Out of the Mouths of Babes...

Hey Everybody,

I'm blogging today from Jai's hospital room :-(. She was admitted on Sunday for treatment of an asthma exacerbation. She has been what we call a "wheezer," requiring albuterol nebulizer treatments as needed, since she was about two. They don't like to label kids under 6 (i think that's the right age) as asthmatics for insurance purposes as they may wheeze but not actually have asthma. But I think the verdict is in for jai; she has asthma. She began having symptoms on Saturday evening that worsened Sunday morning, so we decided to bring her in. I thought that she may need continuous nebulizer treatments but I had hoped that we could avoid it. On admission, her chest was so tight that no wheezes could be heard (all bad). So she was placed on 40% oxygen with continuous nebs. They tried to wean her off the continuous treatments last night but she began to drop her oxygen saturations, requiring oxygen via nasal cannula. She subsequently started to retract or use her accessory muscles to breath, so they had to put her back on continuous nebs.

Needless to say, these last few days have been a whirlwind for us. I thank God that my residency program and the people that I work with have been so understanding, allowing me to take the time off to be with my little love. They have been constantly checking on us to see if we need anything and even brought Jai a card, bear and balloons. I've also gotten wonderful support from my family and all of you who have sent messages and texts to check on us. Your concern has not gone unnoticed and I appreciate all of the prayers for her speedy recovery more than you all know.

Jai is just ready to go home. Today, she told me that the doctors keep saying she has to stay on this mask and that she can't eat but they don't know how it feels because they don't have to wear it. That is quite a profound statement coming from a child. Y'all know I try to find the lesson in everything and I am pretty sure that that is my lesson. As a doctor it's easy to say that the patient should just take this medicine or remain  NPO (nothing by mouth) for days because that's what best from our perspective, but we have to take the time to put ourselves in their shoes. It's very easy for you to say someone should do something when you aren't the one who has to do it, or suffer through it.

I also learned the importance of explaining procedures to patients from another comment that Jai made. They had to draw some blood from her IV line and she told me that the doctors were gonna make her dead because they keep taking her blood. Of course, I was extremely disturbed by her thinking she was going to die. I had to explain to her that they were just getting a little blood for lab work and not enough to hurt her. I also explained that her mama would never let that happen! I wouldn't even allow the phlebotomist to stick her again for blood this morning and told them they'd have to try to draw it from her I, as they had to stick her THREE times on admission. I wasn't going to let it happen again. (I know...Doctors make the worst patients (and patient's moms!)).

I always say there's a lesson in everything and I've already learned quite a few since being here. Ultimately, I just want my sweet baby girl to get better and get back to normalcy. I hope that you all will continue to pray for her and I'll do my best to keep you all posted.

Sorry for the short, stream of conciousness blog this week!

Mahogany Pearl: "Never be afraid to trust an unknown future to a known God" - unknown

Love, Your Favorite MD,

Keisha B.

Your Attitude Determines Your Latitude

Hey Y'all!!

I've made it to the middle of my 2nd rotation! The days since my last blog have been quite eventful. I finally got into the OR and did my very first c-section as a surgeon! I was so nervous that my hands were shaking. I told y'all I would probably be like a bumbling fool in the OR and I was! Thankfully, my upper level was very patient with me. One thing that I really liked about our program here at the U is that we get to operate during our intern year. You have to wait until the second semester or even 2nd year in other programs. They only allow the interns to assist, i.e. retract. I prepped the patient, scrubbed in and my senior and I draped the patient together. After we were all set to go, I just knew she was going to do the whole thing since this was my first one (we're all about "see one, do one, teach one" at the U). But, to my surprise, she immediately said, "Knife to Dr. Bell." I was PETRIFIED! I had been studying the procedure like a maniac, but my mind went totally blank. Thankfully, she was there to guide me. She would ask me what instruments I wanted next, advise me as to how to properly dissect, etc. I really liked that she would give me constructive criticism when I needed to improve and tell me when she thought I did a good job. I tried to liken myself to a sponge and absorb everything she had to teach me to ensure that I improve and that I don't make the same mistake again. It was an AWESOME experience!

I think I've gotten better at my duties as OB-I and I take keeping "the book" very seriously. I've even developed a color coded system (I know, I know...I'm lame! LOL!). I've always taken any job that I have seriously and do the very best that I can in my capacity. Therefore, I really enjoy getting the calls to schedule patients for their inductions or procedures. EPIC frustrates the heck out of me sometimes though because it won't allow me to do a lot of the pre-admission work days before hand, as I would prefer to do it. But I'm sure that's just me being anal. I'm also enjoying the other facets of my role this month. I've learned how to round more efficiently so that I can get a few extra minutes of sleep in the morning! I'm also learning how to be more efficient in clinic so that I may see more patients. Clinic is very fast-paced, but I'm enjoying it.

On an entirely different note, if you remember my last blog, you remember me speaking about my "test" a few weeks ago. A new test came this week when I was told by someone at work that I come off as if I have an attitude and have been perceived by many to be giving attitude. Of course, it upset me because I don't knowingly give anybody attitude at work. There is more to this ordeal that I don't want to go into, but it made me do some soul searching. I know that I am a very serious person. I'm not one who is very giggly and playful and I can be very intense. My brothers call me Eva (as in Deliver Us From Eva) because I'm very blunt, straight forward and sometimes brash. I never mean anyone any harm, I'm just very direct. I think it comes from being the eldest of 8 children and a mother. I've acted as a mother figure for most of my life, standing in for my mom when she was working her butt off for Ameristar. So, I've always been really serious. People who don't really know me can take this as attitude. Even in silence, I could be thought to have an attitude or be angry. I also know that if someone raises their voice at me, my natural reaction is to raise mine as well. But most of you who really know me know that if I REALLY had an attitude, EVERYONE would know it! LOL....but seriously, I don't hide my feelings well.

I've realized that I have to be more mindful of this but, I also hope that people will take the opportunity to actually get to know me so that they may see that I'm definitely not the intern with the attitude. That is far from who I am. I am here to learn and I want people to want to work with me and teach me. Being perceived in this way will get in the way of my training and I refuse to allow that to happen. While I don't feel that I should have to change who I am for other people, I do have to be more aware of the "aura" I give off. I know for sure that I will have a good working relationship with those who choose to actually get to know me. Assuming that a person is a certain way and not taking an opportunity to get to know them is an injustice to that person and sometimes not getting to know them can be your loss. (That lesson is for me as well.) So, I'm praying about it.  This whole experience is a learning experience. I learn something new everyday. I try to get the lesson out of everything so that I can become not only a better physician, but a better person.

On a much lighter (and exciting) note, Jai started Kindergarten this Monday (see pictures below)! My baby is a big girl now! She looked so cute in her little uniform and she was so excited! She got out of the car and almost didn't say goodbye! She really enjoyed her first day and talked a mile a minute when I picked her up from aftercare about all of the awesome things she did! I can't believe she has grown up so fast. I love that little girl. She keeps her mama sane! She is also what keeps me going when I feel like this thing is getting tough! I'm so thankful for her presence in my life. Who am I that He would have blessed me with such a wonderful treasure??

That's all for now. Keep praying for me, y'all!! I need it! :-)

Mahogany Pearl: "The most important thing in communication is to hear what isn't being said." - Peter F. Drucker

Love, Your Favorite MD,

Keisha B. :-)

New Beginnings

Hey Everybody!!!

I made it through my first month!! There are many times when I thought I wouldn't, but I did. It actually went by much faster than I thought it would. I hope the remainder of my intern year feels that way. I am now the OB-1 (or OB-1-Kenobie as one of my favorite friends called me). I am the keeper of the coveted black book in which scheduled c-sections, inductions of labor, scheduled dilation and curettage and cerclages are scheduled. I have to post the scheduled c-sections on the OR schedule, do pre-op orders, write H&Ps, ensure patients are properly consented, etc. I also have to present these patients at the board at morning sign-outs. In addition to that,  I also round on post and antepartum patients in the morning, getting to the hospital at 4 AM. My favorite part is that I finally get to operate!! I'm sure I'll be more like a bumbling buffoon at first, as I haven't been in the OR since last October, but I look forward getting in there and learning how to be the best surgeon I can be. I also get to go to OB High Risk clinic, where patients with high risk pregnancies are seen. I look forward to having a little bit of continuity with patients, getting to see them on a weekly basis, unlike in OB Receiving. I actually did have a few frequent fliers there, but it's an ER so there is no real continuity.

I started in my new position last Thursday. I shot out of the bed when my alarm clock went off at 3 AM because, as anyone who knows me knows, I HATE to be late! Rounding actually went really well. I like my rounding team which includes the OB-III, a third year, aka my BUDDY (she's awesome), the intern on clinic and the House Officer-I, aka the HO-I. The interns round on all of the patients, then we present them to the OB-III so that she may update the list and have it ready to present at sign-outs. On days that I don't have clinic or surgeries, I go to OB Receiving to help my intern classmate who is down there this month. I actually miss OB Receiving!! I know it sounds crazy to those of you that I've actually spoken to about the experience, but I do miss it. I learned so much down there. OB-I is a much more slow paced position so it was weird to go from running around like a chicken all of the time to actually being able to grab some lunch. I enjoy going down there, helping out and seeing the wonderful nurses who carried me through last month. Did I mention that they are AWESOME?!?!

On another note, I got my first "test" last week. When we started, someone said that this year would be like a constant "rush" or "hazing" process; from people talking crazy to you to walking past you and not speaking. I don't care about anyone not speaking to me. I'll speak initially but if you continue to not speak back, I save my breath as I may need those breaths to say something to those that I actually love when I'm on my death bed. Honestly, it takes more energy to purposely not speak to a person than to just say hi. It's just so stupid. But, anyone who knows me well, knows that I don't really take people talking to me sideways very well. Many times, I will say what I want to say in response without thinking about it. I had hoped that no one would every speak to me in a way that was disrespectful, as I believe that regardless of one's level, everyone deserves respect. I am, after all, 29 years old and I am not a child. I put my "clown-suit" in retirement before residency started because I didn't want to be "that girl" who has the attitude. But I almost dusted it off last week when someone called me and talked to me in a way that I would never talk to anyone about what I "better learn to do, etc." It took EVERYTHING I had not to bless that person from here to next week. I was so angry that I cried because I had to hold in what I really wanted to say. But what I really wanted to say would probably have gotten me put out of the program. Y'all know that I am one of the sweetest people you could probably ever meet (at least that's what I've been told) but I come from a long line of women who don't take crap from anyone and when something like that happens, that side of me comes out and it's really not one anybody wants to see. I am from "VERNDITION" (virden addition, LOL), after all, and I don't do passive aggressive; I do aggressive aggressive.

I have no problem with constructive criticism and correction, but I do have a problem with being spoken to as if I'm less than you or as if I'm a step-child. While I may be an intern, I'm an adult with a 5 year old daughter, so I'm far from a child and I don't even speak to my child that way. This is my 2nd month. I still have a lot to learn but I will not be spoken to like that again. I had to leave and pray so I wouldn't do or say anything that would hinder my progress. What I learned from that situation is what I do not want to become and how I will ensure that I will not behave. Being an upper-level doesn't give one the right to be disrespectful. My normal reaction in situations like that is to "read" that person and then act as if they no longer exist, because I don't do 2nd chances. I know that's not right. I'm praying about it, but I always thought it was stupid to allow people to treat you badly over and over again. Yet, I know there's a big lesson in this, as I know that I have to be able to work with this person and I'm sure this person won't be the last in my career. I'll just have to keep praying that my "knee-jerk" reaction never comes through. Please, don't get me wrong, there are many sweet people that I work with; upper levels who have helped me so much and are the sweetest things ever. I've learned so much because of a lot of them. Even this person has been nice at times, but sometimes it only takes one incident to really throw your experience off. What I also realize is that sometimes people have things going on in their lives as well that cause them to say and do things out of character.

I hope that y'all will continue to pray for me, as I am presented with new challenges everyday. Knowing that this is my calling keeps me going. I enjoy working with the patients, my classmates, the nurses and the upper levels who strive to teach me and make me better. I pray that I just keep my eye on God and my goals and not allow people to bring me to a place of anger where something can be said that causes me more harm than good. After all, people can say what they want, but I am the only one in control of my response. It's all a part of my journey and I'm sure there's something He wants me to learn from it. I'm determined to learn all lessons that He has for me to learn! :-) One month down 47 to go!

Mahogany Pearl: "A closed mouth gathers no foot."

Love, Your Favorite MD,

Keisha B.