taking Wednesday-Friday off. Thursday I turn a quarter century old...  (0_0) ...... I'm heading to Heidelberg for the Semi-Live Urology Conference during my free days.

Hope everyone had a lovely week! Stay healthy!

Baci

V

Week 9: Study, work, little sleep, repeat.

To sum up my last week: work, study, little sleep, drinks, science, boots.

I can't really keep my days straight. Nothing extraordinarily exciting happened patient wise. I spent my evenings studying and when I was fed up that the results were not that great after a 10 hour work day, I went to bed at 10 pm and got up at 4 am on Thursday to study before going to work. 

Tuesday was such a lovely day outside! There was real, full on sun! We didn't have any coffee pads left on the ward for our coffee machine in the doctors office and I had all my immediate tasks completed, so I told the doctors I would be more than happy to walk to the nearby grocery store and buy some. Thank you coffee addiction! The doctors gave me some cash and I was able to enjoy a few minutes in the full on sun! In a t-shirt! The other pedestrians looked at me a bit weird but that temperature and weather is great weather for Wisconsin standards. 

Saturday wasn't much different for the first half. Library from 8am till 3pm. Afterwards, I met a friend for coffee and then attended the Night of Knowledge. This night takes place in many big german cities and it was the second year in my city. The while city is involved. My main visitation sites where the hospital (go figure) and the northern campus (chemistry, physics, astrophysics, Max Planck Institute for Solar System Research). The urology department and a few others had a stand with two models of the DaVinci robot for interested future surgeons and video game enthusiasts alike. The bulk of my time was spent on the north campus though.

I heard a lecture from Jens Frahm (important in the development of the MRI) about the newest developments in MRI technology. He showed us some cool videos of real time images. I've had a real time MRI done of my heart (I really need to get those images). Afterwards, I listened to a lecture about astronomy in South Africa. I really love astronomy and could listen to lectures about the topic all day. My aunt and uncle met up with me and went back to the hospital. I helped the visitors use the DaVinci. Although it wasn't planed that I even help out, I stayed until 12:45am taking everything apart.

This morning (Sunday), my friend and I left early in the morning to drive to Düsseldorf. After a quick stop at Starbucks (something we don't have in our small town, so every time we are in a larger town we tend to make a stop), we went to a restaurant called Mongo's. It's a Mongolian restaurant where you can put together your own dishes. We ended up eating for three hours. It was so delicious! And since it was mostly vegetables and fruit, I was full but not the completely uncomfortable full you feel after carb binge eating. 

We then headed to our actual reason for being in Düsselfdorf. The boot exhibition. It's a HUGE exhibition that deals with anything body of water related. We spent our time in the scuba divining and yacht exhibition halls. Thought I'd take the biggest yacht (7,000,000€) home with me.... 

Tomorrow it's up and early again......so it continues......

P.S. Recipe: I am always tying new ways to use what is available on the ward to make something delicious. Especially when it's cold outside, I like to make a cup of hot lemon with honey. So this recipe is no rocket science:

Lemon juice (quantity depending on level of preferred tartness)

Honey (quantity dependent on level of preferred sweetness)

Hot water

So simple and yet so very delicious!

Week 8: Tulips, Talkative patients, Test preparation & Thai massages

boring

[bawr-ing, bohr-] 

adjective

1. causing or marked by boredom
Origin: 1835-45

Boring is not an adjective I would use to describe the first full week back at work.

Monday started the week off with a bang. I was in the hospital until almost 6pm. The day started out with only half of the ward filled with patients and then BAM....the whole ward full from one minute to the next. We also had an oddly over proportionate amount of female patients. Three of them consumed quite a bit of my time which consequently lead to me being in the hospital so long.

Up dark and early....love a good full moon

The first, (understandably frustrated with her progression and constant fall backs in therapy) started to cry while we three doctors were leaving the room. The men left, I stayed, held her hand and comforted her until she had stopped crying.

The second, I merely wanted to take a brief history and fill out the admissions form. In extremely quick twist and turns, the patient brought the topic of conversation to geology, the definition of one's mother language, bilingualism and how she sees the world. There was no stopping it! I tried to redirect the conversation back to the topic at hand thrice....she didn't seem to get the point or at least just didn't care. I was saved by one of the doctors who had to get her informed consent for a procedure. I should note that the male nurse student was in the room before me to fill out the nurses admission form (a normally quick thing) and I waited about 15 minutes for him to be done.

The third was a charm, she's known to the department. A dependent personality. The first time in the room, I had to place a line and she explained her whole medical history to me. She told me others usually have problems placing lines but that she liked my calm and friendly aura and believed that I would be successful. I placed it on the first try. This promoted me to her new personal favorite status. Uh-oh.  That was in the morning. A few minuted before I was ready to pack and leave for the day, the nurse informed me that the patient needed a new line placed since the one from that morning gave up. Greeeeeeeeeat. I spent the next half an hour trying to place a line. I was actively doing something those 30 minutes (had to poke her 4 times before it worked) and she used that time and told me her whole personal history. I couldn't have escaped that even if I wanted to. The line needed to be placed.

By the end of that I was drained. The others had gone to the afternoon meeting without letting me know (they thought I had already left). When I caught up, they were all shocked to see I was still there.  I left the hospital and bought myself tulips as a reward for the day.

We have a new resident and a new intern in the department. The resident was also on my ward. This allowed me to work on some other things during the week. I translated a release letter into English for one doctor, proof read an English paper for another doctor and was able to help the doctor doing admissions with those.

I was treated to a Thai massage on Wednesday!

Best Moment : I was visited by Pat. X this week. He had his follow up meeting with the general surgeon and he is tumor free! I was so happy to hear that. We talked for a bit before I was asked by one of the doctors to do something else. (It was a task on the ward I wasn't really responsible for so it kind of irked me that the task wasn't given to the responsible intern and rather to me just because I was at the wrong place at the wrong time. I obviously didn't say that and completed the task.)

Made it out of the hospital in time for the sunset. Score!

Friday, the other intern didn't come at all! I was in a really bad mood already (I'll explain below) and planned on getting my work done and leaving as early as possible to go to the library. Now I was hopping from one ward to the next. Its extremely annoying when a doctor doesn't have a clear plan for the day and rather just throws tasks your way that easily could have been collected at the beginning of the day. I didn't sit down once until lunch. I also didn't leave the ward for the library until 4:30pm.

Wanting to draw blood, can't find clean equipment & then find this in the closet. Not ok. Guess who cleaned up.

Worst moment: I was in such a bad mood because the night before, I had worked on two blocks of questions for the USMLE and it was the worst result I've had yet! I had been steadily increasing my score over the last few weeks so this turn really shocked and upset me. This USMLE business is tough. Its not fun. It consumes almost every free minute I have. Not to mention the constant pressure I feel regardless of what I'm doing. I would much rather spend my nights after work and my weekends doing something else or relaxing but instead I'm spending hours with the USMLE prep. Someone once asked me if I was doing the USMLE on the side....I had the urge to punch him. I'm schduled to take the exam March 30th. So until then, I will still constantly feel pressure, continue to lose hair, continue to have stomach aches, continue to have psoriasis outbreaks  and continue to spend the largest amount of my free time with this stuff.

I spent most of Saturday in the library and have to work on doctor thesis stuff today (my doctor thesis professor sent me an email requesting I put together a presentation of results....perfect timing.......)

I wish you all a lovely Sunday and hope its much more relaxing than mine :)

Stay healthy!

V


P.S. Recipe: I very often make myself a smoothie in the morning to take to work. The first few weeks I drank a lot of kale smoothies (since it was the beginning kale season) but have now switched to pure fruit smoothies for a while. So delicious and fairly quick to make. Especially with the NutriBullet I have. This week:

Lemon didn't make the cut for the picture.

1 Banana
3 fresh squeezed oranges
1/2 fresh squeezed lemon
1 chunk of papaya

Yum!

Doesn't get much shorter than this....week 7

I really don't have much to say. I went to work on Monday and the doctors from the New Years Rotation were shocked to see me there. One of the doctors wanted to send me home almost immediately. Since I was already there and had gotten up at 6 a.m., I stayed.

The day was a busy one. I was sent from one task to another, one blood draw after another (some patients twice), one phone call after another.....

The doctors had all agreed to get the work that had to be done, done in a timely fashion. This meant that I was out of the hospital around 2 and was told not to show up for the rest of the week. (I would have came Tuesday and Friday but I'm also not going to beg them for that....I can handle a few days off of work. Gives me the opportunity to study.)

New Years was rather relaxed. I had dinner and watched a movie with two friends and watched the fireworks at midnight being lit on the streets.

I also booked my first vacation in the mean time. Stay tuned to find out where it is I am heading in February for 9 days.

When my dad heard I had booked my vacation, he insinuated that interns now a days have a much more relaxed life style.

I won't argue with him that getting paid nowadays is a fabulous improvement opposed to back then. I also really can't complain about my work environment which might allow me to leave work earlier (I usually end up staying anyways). However, I still work a 40+ week for minimal pay (its pitiful when calculated on the hour). Also, its really all about optimizing the time and money you do have. I don't fly direct because layovers are cheaper and I spend a lot of time looking for the right flight that incorporates weekends or holidays so I don't lose vacation days.

Over the many years of looking for and booking flights (in the meantime not just my own but have become somewhat of a personal travel agent for family members) I've developed my system of finding just the right flight.

I'll be working the weekend shift before I leave which gives me Monday-Wednesday off.....3 less vacation days used!

I hope everyone had a good holiday season and had fun over New Years. Now its back to the real world tomorrow!

Stay healthy!

V

Week 6: Short but sweet (like all those cookies and yummy treats you've been eating)

First, let me wish you all a Happy Christmas (as the Queen of England would say) and/or Happy Holidays! I hope you are spending some quality time with loved ones and if you can't be home with your family (as I wasn't home in Wisconsin this year) I hope you used today's technology of Skype or Facetime to stay in touch.

I wish you all.....a Heppe Christmas

I showed up for work on Monday and Tuesday. Other interns decided not to but I didn't want to risk my vacation days being used for days I could easily be working. I think my colleagues were quiet happy that I showed up.

Monday morning, still during rounds, the chief attending told me I'd be assisting in his operations that day. This was after we had almost seen all of the patients and about everyone of them had labs ordered. The ward doctors had hoped I'd be around to draw all the blood for them, when the announcement came that I'd be in the OR, even before the morning meeting started, the realization dawned on them....and their facial reaction was a little bit priceless.

We had two operation to perform. The first was a smaller one that was finished relatively quickly. The patient had a hydrocele. A sack filled with fluid in the scrotum essentially. This patient had decided to walk around with it for years and thought three days before Christmas would be a fabulous time to have it operated.......

Great Idea sir......

After the fairly quick first operation came the second, somewhat lengthier one. The patient had had his bladder removed at the beginning of the year and was back to have a incisional hernia repaired. The chief attending and I were joined by the general surgeon that I helped operate Pat. X with. Since hernias aren't part of the field of urology but the patient's incision was due to an urological problem, the departments worked together. Additionally, the surgeons are friends and don't find much time outside of work to see each other so they use operations needing both specialties as opportunities.  The chief attending and I were also interested in how hernias are being treated currently. Basically, a big sheet of material was inserted and sewn onto the abdominal inner wall.

After the operations, I returned to the ward for lunch and finishing up whatever needed to be done.

Monday night, I attended a basketball game with some of my girlfriends.

Tuesday, I was called back into the OR. This time however after rounds, morning meeting and blood drawing. This was the first time operating with this particular attending. We removed a testicle due to testicular cancer. The patient had noticed a swelling only two weeks earlier.

Public Health Announcement: Men, check your balls. Seriously, know what your testicles feel like and notice when something changes. It can go faster than you think. I have many guy friends, your guyss hands are in your pants 95% of the time anyways. Optimize that time ;)

I was allowed to leave after the operation was done in order to catch the train to Hamburg, where I spent the holidays with extended family.

My adorable little godchild

Hamburg Rathaus

In this time, I found a TV show to watch while babysitting my godchild. Cosmos: A Space Time Odyssey. I fell in LOVE! I've always been fascinated with astronomy and even took a class back at UW-Madison. This show is beyond fantastic! The information, the graphics, the facts and the way it is hosted by Neil Degrasse Tyson is just great. I read up a bit and found that it is a sequel to a 13 show series done by Carl Sagan. After I'm done with this series, I'll look at the older ones and see how far we've come. The show has resparked my inner super nerd. I would love to return to college after med school and take more classes in Astronomy, Biology and so much more. The world we live in, the present time, and we ourselves are so insignificant in comparison to the time of the universe. At the same time, this show portraits the stories of people who were so vital to our time and how the smallest of coincidences lead to where we are today. If you want your mind blown.....watch this show!

I'm in LOVE. I'm also a HUGE nerd.

Its back to work tomorrow and Tuesday. We have off Wednesday and Thursday, which I will hopefully spend in the lab and library. New Years Eve will be a quiet one (as of now) with a good friend.

I wish you all a great new year of life, filled with happiness, success and most importantly health! I hope that our civilization calms down with all the havoc going on in the world and focuses on the good and comes together instead of driving itself apart. Happy New Year!

V