day 5

day five, a song that is often stuck in your head:
for some reason, it's always this one...

preach, Freddy Mercury. preach.
and i dare you not to bang on your steering wheel during that drum riff near the end... 

in the interest of full disclosure,

i felt i should share the following with you

i received this touching series of texts today.

and no follow up "jk i love you" text

as you can see.

not all hearts and roses up in here.

real talk.

from someone who, apparently, does not rock.

songs and stuff

day four: a song that calms you down

i don't know if you've noticed, but my life can often use some calming influences
so i can't just pick one song
i have an arsenal of them
all on one playlist.
i'll spare you the full gauntlet, but here are three of the more effective ones


soothe me, Norah.


Yamagata and Lamontagne. damn. i literally cry when i hear this song sometimes.


i don't think i really need to say anything else about Bon Iver.
but I will. because i've literally spent the last hour and a half
watching their Radio City Music Hall concert
(via YouTube on the new behemoth television. lemme just say...wow.)
so basically i've been experiencing goosebumps for 90 minutes.
care to do the same? here you go.


in my drunk-on-music, uber-contemplative state,
i've been thinking about the past few days
and how i just can't shake this incredibly happy feeling i've got.
my job is challenging and fulfilling, though gross and stressful a lot of the time.
and i get to do life with this guy

 why yes, that IS eggroll grease right near my belly button.

 we're better candid.

and Target makes the BEST fake leather jackets.

even working nights is turning out to not suck.
going to work at 11pm means i can be this guy's date
to both a rehearsal dinner and a wedding on Friday and Saturday nights (respectively)
i earned major street cred with the boys by doing that, bt-dubs.
they were all, my wife would NEVER be out if she had to work later.
there were even two sweet comments from my hubby...unsolicited and everything


driving in the car on the way to the rehearsal dinner,
after i put on this song and started rapping along with it

putting on my emphasis on the "ain't nobody gonna die today" part
(i mean, obviously. remember what i do.)
he looked at me and goes
"you know, you'd be impossible to replace if anything ever happened to you.
you're pretty hardcore."


oh so THAT's why.


then he randomly thanked me for cooking dinners for him
to take to work all last week.
"you have no idea how nice it was to have homecooked food."


warm fuzzies, all around. yes?

shit ER patients say

i know you're not supposed to talk about religion or politics in public.
but if you ever find yourself in my parents' home,
they'll consider it a private residence
and open fire.


i kid. but seriously.
my dad is passionate about politics.
and we have differing views.


this time of year, every four years,
is...interesting.


segue: day #3, a song that reminds you of one of your parents

i have a distinct memory of riding in the car with my dad...

and, as i told you before, we were a strictly-Christian-Contemporary-Music family

but this song came on the air

and my dad started singing every. single. word.

this was the moment i knew my dad was the coolest.

and it stuck with me all the way up till my wedding

and ill-fitting though it may seem,

this was the song my father and i danced to at my reception

it's a long-ass song.

so after 2 minutes or so, everybody joined in.

moving on...

without broadcasting my political views on the blog
(which, admittedly, are poorly thought out
and primarily based on knee-jerk reactions
and personal experience. i've been a little...busy...for the past few years.)
let's just say that i'm an advocate for the 47%
they are the reason i get up and go to work in the morning.
it is my honor and privilege to serve these people
who have nowhere else to go.
some may call them "freeloaders"?
pretty sure the words Jesus used were "the least of these".


but i digress.
they still find themselves in ridiculous situations.
rich and poor alike. insured and uninsured.
everyone has predicaments.
and i'm here to document them.
devoid of any and all identifying information, of course.


so without further ado:


patient: "i feel like a baby is sitting on my chest"
me: "a baby?"
patient: yeah. i know people usually say it's an elephant. but for me it's a baby.
....

me: do you have any medical problems?
patient: no.
me: then what are these 12 medications you're taking for?
patient: well i USED to have high blood pressure and high cholesterol and diabetes. but now i take all those medicines. so i don't have those problems anymore.


pregnant patient: is it true that if you do this [patient is standing. bends knees and gyrates hips as if using a hula hoop] then yo baby cord be wrapped around its neck?
me: no.


me: so tell me what brings you here today?
patient: this is the worst day of my life. i was just driving along and some dude sideswiped me and now i'm here.
me: the chart says the police brought you here...because you were driving drunk? and you wrecked your car?
patient: well, yeah.


me: tell me what happened?
5 year old patient: i got hit in the face with a soccer ball during my soccer game. then i got a headache. then i threw up.
me: i'm sorry you didn't feel good. why do you think you threw up?
5 year old patient with frowny face: i think i ate too many sweets.


God Bless America, friends.
and God bless us, everyone.

DNA repair

no, I haven't discovered a cure for cancer.

this post is about makeup.

i know.

it's a doctor's blog.

could've gone either way.

but i digress.

remember when i said i was getting sponsored?

this post is about one of the perks.

SkinCareRx sent me a free product.

and i'm here to tell you all about it.

this is a sponsored post.

did you get that?

me. sans makeup.

so here's me.

post shower, pre makeup.

this is a tale about my daily beauty routine.

 here's Neova DNA Damage Control.

say hello to my little friend.

so it's kind of got the consistency of liquid foundation, only thinner.

prior to trying this stuff, i'd jumped on the BB cream bandwagon

and i wasn't entirely unhappy

it's just that my face got all greasy with the BB cream

in this insane Texas heat

not so with DNA damage control

post-application of DNA damage control

in medicine, we'd say "status post" application of DNA damage control

because we're huge nerds.

anyway. see my face?

not shiny.

sorta glowy.

still see my skin and not a crazy amount of foundation.

best part is, this stuff has SPF 45 and a moisturizer in it too

i love tools that multitask.

meet the rest of my beauty routine:

Lorac POREfection in PF5

MAC bronzing powder in Refined Golden

MAC eyeshadow in Paradisco and Mythology

MAC eyeliner in Smolder

Maybelline Volume Express mascara in Very Black

Smith's lip balm in Minted Rose

and some assorted brushes

and here's the finished product

my skin has a lot of imperfections

this is a product of growing up in Florida. basically on the equator.

once, somebody told me "your face looks like one giant freckle"

super cute.

but i embrace the imperfections, instead of caking makeup on to cover them up

this DNA damage control is perfect for that

a little coverage, but still mostly me.

make a gif

i blow kisses whenever i can.

which is not often.

oh, and remember when i said i was doing 25 Songs, 25 Days?

i keep forgetting.

but here's day two: a song that reminds you of your most recent ex

my "most recent" breakup was in 2007. super recent.

and this song was my ringtone whenever he called.

gosh i love Death Cab for Cutie.

"What Sarah Said" was my theme song in 2005...

which was the first year i worked in a hospital

but anyway. don't you love this song?

some thoughts

 this is a shot of my boys this weekend.

Waylon is growing up.

clearly.

let us not forget how he looked a mere 3 months ago.

be still my heart

this weekend was perfectly simple.

i worked all weekend, but a different shift every day

so we married folk got in lots of hangout time

at random times

friday night we ordered Thai food

and watched two movies on Netflix

and stayed up way too late

saturday morning we slept in like woah

then went to Cracker Barrel for breakfast brunch

i worked an evening shift

then came home at midnight 

just in time to catch the end of "Obama Revealed"

and the beginning of "Romney Revealed"

and we stayed up way too late again talking about politics

sunday we slept in again

(this is the beauty of working nights. the sleeping in. oh is it ever glorious.)

then watched some football

enjoyed the rare San Antonio rain

ordered a pizza

chatted argued with my dad about politics (on the phone)

went to the hot tub

watched some more football

grilled some steaks

then i went to work again.

i got to thinking about how nice this life we have is

i don't always feel that way about it

so i feel like i should document it when i do

to help me remember

that this time when it was just the two of us

was precious

and special

something to be treasured.

someday

our babies will be born

and life will be brand new right along with them

i look forward to it.

someday.

but for now

we have this.

our own little kind of wonderful.

and i kind of love it.

nerding out

[via]

i don't often talk about my job on this here blog

part of that is due to the fact that my patients are real people

and God forbid i don't do a good enough job covering up any identifying information

and they read this blog and realize i'm talking about THEM

not cool.

not professional.

not gonna do it.

especially since my major defense mechanism in dealing with the stress of my job

is humor.

sometimes you just have to laugh at the situations people find themselves in.

it's how i cope.

and sometimes, the stories are really funny.

but not everybody gets that.

so i just avoid the topic all together.

but it occurred to me that, in all other things,

i try really hard to be honest on this blog.

so for me to completely leave out what i do,

is pretty much a lie of omission.

so in an effort to open up about my job,

here's a little story about medicine

and how great it works when you use it right.

(let's see if i can make this make sense.)

the other night, a patient came into the ER

(duh. where else would i be?)

he was complaining of chest pain and saying he couldn't breathe

i believed him, because he looked like shit

grey, diaphoretic (sweaty), clutching his chest,

using all of his accessory muscles in his chest and neck for every breath

and his oxygen saturation was only 72%

he said he was diabetic with high blood pressure and that he had asthma

i listened to his lungs while a tech got an EKG

his lungs sounded really junky (rales is the dr. word), like they were full of fluid

not really wheezy, like he was having an asthma attack

his oxygen saturation got better with a face mask...now 100%

the EKG was really poor quality, 

since he was using so many of his chest muscles to breath

but it showed he was having a heart attack

and his blood pressure was thru the roof: 237/138

crazy high.

and his heart rate was in the 140s

we gave him a Nitroglycerine tab under his tongue

and Aspirin to chew

and tried to get a better quality EKG 

so we could decide if we needed to activate the cath lab

the repeat EKGs were more normal, and argued against him having a heart attack

but his blood pressure and heart rate were still crazy high

and he was still working to breathe

even though the subsequent EKGs looked better,

the patient still didn't. 

and it was hard to ignore that first one.

so we activated the cath lab and the cardiologists were on their way in

in the mean time,

we started a nitroglycerine drip

and put him on a BiPap machine to help him breathe

here's why:

Nitro(glycerine) works to dilate your blood vessels

this is good because it makes all the vessels in your legs and arms larger

so they accept more blood and take it away from your heart

this makes it easier for your heart to work

and decreases your blood pressure

nitro also specifically dilates your coronary arteries

this helps more blood get to your cardiac muscle

which is good when you're having a heart attack

(that's the chest pain you get during a heart attack: 

the cardiac muscle starts to hurt as it dies because it's not getting enough blood)

so Nitro: lowers blood pressure

makes heart work less

gets more blood to heart

make sense?

BiPap is a machine that attaches to a face mask

and it blows air into your lungs

lots of air when you're taking a breath

a little less air when you're not taking a breath

this helps keep your lungs open, so they don't collapse when you exhale

this pushing of air into your lungs also helps keep fluid out of them

the air is there, so the fluid can't be

(i'll explain more about fluid in the lungs in a sec)

back to our guy:

by the time the cardiologists arrived

the EKGs had totally normalized

the patient's lungs were crystal clear--no fluid or rales

and his blood pressure and heart rate were lower-- 170s/90s and 80s

now, as a refresher, this is the path that blood takes around your body:

deoxygenated blood: veins-->vena cava-->right atrium-->right ventricle-->

pulmonary arteries-->lungs

oxygenated blood: -->pulmonary veins-->left atrium-->left ventricle-->aorta

-->arteries

turns out, he wasn't having a heart attack

he was having what we call a Hypertensive Emergency

basically, his blood pressure was so high

that his heart couldn't effectively pump out blood against all that pressure

this was causing the blood to back up into the lungs

and the pressure of the blood in the pulmonary circulation

was so high, that it was causing fluid to leak into his lungs

which is why he sounded like there was fluid in his lungs

..because there was.

it's called Flash Pulmonary Edema

the Nitro drip and the BiPap machine saved this guy's life

isn't medicine awesome?

well, when you know how to properly use it

(side eye personal physician of Michael Jackson)

in Emergency Medicine,

we have a few phrases to describe the emotions 

that I was going through during this patient encounter

"elevated sphincter tone"

"need a change of pants"

"pucker factor"

they all describe how terrified you are as a doc

when your patient is knocking on death's door like this

and they're sort of gross

this is a profession dominated by men, after all.

for me, i prefer to describe it like a lady:

"my heart beats faster"

he says it well

hope you enjoyed this small glimpse into my every day

this is what i'm doing when i'm not blogging

it's actually what i'm doing right NOW

since i scheduled this post

because i'm at work.

boom.

thankful

cheers, Nonni. us, after the funeral. celebrating her life.

i'm feeling especially thankful today.

--i'm thankful Nick's and my crazy schedules are finally weird enough that we're actually getting to spend a lot of time together. during the day, even. love that guy. getting to hang with him is such a treat.

--i'm thankful we got to watch football last weekend on our new big screen tv. materialistic? yes. but we've wanted one for years and finally were able to make it happen. the hindquarters of the football players look so much more phenomenal on a 55" screen. sayeth Nick. 

--i'm thankful that everything is working out for our winter Euro trip. we got the time off. together. and we booked our tickets. it's official. Salzburg and Venice in January 2013. where should we stay? what should we do? i know you all have brilliant suggestions. lemme hear em...

--i'm thankful that it's actually cooling down a bit in San Antonio. you can set foot out the door without getting immediately drenched in sweat. i actually sat OUTSIDE on the porch last night. for over an hour. drinking wine and catching up on all your blogs. it was delightful.

--i'm thankful for all the men and women who have sacrificed their lives and limbs in defense of this great nation of ours. i'm proud to be serving in the military alongside them. it's an incredible honor to be supporting these selfless men and women, for whom politics are less important than accomplishing the mission, and for whom service comes before self. they are why i do what i do.

--along those same lines, i'm thankful to be learning Emergency Medicine from the people who put it into practice in Iraq and Afghanistan in support of our soldiers. i am constantly in awe of what they've done. they embody Emergency Medicine: prepared to heal everyone. even our enemies. takes a lot of guts, and i'm incredibly lucky to have such badass mentors.

--i'm thankful for The Avett Brothers and their new album. it's lovely. can't wait to see them at Austin City Limits. 

--i'm thankful to have such a great body of readers. your constant support and friendship is such a blessing to me. i can't wait to meet each and everyone of you and give you a hug. 

i don't know if it's the 9/11 memories, or something else. but this is where i'm at today. and as you all know, sometimes you just have to blog when you're feeling particularly gushy. 

so there it is.

cautionary tale

i've been struggling with how to tell this story

or if i should even bother telling it at all.

i don't want to give it any more time and attention than i already have.

but in the end, i think it might be worth it

to make you aware of what can happen when you choose to share your life on the internet.

last week, i got an email from a reader

letting me know that she had seen an image of me

in a presentation that was posted on Facebook.

she sent me the link so i could confirm it was me.

she said she thought it was weird that they used my image

so i followed the link and found out why

i found that a private school in the U.S.

had put together a presentation entitled "Dressing Appropriately"

one of the slides had a picture of me (with my face blurred out) 

in an Herve Leger bandage dress

next to a picture of another girl with her face blurred out

and the title read "One of these girls has a bad reputation in school...

can you guess which one?"

after reading through the presentation,

it was clear that it was geared toward middle-school girls

and instructing them on appropriate attire for school.

i was perturbed for a number of reasons:

1. an image of me had been stolen off my blog

2. my character had been called into question

3. i was so easily recognizable that someone knew it was me, 

even though my face was blurred out.

i contacted the school administrators

asking them to removed my image from the presentation

and to disable the link

which they did in a very expedient manner

and they also apologized.

they said my image had been found using a Google image search.

and that they never meant to paint anyone in a negative light.

...

i am sharing this story to make you all aware that things like this can happen.

if my reader (thank you so much. you know who you are.) had not let me know,

i would still be living my life in blissful ignorance

unaware that my image was being used in such a slanderous way.

as it stands,

i'm still reeling and trying to recover.

it feels awful to have strangers insinuate terrible things about your character.

and to know that you are appearing on the internet in places you never intended to.

 

the internet can be a scary place.

especially when people take things that are not theirs

without permission.

i've been guilty of this.

using images i didn't have permission to use.

i won't be doing that ever again.

because it feels like shit when it happens to you.

i've read some other bloggers' horror stories

about how they were sued for using images without permission

or how their pictures of their kids turned up on t-shirts in foreign countries

 i honestly didn't think it would happen to me

i didn't think my blog was big enough or popular enough.

apparently size doesn't matter.

so let this be a warning to you.

please be careful.

and if you ever see me turn up somewhere else on the interweb

please don't hesitate to let me know about it.

tennessee wedding

so here's how the weekend went

according to my iPhone

 

preflight beers in San Antonio

reunited with my best buddie Julie

the med school crew!

yes. these are all doctors.

  okay that's a lie.

one is a lawyer

and one is a PA.

we ambushed the groom as he was trying to get on the elevator

TO GO GET MARRIED

and made him take a picture with us out by the pool

[note the UTennessee coozies. purchased especially for this event.]

nick was in the bathroom (or something)

so Foster was my stand-in date

 

 Fancy Flemings

substitute the dude in the seersucker for the groom,

and you've got a former roommate shot

(these were Nick's roomies in med school...before i snatched him away)

 

we rode buses from the hotel to the ceremony to the reception

and back to the hotel

best. wedding. idea. ever.

hi. we're at prom.

 

just in case you guys thought nick had gotten good at not closing his eyes

while taking pictures

nope. 

 

yeah yeah

so maybe i DID take a lot of pictures of us

 

 

but here's the bride and groom making their entrance!

me and Colleen. sister-in-law of the groom...

and my Vegas partner-in-crime.

love her.

[woah purple uplights.]

 

 

Nick stole somebody's glasses.

he looked super hott in them.

i'm thinking about making it a permanent thing...

this Nick-in-glasses.

we obviously had a great time.

further evidenced by the fact that i woke up on Sunday morning

to find my liver lying on the floor next to me crying.

so. many. gin and tonics.

guess who's NOT pregnant?

this guy.