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Dear all,

How do you tell when you’re REALLY stressed? You make three different food things over the weekend. I made candied almonds on Friday, Oreo truffles on Saturday, and just now I finished baking black bean brownies with M&Ms. I’m not eating it all of course, gods. But the fact that I needed to do that plus take a 3 hour walk on Saturday shows how incredibly stressed out I am…burned out, too. But it’s okay, I only have 5 more weeks of surgery/emergency, then 3 weeks to study for Step 2, and then I can FINALLY have a break. Come on, Annette, fight on!

The week started off with a bang already. It was a clinic day, and one of the patients I saw came in with severe abdominal pain that timed with her periods.


My senior wanted to get an Xray, though, and lucky she did: they found she had a friggin’ VOLVULUS, and her large intestine was twisted around her uterus. Uhh, that isn’t very common, guys.

She was supposed to go to the hospital STAT to get a CT and, you know, get stabilized before surgery.

But there was tons of paperwork that needed to be done. She was a 9 o’clock patient, and I had to leave for my standardized patient encounter at 11. When I came back after lunch, she was STILL there. And when we left for a conference at 4, she was FINALLY getting onto a stretcher to go to Upstate. Like seriously, she could have walked there and gotten there faster. It would have been super painful for her, but faster.

She ended up having surgery the next day, to take out her entire sigmoid colon. But no colostomy bag! She’s only 29, and that was one of her main concerns. (Honestly, I’ve never seen so many colostomy bags than in the last two weeks. So many. Most of the temporary, but so many.)

Also got to see another breast implant surgery on Tuesday because the patient’s old left implant had burst. But, since she didn’t want anyone knowing she had implants, she came in to get the fixed just like they were before.

…Okay, I’m happy that people can get implants to make them feel better about themselves and stuff. But it’s still super strange for me when I see this 65 year old grandmother have perkier breasts than me…and I know that’s just my fault for thinking this way, but…age gracefully, dammit. “OTL (She wasn’t a cancer patient, either. She just always had implants and didn’t want her two ex-husbands, current boyfriend, or 5 children knowing that. But okay madam, YOLO.)

Wednesday was probably the worst day of surgery for me. I was super tired and hungry, and upset because Donald Trump was campaigning in Plattsburgh AND Syracuse, and I was sick and tired of him existing. I hate politics. I try to stay away from it in life and on this blog, because I don’t like starting fires, and I prefer leaving calm debates to well-versed people like Harsha. But that day was different. That day, the scrub tech somehow brought up how if Bernie Sanders doesn’t get the nomination, he’s going to vote for Trump. The anesthesiologist (who is not the cute anesthesiologist from last week, and he actually hasn’t been around all week, unfortunately) immediately said that was super stupid. I mentally agreed, but kept my mouth shut.

Scrub tech said something along the lines of it’s fine if he does it, because it’s his right to vote and it won’t change anything because Hilary would win New York anyway, etc. etc. etc.

Then I opened my big fat mouth and whined, “Whyyyyyyyyy do you think thaaaaaaat.”

I shouldn’t have, but I got on my soap box of “if everyone thinks that way, then Trump WILL win New York, and then I’ll hate everyone and everything and admit myself to 4B for suicidal ideation because I won’t want to live in this world anymore.”

Tamara was super wise and didn’t say anything, instead helping our senior, who was also silent, finish suturing. But I kept blabbing on and on as the anesthesiologist and scrub tech kept arguing. And right after the patient was ready to leave the room, my senior scrubbed out and announced, “Well I’m voting for Trump and I don’t care.”

I clamped my mouth shut and didn’t speak anymore. If she gives me a bad evaluation, it’s okay, because I can just say she was discriminating against my political stance…but still, that was a valuable lesson for me. No matter how tired, how stressed, how burned out I am…don’t talk about politics. It was also super unprofessional of me, and I’m ashamed of myself for speaking so bluntly and irrationally while working. Ugh, I’m so immature sometimes.

Thursday was even more tiring. I had that same scrub tech but kept my mouth shut the entire procedure. Then, in the evening, us surgery folk went out for burgers at Blarney Stone. I had gotten a ride from Helen and Patrick and didn’t have my ID…even though I was wearing my badge that says “MEDICAL STUDENT”, the bouncer didn’t let me in initially, and I was turned back where I ran into that hot psych resident (who is getting less hot each time I see him, not sure why, hahahaha) and his girlfriend. We went in through the side entrance to maybe run into a nicer bouncer? He still didn’t let me through until his boss was just like, “she looks sketchy, let her in”.




Anyway, that’s not the only amusing thing that happened. After getting my burger and 10 wings and devouring everything like the pig I am, I went up to order food for a friend who was coming later, since it was packed and waiting in line to order would take 15 minutes and another 15 for the food. As I waited, I neared the table where the residents were sitting with two other people I didn’t recognize. I overheard his girlfriend say, “There are some third years I hope go into psych!” energetically. I turned to them, pointed at my face, and said, “Am I one of them?!”

She kind of laughed awkwardly and kept talking to the people at the table. Hot psych resident was actually standing behind me and didn’t say anything.



But actually, speaking of that…Dr. Schwartz said something pretty profound at our meeting last week. He told me to pretend that it was a 5 PM on a Friday night, and that I had to choose one more patient out of three before leaving. (Or not choose any at all, but that’s not the point of the test.) Would I stay behind for the sinusitis patient, the schizophrenic, or the broken leg? I was musing over that question for the entire last week, and I think I finally decided that I’d go for the schizophrenic. I’ve slid off the fence and into the psychiatry camp. For now, though; let’s see what happens in a month, hahaha.

So after that fun awkward thing, gods why am I so awkward, we kept talking about how much it sucks that we’re stuck in surgery. Then we left at, like, 8, because we had to be in the hospital before 6 AM. Partying hard, guys, partying hard.

On Friday, I attempted to give blood at the blood drive for the first time in my life. I remember trying once at McGill but they wouldn’t accept my blood because I was anemic, but without a firm number. But that day I got concrete information: my hemoglobin was 10, way too low to donate, and shouldn’t I be taking iron pills or something? Hahaha. The woman who measured it said that next time, a way to cheat is to eat a tablespoon of molasses the night before and morning of donation, and that would make my iron rise enough to pass. Isn’t that like doping, though…? I still want to donate, though, since I’ve seen how much blood is used for patients here, and it’s really opened my eyes to the need. But I don’t know if giving unhealthy blood like mine is good for patients. Hm.

Anyway, I was super tired on Friday evening that I didn’t want to do anything except eat newly made candied almonds and read for fun and sleep, instead of going out to celebrate with the rest of the class. (I HAVE NOTHING TO CELEBRATE.)

On Saturday, I went for a three hour walk in the sunlight, being very careful to avoid any crowds and patriotic music, because even if there’s someone I detest less than a mile from me, I’m not going to let that stop me from getting much needed vitamin D.

Today I’ve got a boatload of stuff to study. I’ll probably head to the library shortly because I have too many distractions here, hahaha. Actually, maybe I can study outside, because I just need my Kaplan book and a highlighter. Yeah, I’ll do that instead.

Anyway, congratulations to all my classmates who finished third year! We’re so close to being physicians…all this pain will someday be worth it…one day… “OTL Meanwhile, I’ll be here next week, after my subspecialty week of anesthesia! I’m looking forward to how chill people say it is, haha.

Most Sincerely,
Annette Liem

~Sarcastic Quote of the Week~
Anesthesiologist: Well, well, well, if it isn’t Dr. Nsouli’s daughter and…the Trump assassin.
(Disclaimer: I never said I wanted to assassinate Trump, nor that I would hire someone to assassinate him. But you know, if he becomes president, and ruins the world as we know it, there will be some people who will say, “We should have killed him when we had the chance.” Like they do for a certain person who once terrorized Europe.)