Monthly Archives: December 2016

Yeah this year was hard but a lot went right so we’re in our yard singing silent night because all is calm and ’cause all is right when you end the year singing silent night.

(Holderni Christmas 2016)

 

I heard this song a few days ago and loved it because it is so true. This year and really a lot of the past years have been really hard, but in the midst of the chaos and stress, there totally were things going right. I have met some awesome people that I might not have met without the struggles that pushed me to reach out.

 

Sure, school is not really a good place for me to be, but because I will already be in town for the last rotation block (and at school), I have a good reason not to live in the res hall the last week before graduation…sure, it’s free, but safety is something without a price tag, and I’m pretty sure I’d rather drive back and forth and stay somewhere else even if it is a significant time/money/effort commitment, because driving back and forth to school is likely less stressful than being trapped on campus would be.

 

Anyway, check out the before, during, and after pictures of the car wash. Yes, I did go to the expensive car wash…my mom told me to, and I try to obey…and besides, I figure I don’t spend much money on myself, so it is okay to splurge once in a while…

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during

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Totally unrelated, but today my water bottle leaked in my lunch box…I mean, it always leaks, but today about half of the water was not longer contained in the bottle. It is approximately a 3-cup water bottle. My phone, wallet/keys, paper towels, and everything else in my lunchbox was dripping…including the candy in my lunchbox. There were some jolly ranchers in there…let’s just say that I’ve never really liked the idea of candy wrappers that don’t actually seal due to the germ component, but this is another reason that non-sealing candy wrappers are frustrating…now everything from my lunchbox is sticky from dissolved jolly rancher…on the positive side, my phone has never smelled so delicious!

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Don’t Bury Me I’m Not Yet Dead

(I’m Alive – Superchick)

Winter storm Decima did not decimate me. Scared, oh yes, but I’m fine.

See, I didn’t want to leave on Friday because then I’d have to pack my car in the dark. Before I could do that I’d either have to pack all my stuff before leaving for clinic in the morning and lose precious presentation practice time (even though TBH it’s not like I got much practicing done anyway) and/or I’d have to pack in the evening when I got home, very likely pushing back bedtime which would make me stressed out, particularly because I was still trying to catch up on sleep from Midyear, so I’ve been going to bed at 8pm and wasn’t particularly thrilled to go back to a 9pm bedtime the night before leaving.

So I waited for Saturday. I packed up the car Friday afternoon, right around the time the ice was supposed to be melting, but actually was accumulating. I proceeded to a combination of scare and reassure myself by obsessively evaluating the weather for Saturday every 20 minutes for the rest of the day.

Saturday morning it had finally come above freezing. I made one mistake: I looked at the weather and saw that it was drastically different in the city I was currently in than it had been when I went to bed. Not a different like the weather is way more horrible than before (and not that I was going to be in that area long anyway) but different. That, of course, brought of the fear that the weather everywhere was going to be different, and WAS going to be the bad kind of different.

It was rainy and a little foggy, but otherwise fine for a while. There was some idiot I had to pass no matter how fast I had to drive to get around him/her because he/she apparently had decided the hazard lights were the high visibility lights and it was driving me CRAZY.

It became a little windy, so I slowed down because fear…which actually turned out to be a blessing, because right about that time I both hit a patch of ice and simultaneously realized that everyone in front of me on the road had come to a complete stop. By slowing down I had enough time between that realization and stopping to not hit anyone or anything…and there I had a little freak out. I didn’t know how long we’d be stopped. I didn’t know if it was stop and go forever. I didn’t know if I should turn off my car. All I knew was that I was not a happy camper and was now trapped about 70 miles from point A and over 400 miles from point B. Not happy.

Long story short, I was actually pretty close to the front of the stop. There was a semi that got stuck and was blocking the road, and there we were waiting for a tow truck. TWO snow plows went along the shoulder to get around us…why? I’m not sure seeing as how there was no snow. Eventually I figured out that I should turn off my car. I did keep turning it on long enough to clear the windows so I’d know when we were moving again though. About an hour in I also turned off my hazard lights. Everyone around me was stopped anyway, so it’s not like it was going to surprise anyone that I was stopped. I started a trend and everyone else turned off theirs as well. With the car off, it started to get a little cold eventually. Because I am a genius that way, I had a thin sweatshirt jacket, an unlined wind breaker that is essentially a shaped piece of thin polyester, and that’s about it for cold weather gear. (Hey, don’t judge me, sitting for like ever on the road in a turned off car at like 30 degrees wasn’t in my plans for those five weeks). I am good at improvisation, however, and used a skirt and my pajama shirt as a blanket for my legs and the pajama bottoms actually made a scarf that was the only time I have ever described a scarf as comfortable…also one of the only times I’ve ever worn a scarf, but considering the other options in my laundry basket, unless I was going to completely undress and start over there weren’t any other tops I could get on over the top I was already wearing so I needed something to keep my body heat near my body. I also changed from my tennis shoes to my boots. That was a mistake. The boots are comfy, but warm they are not.

So anyway, about two hours later we finally started moving again. It was really only that one patch that had been icy, but I was now scared and drove slowly with two hands on the wheel most of the time just in case. As I started relaxing and speeding up, semis started passing me and throwing icky stuff at my window. I thought my windows were freezing and I about gave myself heat stroke (mild exaggeration) trying to melt the “ice” from my windows, because I couldn’t see very well…so now I was that idiot on the road driving slow for no apparent reason. I now have a lot more empathy for the idiots driving slow. I found a(n overpriced) gas station and figured I’d put gas in and scrape off the ice…well, as it turns out, it wasn’t ice…it was mostly salt with a little dirt mixed in for good measure…there weren’t any squeegees at that gas station so I figured I’d use my wiper fluid and that’d have to be good enough…well if I were driving backwards it’d be GREAT and if I could drive from the passenger side it wouldn’t be too bad, but the fluid doesn’t squirt far enough to reach the drivers side.

So for another 200 miles I drove slowly using the mostly the passenger side to navigate and constantly hoping no semis or snow plows or other large vehicles would go by because every time they did I’d have next to no visibility for a few terrifying seconds in addition to being sucked in to the wind they create. Eventually I found an exit with a gas station…a gas station that must know people are getting desperate when they get there, because it is 20 cents more per gallon than the gas station I would have gotten to in one more exit (oops) and it is about 3 miles from the actual exit (so I’m not really sure why they are advertised on the exit board hashtag annoying). Luckily they did have squeegees so I could finally see where I was going. That was super helpful. Now I could finally drive as fast as everyone else. I do realize it is best to drive a fast as I feel comfortable with, not how fast the people around me are comfortable with, but I hate being that person everyone is annoyed by…

So yeah, the rest of the drive was moderately uneventful. I did almost get myself pulled over though. See, there was a semi that had been on my bumper for miles and I was getting annoyed, so instead of being responsible and slowing down until the guy got frustrated and went around or changing lanes, I sped up to create space (which by the way was completely ineffective). Right about that time I was kind of stir crazy and was in my wave at inanimate object or wave at people who are miles away mood, and was waving like a lunatic at a pretty logo on a building when I saw a police car go past me and turn on its lights. I looked down at my speedometer and went “can I say that bad word now” (quote from Inside Out). So I slowed way down and was about to pullover and stop when I realized the police car was still going and must have had someone else in mind. Thank God. It would be super embarrassing after driving slow all day to get pulled over an hour from home for driving 20 miles over the limit.

Also, it wasn’t icy again after that spot I sat in forever until I got to my neighborhood.

I think in the last 10 weeks I have grown about 5 years in communication skills, probably 3-4 of those years in the last 5 weeks. While I was in the car I sent texts (only while in park), made calls, left voicemails. All intelligible appropriate conversation. I was so proud of myself. Also, in these weeks I have learned that I can do hard things.

I might not be learning a lot of pharmacy, but I am learning a lot of life skills that are arguably more important than learning pharmacy skills for a pharmacy setting in which I have no interest.

A Radiant Light

(Rise – Danny Gokey)

I have worked harder on this rotation than on any other rotation…but I don’t feel like I really have anything to show for it, because this rotation I worked really hard on communication skills. I kinda wish when I was trying to decide between the difficult conversations and the emergency medicine sessions at Midyear that I’d picked difficult conversations, because in reality, that is what I have really worked on.

I gave a journal club presentation to which I was late without a full lunch, much less any skittles. I advocated for myself when my grade didn’t reflect the comments on the evaluation.

Today I conducted two phone visits ALL BY MYSELF!!

I am so proud of me.

I might be half asleep right now because the past few nights this has been bedtime in order to get as much sleep as possible in to catch up from Midyear, but I am alert enough to know that what I’ve done is really awesome and deserves some recognition.

This is the girl who just a few years ago carried her computer with her everywhere to allow her to write any necessary communication that couldn’t be handled with pointing, nodding, and shaking my head in asking teachers questions. This is a girl who in an emergency probably would have stretched her comfort zone attempting to text 911 even once she did become a more fluent speaker, because talking on the phone was still too hard.

This is a girl who had never been completely in control of a patient visit in person, and has now been in control of two visits over the phone! Two successful visits over the phone. Was I scared and praying the whole time the phone was ringing that no one would pick up…umm…okay fine, definitely yes, but bravery isn’t not being scared. Bravery is doing it, scared. And I did.

If I had any energy left, I would be jumping up and down.

Also, I still don’t agree with the apparent mismatch between positive comments and negative grade, but after advocating for myself (one of my goals first year) and talking with my preceptor (using my words) it sounds like my grade might actually be an A at the end of all this.

Take that all those people who thought I couldn’t do it! Just watch me do it!

You might have tried to convince me I couldn’t, but I’m proving to you and to me that you were wrong!

Where there’s a will there’s a way, and you better believe this bull-headed girl has a will! My classroom grades may not be perfect, but I am going to do whatever I can to make my rotation grades as close to perfect as they possibly can be. I am good enough, and I deserve it!

Do the angels fill the air? Do you reach out and touch them?

(Dreaming Jacob’s Dream—Michael Card)

 

Lol, so I think this is from the Christmas musical The Plane Truth when I think it is Joseph who says “scare me any worse and I’d be with the Lord!” Umm, yeah, that was me on the way home from church this evening. God definitely was watching out for me so that I didn’t meet the angels this evening.

 

So for this story to make sense, you need to know that I didn’t have much sleep most of last week and have been sleeping like 11 hours at night the past two nights and sneaking in a few minutes of eyes closed time here and there as I find an opportunity in between doing homework…okay fine, in between staring at my homework but being too tired to actually do anything. Keeping my eyes open has been a chore.

 

So anyway, I was driving home from church, and I almost fell asleep…not like my usual way overtired kinda napping against the window at the stoplight or anything, but like I was driving down the freeway and suddenly my head was in my lap. Luckily, as I drifted to sleep my foot came off the gas and the slowing of the car I think is probably what kept me from falling all the way asleep, but that was terrifying. I am so fortunate and blessed that I woke up in time that I stayed in my lane and didn’t run into anything, but it was really scary…

 

I think perhaps I may have learned my lesson about driving half asleep…’cause I definitely do not want that to happen again, because next time I might not be so lucky. I love seeing my friends, but I also like being alive…actually, sometimes I’m not so sure about being alive, but I do like Monkey, my car, and crashing Monkey would be a horrible waste of resources, because Monkey was expensive and still has a lot of usable life left. And dying in a car crash would probably not be a good way to go.

 

On a moderately less serious note, I was thinking recently about answers to interview questions…lol…so I was wondering if being able to pretend that I am having a good time counts as a strength…’cause I hate conferences/retreats, they really really really are not my thing, but see me at a conference/retreat and the closest I’ll get to telling the truth is to say it’s okay…most of the time I keep smiling and telling everyone what they expect and want to hear, that this is great. Everyone tells me it is awesome, so most of the time I feel like I can’t tell them how much I am not enjoying it. People don’t seem to believe that someone might not be having a good time, as if I am making things up or exaggerating when I say that I don’t really want to be there, but I can assure you that after a fall retreat for two different churches, a few leadership retreats for college, and now Midyear, I am very much sure that I do not like it Sam I am. I do not like it in a box, I do not like it with a fox. I do not like it in my hair. I do not like it anywhere. Everyone tells me going into it that I have to go because of how amazing it is, and afterwards everyone tells me I should be glad I went because of how much fun I had, but in reality, I didn’t have fun. Sure, given enough time in one place, I am sure to have a fun moment or two while I am there, but the overall vibe is not fun. The overall vibe is how many more minutes until this is over…but you’d never know that aside from reading it here, because in real life I have learned not to be a negative Nancy about these things because I will essentially be told that I am wrong, and when I already am unhappy about having just spent the time at the event in question, I am very much not in the mood to be told how much fun I had, so I quickly learned to keep my mouth shut. I keep an open mind and go into new experiences giving them the chance to be good even though all my prior experience tells me that it probably won’t, so I don’t condemn the experience before having it, but I feel like at this point in my life I have tried enough things to know what I like and don’t like, and conferences/retreats fall firmly in the category of I’ll go if it feels like the right thing to do, but there is a very good chance that I will not like it. (Although I will say the first fall retreat I went on actually was almost a good time. Those kind of things aren’t really designed with a person like me in mind, but being surrounded by people who knew me pretty well actually wasn’t half bad…that one fell pretty darn close to the category of good. Not good enough to ever go again, but good enough to have positive memories. Let’s just say that at the other church’s retreat (which was actually if I remember correctly in the winter) I spent a lot of my time in my room, alone, crying. I was left out as usual and once they successfully got me to agree to come, no one really cared that I was there anymore). I am very happy to live vicariously through pictures of events so I can be happy with you about your time at the conference, but actually being there myself just isn’t my thing.

(For Recap of my time at Midyear, see the previous four-ish posts…)

Even though things don’t make sense or seem true

(Believe what the Lord says to you–Fear NOT! Musical)

 

So yeah, with staying up “late” every night combined with a full awakening in the middle of each night, the last day of the conference is a bit of a haze. I got up and went to a session on fungal infections in the morning. I felt proud that a few questions that seemed like no brainers to me were missed by quite a few or even the majority of the real pharmacists. The breakfast wasn’t nearly as good as yesterday, but it was food and filled my stomach either way. Oh my. Some people have no tact…and maybe that is how you know they already have a secure job they plan to never leave. The person next to me originally sat down with four coffees (not small). She then proceeded to get up while the speaker was talking to get four more coffees. Like seriously? That and the fact that I threw away practically the equivalent of a tree this morning are probably why this conference is so ridiculously expensive.

 

I then went to a session on autism. It was a pretty good session. A little surface level, and not what I was expecting, but it was definitely a good session. Then I went back to the hotel room because supposedly we were checking out together at 10…hahaha yeah, of course my roommates weren’t ready yet. By the time they were, I didn’t even care that they were super inconsiderate of the hotel staff by leaving stuff all over the room that they had decided they didn’t want. We didn’t split the bill very equitably, but by that point I was really frustrated with them and way too tired to argue and very well may have just paid the whole thing if it would end the conversation about who owes what. I know they gave me more than my share to pay, but I really don’t care.

 

I went back to the exhibit hall one more time. I was so tired that I really just was trying to remain upright, but I did strike up a few conversations. I also found a water bottle and juice mix I really wanted, but the dude at the booth really wanted to give me a bag of barbecue flavored chips (yuck). I wasn’t in the mood to argue, so I took them.

 

I went to a psych and neuro session. I was proud of myself for agreeing to be the spokesperson for my table, but as it turns out, the moderator with the microphone didn’t really care who the table had nominated as the spokesperson, so I didn’t actually have to say anything. I didn’t necessarily learn anything, but I did have a good time chatting.

 

Next I went to a women in leadership session. It wasn’t very well done. Most notable in that session was a woman from France who came up to the microphone at question time and ranted for like ever about how awesome she was and she doesn’t have a question but just wanted to tell us about how awesome she is.

 

The next session I went to was supposed to be about the internet and pharmacy. It was actually about how smart devices are all over and isn’t it awesome how we might have self-driving cars soon? France lady was at this session and took the opportunity to get up an rant again at question and answer time.

 

Then I tried really hard to stay awake. I rode the elevator up to the 30th floor then pressed the button to go back down again. It is probably a good thing that they split up the elevators so that each one only goes to a handful of floors, because waiting for it to come back took forever, and I can just imagine how much longer it would take if people needed to get on and off at each of 30 floors. Someone thought that one through.

 

That is maybe the one thing the hotel does well. The showers have awful water pressure, our bathroom door didn’t close all the way and was super squeaky, there was toilet paper stuck to the walls in the bathroom, the elevators to the floor my room was on usually smelled horrible…yeah, I definitely wasn’t a fan. Also, both at my hotel and the one the conference was actually at smoking and drinking is allowed which means the smell was really nasty.

 

It’s a good thing I planned to be at the airport way earlier than any normal person arrives at the airport…I kind of assume that being just over two miles from the airport that if I book a shuttle for a 9pm pickup I’ll be at the airport around 9:15 to 9:30…umm, yeah…that was very not the case. I had a 9pm pickup, but there was someone else at my hotel with a 9:15 pickup so we waited for them before the shuttle left, then we went to two other hotels further away from the airport before turning around and going back towards the airport, and I was the last one dropped off at the airport at almost 10pm. I could have walked faster than that…not that it necessarily would have been safe to walk at night with so little sleep all week and not knowing exactly how to get where I was going, but it would have been a LOT faster.

 

But anyway, I made it to the airport, had the bag checking guy tell me about how lots of people show up the day after their flight and don’t understand why they can’t get on the flight for the day they showed up so he was glad I understood how flight dates work, made my way through the TSA who were crabby, but at least didn’t make me do anything besides put crap in bins into scanner, walk in a line through the metal detector, then pick up all my crap and find my way to the gate. I found it. I tried to sleep but there were people everywhere and it was cold. I got on the plane. The guy next to me smelled horrendous. I know I probably didn’t smell like daisies and roses by this point either, but I know I didn’t smell that bad…I had at least showered that morning. So yeah, between the smell and the loud people around me, I didn’t really sleep on the plane either.

 

I got home, ate, showered, slept, unpacked (mostly?), tried to do homework…still so tired…I barely got out of bed in time to show up at my rotation site on time…Let’s just say waking up with 20 minutes to get to the car is already challenge before you can’t find your phone or keys…in reality it wouldn’t have mattered if I was late because no one was going to be there to find out, but of course that didn’t occur to me until I was already there.

 

I eat for a lot of reasons: hunger, boredom, stress, exhaustion, just because it’s there…so…hmm…no surprise there why I ate so much at Midyear…although I will admit that I did over-pack on the food front. I don’t have a very good idea of what a week’s worth of food looks like, nor did I know for sure coming into Midyear if there were any free food opportunities with food I would actually eat. Now that I saw how much food I brought back with me versus how much I packed in the first place, I can safely say that while the nutritional balance may have started skewing away from fruit and vegetables, the amount of food that was left is probably at least half of what I started with…I originally packed food because I was told there wouldn’t be time to buy food. In reality, if I weren’t a picky eater buying food would have been easy and definitely possible to fit into the day, and even being picky, I would have had time to walk to McDonalds for most meals if I had wanted to. It ended up being great that I packed food, because at the beginning of the conference I was too stressed out to even think about leaving the hotel to go anywhere, especially not to somewhere that involved standing in line, placing an order, then waiting for it to be ready, and by the end of the conference I was too tired to think about doing anything unnecessary. No wonder I ate way too much…

 

So tired…and I have to be able to present a formal case I haven’t even finished writing yet next week… hashtag overwhelmed.

I cannot hardly keep open my eyes

(sleep-plumb)

I decided Monday night that despite the registration link not working I’d try just showing up and watching the live cast of the event in the hallway because the topic sounded like one I should know about—USP standards. That morphed into deciding to get there in time to see if I could actually get in. Unfortunately, my ability to estimate time is somewhat nonexistent and I looked at my phone at 4:30 and then not again until 5:20, so I had about ten minutes to get ready and actually show up on time. So that didn’t happen, but luckily they started so late that I still got there, found they were accepting walk ins, and had a place to sit long before it started. The breakfast was great even though not much food was left by the time I got there. There were square hash browns which is my favorite kind. The square ones, in my opinion, are far superior to the shreddy ones or the round ones. Also, there was bacon and amazing apple juice. The talk itself was pretty good too. Although I do wonder how my friends at the FDA write up 8.3 things at each visit…lol… Then I almost forgot about the next session I was headed to and so I was a couple minutes late again, and this time I legit was late since they seemed to have started on time. It was pretty interesting, because it was structured as a debate session. I appreciated that it was a topic that I actually could keep up with and have my own opinion, although I don’t think the presenters did a great job sharing their opinion as they debated, rather they spent most of their allotted talking time bashing the other person without including data to support that bashing.

 

I went from there to the showcase. I was actually at the showcase for almost an hour…but a lot of that was because I went to chat with a few people. Also, I saw someone on my way out who told me I really needed to go see a particular program. Being the obedient girl that I am, I did go see that program. I knew pretty quickly I wasn’t interested. It was an adult hospital and while the person talking did tell me that they have a children’s hospital on site, when I asked how much I could focus my time at the pediatric hospital the response was that “for the benefit of the resident” they don’t think it is a good idea for PGY1 residents to be exposed to pediatrics. At that point my ability to be open minded completely disappeared. I had already stated that I was interested in pediatric critical care by this point, so obviously we could have cut this conversation short if you knew you couldn’t offer that. I pretended to actually care about her rant about her stupid program, but if you aren’t interested in letting me even see the ONLY population I have any intention of focusing my service career on in the future then I am not interested in anything else about your program. I know some adult hospitals with onsite children’s hospitals will allow a PGY1 to spend all their time on the pediatric side, so I really was willing to give this program a chance, but seriously? No exposure? Why even bother? That is a huge disservice even to a resident interested in adult medicine, because even in a dedicated adult hospital there will be a little triaging of pediatric concerns as well as the teens and tweens who don’t quite fit in a pediatric or an adult setting.

 

I went back to my room to calm down and try to study, but there were already all my roommates there so what really happened was that I walked in, tried to get ready to study, then walked back out. I tried the exhibit hall again because I figured that was one way to get homework done. The goal for this rotation that I chose to focus on since for AmCare we have to select one of the rotation goals to work the most on, was communication skills. The exhibit hall gave me lots of social opportunities. Sure, I had to feign interest in certain products in order to glean opportunities to practice social skills, but I did it. I actually had some pretty good conversations. I talked with one EnFit rep who clearly was so full of himself that he couldn’t take any criticism and just wanted me to be proud of him for his crappy product, but then I found another EnFit rep who actually was very personable. I brought up to her again about the major problems with their products. My goal was to either keep the biggest issues on their radar or to find out what they had figured out since the last time I talked to them towards the end of my HSM rotation. As it turns out, the rep told me she wished people asked the questions I was asking sooner, because they had had to go back to the drawing board to figure it out. She did show me some of their solutions to the problem. I don’t think the solutions are great—the old syringes are still far superior to the new syringes plus the solution they figured out—but it is certainly a step in the right direction…and I totally understand that most people forget about pediatrics and see a syringe as a way to access an enteral feeding tube and kind forget the reason the smaller syringes exist is because in pediatrics we use syringes for oral administration. I see a few years down the line when the EnFit syringes are all people are familiar with someone coming up with this great idea for a much better pediatric syringe…just like the ones we have now. For feeding tubes I think the new syringes are a great idea so that they lock on to the tubing, but for oral use they are awful. The fix is a step in the right direction, but still isn’t anything close to ideal.

 

I also talked to the First compounding kit people. I let them know about one (of the many) reasons their products are annoying. The rep seemed to actually care about that and I hope they take it into consideration and potentially redesigning the product. Since their goal in being there is to get their name out there I didn’t want to be a negative Nancy, but chances are I’ll have to come here at least one or two more years to be shown off as a resident, so perhaps in future years I can address other issues with the product. I also talked with a children’s hospital that has a PGY-1 program. It wasn’t one I had on my list, and I wasn’t sure why I eliminated them, so I listened to their spiel, and while it sounded like a great program, not knowing what had kept it from my list before, I opted not to add them to my list. If I fail to match and have to apply again they might come back into consideration if they also don’t match, but we’ll see.

 

From there I dropped some stuff off in my room and then to the showcase again. I discovered that there was at least one other internal candidate at my hospital…which was a little scary because I was kind of counting on being the only internal candidate as being a motivating factor in selecting me. I stopped by the FDA booth a few times. When it was manned there were no signs and only one person, but most of the time it wasn’t even manned…lol…I guess they aren’t worried about attracting anyone…

 

I also went to a session on critical illness in pregnancy. It wasn’t what I was expecting—focused on DVT and hypertension management in pregnancy whereas I was more interested in balancing the needs of mom and baby and exploring how various treatments may affect the fetus—but it was a good session. Then I tried really hard to do homework while my roommates kept doing all sorts of other things to keep me distracted. I tried to go to student’s night, but it started at eight and by the time my roommates finally managed to get a shoe on BOTH feet, it was already 9 o’clock. I figured I’d go for a few minutes even though we were late, but whoever planned that event clearly had very few brain cells and if I hadn’t been with other people I wouldn’t have made it all the way in before I left. I love loud music, but that music was too loud even for me. I guess electricity must be expensive, because they had people stationed around the room holding flashlights. There weren’t any snacks or drinks—not even the kind I wouldn’t be interested in anyway. Unless we were just too late and missed it, it appeared there wasn’t any programming except stand around and talk—except you couldn’t do that because the music was too loud. The music wasn’t even good either. I lasted about 3 minutes.

 

Then of course a few hours later my roommates had to come back into the room LOUDLY and chat loudly about all the stuff they got at the exhibit hall. They did that for approximately an hour or so…not sure since I wasn’t staring at my phone the whole time. So yeah, I am super exhausted, but I’m determined that if I paid this much to be here that I am going to get everything out of it that I can.

I also was scared because my roommate started talking about being sick but didn’t seem sick, which might mean the real kind of sick. Lol…when I don’t have much sleep it is really easy for fear to sneak in. I’m fine now anyway though.

 

It’s a big world

(Big World Baby – JJ Heller)

The interview went okay, but was kinda nontraditional—it just happened in the hallway. That was actually really good for me though, because I didn’t even realize at first that the interview was happening. I just thought that we were killing time until my interview time started and then that we would do the actual interview soon. Eventually I realized this was the interview. I don’t think I totally messed it up, but I didn’t really get the sense that they were thrilled with me either. I guess I’ll find out what they really thought when they either do or don’t call me up for an on-site interview. I am scared that I won’t get a residency or that I’ll get a residency and find out that it isn’t really what I thought it was.

The opening session was…umm…mostly a waste of time. There was a little part about Cincinnati children’s that was super exciting because YAY pediatrics, and that is a program to which I am applying, but the rest of it was a big waste of time. The speaker had nothing to do with pharmacy and had nothing to contribute to the conversation. He wasn’t exactly the brightest bulb on the tree or anything. I hope his shoes were interested in football, because that was to whom he was talking…and I came here to learn about pharmacy, not about football. Also, I should have left early when some other people did even though they did specifically say not to do that. Sometimes following the rules is frustrating. Instead I stayed, and ended up stuck in a massive crowd for about 20 excruciating minutes, and hated every minute of it. I was not made for intense crowd situations. I much prefer a little quiet alone place where I can see the action but still be immersed in my little bubble. I prefer to choose when to be open to being around other people than to be forced into a shoulder to shoulder back to front crowd. My primary take away from the event: pharmacy is most definitely NOT a small world. Pharmacy is a big big world and not ever something I want to be in the middle of again. I am very happy to be my one little puzzle piece and get to know the people I am connected with and not be put into the same bag with a million other puzzles.

I want to a session on pediatrics that was kind of nice because I was actually able to contribute. I didn’t feel like there was much of a learning experience, but it was nice to hear what drugs other facilities are using most often. Then I went to a session on critical care. No one at my table was actually working in a critical care setting, but it still was a pharmacy related conversation, and I really enjoyed that as well.

I went to the residency showcase and almost walked out before I even finished walking in because it was so loud and chaotic. I actually spent about 25 minutes there. I started with trying to say hi to two of my friends, but I couldn’t find them, so I ended up saying hi to someone else who was at the booth they should have been at. Then I went to see the three programs in which I was interested and sign the sign in sheet of one of them. It was pretty useless. I did what school told me to do and attended the residency showcase, but I saw minimal purpose in it. There are too many people there to possibly be able to wander aimlessly and find a program to be interested in, and if you already are interested, it is way too loud to be able to get any information, besides the fact that probably you’ll only ever see the residents and not anyone who actually knows anything about the program…so anyway, I finished seeing my programs, went back looking for my friends again, saw that other person again, then left. So glad session one was over. I went to the exhibit hall because my mom said there would be cool swag there. It was kind of a fail. I came away with a pen, a highlighter, a handful of Kleenexes, some papers to throw away later, and two pieces of candy which are now in my stomach. I tries really hard there for an hour despite my lack of success because I figure if I have to be here anyway I might as well make the most of it. Torturing myself might be a good thing because if I can handle that then a little stress in normal everyday life will be like nothing. Then I went to a reception which was WAY better than the one the night before. This one actually had real food!! I was too stressed out from constantly being surrounded by people to eat as much as I wish I’d eaten, and as soon as I got back to my room I started eating the snacks from my suitcase, but it was a lot more enjoyable since I wasn’t both starving and exhausted. Just exhausted is at least a little easier to deal with. I also appreciated that someone else admitted that they weren’t a fan of these really loud venues either. I am really proud of myself. I have worked really hard to get through all this. I left the reception because I was so overwhelmed and really just wanted to find somewhere to be alone. I failed at finding somewhere to be alone, but I did manage to find somewhere at least a little quieter, and not being someone who is willing to so easily be defeated, I made myself walk back through the room one more time before actually leaving. I did it!!

I am very glad that I am now like halfway done. Soon I get to go back to normal life, and in a few years I might never have to come here again!!

Also, I was sad today that the sessions I tried to sign up for that sounded fun I couldn’t sign up for because registration closed…sad day…oh well, not the end of the world…besides, I still need the time to work on my formal case which has not been writing itself while I absent-mindedly stare at the wall trying to keep this way over-tired girl awake…after the brain cells used to stay awake there really isn’t much left to do homework which is a major problem. I am also really ready to be done with this place so I can have some alone time. It has been since forever that I have had alone time…even though sitting still in the car to drive isn’t really a great activity, I really look forward to driving to my rotation site on Friday because it’ll be my chance at alone time which I am really craving.

Sneak peak of what I did on Tuesday in case I don’t actually write and post it: Tuesday was a much better day. I still hate conferences, but occasionally the smile on my face was not pretending to like being here. I actually had some great experiences.

You probably think I’m too young

(Just a Friend – Jamie Grace)

I hate how wearing make up feels…and I’m not really a fan of how it looks on me or really anyone else. I think people are prettier without caking on a bunch of colors. I have been wearing it for things like interview though, because I know I look like a middle schooler, so to get people to take me seriously as a possible candidate I feel like I have to put on makeup to try to add a few years to my appearance…no one’s gonna want to hire a middle schooler for a residency, particularly a middle schooler who doesn’t yet have the most refined verbal communication skills and therefore appears to still be operating on a middle school level. From a brief meeting with me I know it is hard to see what is really going on inside my head, and I am working on trying to gain the skills to change that, but in the mean time I need to do whatever I can to win enough time before being written off to show that I really am worth getting to know. Unfortunately, yesterday morning I discovered that my eyeliner applicator had broken…I seem to go through those like crazy and will not be buying the same brand that I currently have again, because some of them haven’t even lasted one application before breaking. I’m trying to use it even though it is broken and use my fingers to make the smudges look intentional, but it is really good that today is my last interview. Two days of make up is more than enough. Maybe for the showcases tomorrow I’ll wear a little eyeshadow or something to hopefully get at least a little extra age appearance, but I am so done with this whole thing.

I might have made a really bad choice…I wanted to be able to do midyear like a big girl, so I didn’t pack skittles…it could have been a really proud experience, and maybe it still will be, but right now it just feels stupid because it took away the best way for me to manage anxiety. Skittles are my Xanax. Staying just a little dehydrated helps me not outwardly show my anxiety as much, but obviously isn’t a wonderful situation. Having a constant supply of other foods helps, but nothing really has the same power as the quick sugar and flavor rush of a bag of skittles.

Getting to midyear was okay…except for how they say you should never touch anything in an airport bathroom and don’t even go near an airplane bathroom…but being a girl, sometimes you have no choice when you know you are going to leak enough to show on your jeans if you don’t do something prior to landing…and then there was so much turbulence that to keep from falling into the toilet I had to hold on to the sink. So grossed out. I survived and lived to tell the tale, but if I have noro next week, that might be why :).

Also, at the airport when I was leaving, some lady held up the line because she was gate checking something but instead of just being a normal person and leaving it at the correct gate check location, she insisted on holding up the line of people waiting to scan their boarding passes to get on the plane because she wanted a baggage handler to come up there so she could show them how to lift her stuff…umm, lady, just sayin’ but no one is going to babysit your stuff while it is on the plane nor is anyone going to pass those instructions on when we land, so either pack appropriately so that your stuff won’t get damaged or realize that you get what you get and you don’t make a fit. Maybe you should drive if you want more control.

In the midst of all my whining about what I don’t like, I do want to mention something I really appreciate. There is something ASHP got right: the nametags aren’t really good for playing with. It is super helpful to not have that one more distraction. On my current rotation my nametag is spinny and feels good on my hands and has lots of bumps to run my fingers along…not good for acting professionally. The ASHP nametags do not have much in the way of moving parts, and don’t really feel good on my fingers, and are smooth. It is awesome to not have to consciously think about what not to do with my fingers while around people.

So far I am finding that I was very right that Midyear is so not for me. I need more structure. I don’t like being in charge of choosing which events to attend when there are lots of things I feel like I should do or want to do all at the same time…and feel like maybe I shouldn’t do any of them and should just study. More importantly, big conferences have definitely never been my thing. I see no point in leaving town for retreats and conferences. If the same information could be shared in a brief email or a quick video, then I would much prefer that to traveling to a new location and then being surrounded by people 24/7. I am not someone who enjoys these things and am thrilled that in a few years I might never have to go again. I know I am supposed to be excited…I was supposed to be excited about fall retreats and leadership overnights too, and while I try to pretend I don’t wish I were at my rotation site instead, these events have never been thrilling for me…in fact, most of the time these things aren’t even enjoyable for me. I am not a fan of the sessions I’ve been to so far either. The first one was basically a time to tell us it is okay to ask questions. Thank you for classroom skills 101. I think I got that part in kindergarten. The next one I went to had potential, but the topic wasn’t something anyone at the table I was at really could contribute to. The interview wasn’t awesome. Primarily it was reading from the same website I read from in evaluating whether I was interested in the residency. Luckily I didn’t have to say much. Unluckily, when it was my turn to say something I said really dumb stuff. Luckily, I am pretty sure he circled next to my name the yes that I was an okay candidate. I have one more interview in an hour then I am done interviewing. That will feel good. I think maybe the interviews are a good wake up call that I am still not where I should be in terms of communication skills. There was a communication skills session I wanted to go to but skipped because it was at the same time as another session I went to yesterday, but I did go to the interview skills session. That was also not what I hoped for. It was mostly just a mock interview on stage. Not a right and wrong answers kind of thing, but just a mock interview. I did glean some questions to prepare for while I was there and used my time to think about questions I could ask, but google could have given me similar results in much less time. I went to a reception in the evening. I was under the impression it involved food. I mean, I suppose it did…if you like unidentifiable cheesy blob or unidentified red and brown goo. I was thankful for the cheerios in my purse because all there was for me was sprite (two tickets = 2 cups), itty bitty pudding cups, crackers, and the like 6 grapes they put out at a time if I got to them first. To get to said food you also had to do some acrobatics to get across the room. It was way too loud in there to have a conversation and eventually I was thrilled to find someone else who would leave early with my so I could escape. That party was a really hard experience, but I did it.

To be honest, once the shuttle pulled away from the airport I wanted to give up and ask them to turn around and bring me home. It was so overwhelming. I now know that I definitely am not interested in any job no matter how awesome that requires me to spend a lot of time in this city.

I have also very quickly learned that Vegas is a very bad place to be if you have a hole in your retina and really need to be aware of whether you are seeing flashing lights…everything is flashy everywhere…or at least it seems that way to me…I am not sure if I need to emergently see an ophthalmic surgeon while I am here or if everything is supposed to be flashy…it is also hard because I am so exhausted and when I am exhausted I also have issues with perception. The casinos are flashy, the billboards are flashy, the outside is flashy. Thankfully I don’t have to go outside again until I want to go to McDonalds or the airport, so I can limit the exposure to the craziness a little, but there is no way to avoid it completely.

I am glad I looked up that there is a McDonalds in walking distance, because there really isn’t anything for me to eat here. There are no chain restaurants to be found in the food courts, and besides just the challenge of finding something edible in new places, there is the additional challenge of being at baseline so overwhelmed that the idea of standing in a line and then ordering sounds dreadful. Thankfully I packed lots of snacks, but I do recognize that eventually I will run out of nutritional balance even if I don’t actually run out of snacks.

It is really hard to be here. I am so jet lagged (in other words staying up late for no apparent reason besides that someone decided the clocks should say a different time)…Also, the first night, my roomies got locked out because they had their room keys next to their phones so they woke me up around midnight. Then they wanted me to go with them to get their keys re-magnetized so I had to get dressed and go on an adventure to figure that out. I am so tired.

I am wondering if it is possible to get hives from stress. I have been getting what looks like hives on my stomach. I thought maybe it was a cat allergy because in September I had what felt like a cold the five weeks I was exposed to cats and then it immediately went away when I left. Then I came back and soon I felt like I was getting a cold again and in like a week I started noticing hives in the morning (after using a towel that was constantly exposed to cats). The problem: yesterday the hives were still there in the evening when I was going to bed, and I am 99% sure my clothes yesterday were not exposed to cats. I thought about it and realized that the hives seem to correlate pretty well with when my stress was highest…the only problem with that theory is that I’ve definitely had more stress than this before, but never the rash. It also doesn’t make sense that is only on one area and not spreading anywhere else…it almost seems like an allergic reaction to my detergent or something, but even then it doesn’t make sense that my legs aren’t breaking out.

Also I feel scared because there was vomit like all over the floor in the hotel last night. I was doing amazingly well on the germ front, even eating my granola bar after it fell on the floor despite very high levels of stress, but seeing that vomit on the floor was my breaking point…I was not doing well last night. Despite how tired and beyond ready to go to bed I was, I was scared of letting my face touch anything and so I couldn’t go to sleep…Luckily I am no longer so trapped in fear and in like 30 minutes the fear dissipated and by this morning it was as if nothing had happened, but for a few minutes it was terrifying, because being in a crisis while being overwhelmed at a conference would not be a good place to be…

And now I have like 20 minutes until my interview and so I definitely need to think about that and post this later…I kinda want to do a daily post, but IDK if that will happen…especially because I don’t wanna be an annoying whiney pants so if I don’t have anything nice to say maybe I should stop writing…

#uneditedsoyougetwhatyouget

It was only a day and tomorrow’s ahead

(Not done yet – Superchick)

 

“I need a day when the world can take care of itself. This isn’t what I wanted how I thought my life would turn out, and I wonder if it’s like this from here on out. Sometimes life gets you, but you go on.”

 

“It’s just life we’ll win in the end.”

 

“and I wanna give up and let it be what it’s been.”

 

“I got this far and I know that I can ride this one out.”

 

So yeah, today was a rough day, but when I was scripting my conversation in my head in case anyone asked when I got home, I came across these lyrics, and you know, that is a good perspective. Perhaps I was in the car for an hour and a half getting home from school because traffic was so awful, but maybe it was good in order to give me some time to cool off and gain perspective…now that I’ve had some time for a more realistic perspective, I think I will politely send an email to my preceptor about my feelings about this rotation so far and particularly about the midpoint evaluation…might be a more productive use of my time than spending it frustrated.

 

I don’t wanna talk about the worst part of the day, but let’s just leave it at it was bad enough that when I saw people walk past and not say hi and then once I calmed down enough to start texting people to hang out and the no’s came in, I felt invisible and unwanted. I considered going home immediately because I was so upset, but since I don’t make it to school frequently, on the off chance that anyone was around to talk to, I went off looking before I gave up and went into isolation mode. A lot of people actually weren’t available, but I did successfully find one person, and I got to meet someone I’ve been trying to meet for a long time, and then I talked to one more person, and I may have responded to the conversation started of how’s it going with something super negative like I hate life right now (of course with my make everyone happy personality this was quickly followed by a disclaimer that prior to today I had loved my first few rotations). However, by the end of the conversation, I was genuinely smiling, and felt okay. I wish I lived in Jones Hall. There are a lot of people there who are really nice. Then I found someone else to talk to on my way out. It was good. I still feel really frustrated and unhappy and overwhelmed about the situation with this current rotation, but it was a good reminder that I needed that there are good people in the world. Sometimes when I am surrounded by constant bad experiences it is hard to remember that there really is good. Not that the nebulous idea of there being good somewhere makes the bad any better, but at least it gives me a reminder that there is a possibility of someday experiencing a ratio of good that is more in my favor.

My dreams are like dust in my hands

(the waiting – Jamie Grace)

Sometimes I hate life and just wish I could give up.

Yesterday I was late for my journal club presentation. I drove as fast as was legal…okay, a little faster than was legal, but didn’t have time to get from clinic to school by the time I was supposed to be there. Being an excessively early person, that did not help the fact that I HATE presenting. Nor did the fact that as a result I didn’t get to finish eating lunch. I crossed the street without looking both ways because I could get to school faster that way, and it would have been totally fine with me if the bus that I came close to colliding with had actually ran into me. I also didn’t lock my car, because that also takes an additional 15 seconds that I couldn’t spare. The presentation itself went great.

Today I was going to get to catch up with someone awesome and was really excited…then things fell behind in clinic (not at all my fault–I was working super efficiently). I didn’t get my work done and I barely made it to school in time for the meeting I absolutely had to be at. The meeting was my midpoint evaluation.

I am really frustrated. I don’t want to be told that I am awesome…I mean, I do, but not if that isn’t what you really think. I felt upset in the meeting because I felt like all we did was talk about setting goals–I wasn’t there to set goals, I was there to find out what I needed to do differently to get an A on the rotation. The only what I am doing now that we actually discussed was that I had done a really good job.

I was overwhelmed with everything else in the rotation already. I looked up my evaluations online. Well, she might have told me that I was doing well, but the evaluations said I was lousy. I’d much prefer the grade be awesome and the words say I suck than vice versa. Please pardon my language. I shouldn’t use bad words to express my frustration, but right now I am too frustrated to care.

In a couple days I have to go to Midyear. I don’t want to. I hate everything. Not true…but I am super frustrated.