good friday

posted on: Friday, March 29, 2013

yesterday one of best and oldest friends came to visit
Mellie and I go all the way back to freshman orientation at good ol' PBAU
she and her hubby Chris are in town for her brother's wedding, so they stopped by
 not surprisingly (or is it?), i had a bottle of bubbly lying around
so we popped that ish and celebrated my chiefdom with someone who actually enjoys the champs
(nick doesn't. so unfortunate.)
 then we went to the River and paparazzi'd ourselves silly
before stuffing our faces with Mexican food

there's not enough to be said about how wonderful old friends are
we picked right back up where we'd left off and didn't miss a single step.
we talked about books and politics and gossiped a bit about old friends
we stole glances at our husbands who had met for the first time and were thoroughly enjoying one another's company.
we commiserated about the awkwardness that exists when you are a married couple of a certain age with no imminent plans for a baby.
it was just so good. refreshing. soul-cleansing. 
Mellie, you are a good one. you can squat on my couch any day.
and tell John Rogers i said hello. :)

enjoy your Easter weekend everyone. think of me in the burn unit...

five things

posted on: Thursday, March 28, 2013

Hawaii. circa 2011.

 call me a bandwagon jumper, but here are my five things.
i specifically tried to pick things that were different from this list i made forever ago. 
here we go...

1. i am the girliest of all the military emergency medicine residents. you all may think i'm a badass, but they think i'm a high-maintenance princess. i may have earned this reputation. but i'm okay with it. it cracks me up that i'm literally friends with guys who know like, 142 different ways to kill a man. like, really good friends. emergency medicine. it's the great equalizer, apparently. 
where girly girls and manly men can find common ground when they both kick ass at intubating sick patients.

2. my biggest guilty pleasures are Real Housewives of Orange County, Rachel Zoe,  and Taylor Swift. if you pulled up next to me at a stoplight, you would no doubt see me belting out and getting DOWN to some 22. my last call of my entire medical career is sunday night, and i can think of no better way to celebrate that than to watch the season premier of RHOC. Heather is my fave, but Vicki is like the car crash i can't bring myself to look away from. can.not.wait. and Rachel Zoe? i can't even talk about it. i find her fascinating and amazing. 
you go girl. 
not above it.

3. food. i love it.  i am not a picky eater. i love me some veggies, all kinds. but hell will freeze over before i turn down a juicy filet mignon. 
i am my father's daughter in that respect. my dad serves flank steak as an appetizer...for steak. not even kidding. he takes medicine for his cholesterol to support his habit, and i'm okay with that. 
food is one of my very favorite things. i will spend money on it and not think twice. i wash and recycle my ziploc bags...can't handle buying bottled water (you can get it from the tap for free!)...and have driven the same car for almost 10 years. but i will drop some bills on an amazing meal. so worth it. 

4. i have really high standards when it comes to friendships. i have worked really hard to learn how to be a good friend, and i have put in a lot of work to keep my friendships going. i have a hard time when friends aren't willing to put in the same effort, and i hold them to the same high standard to which i hold myself. it's cost me some friendships. i won't lie. but i think the friendships i've hung onto are the very best i could ever hope for. 

5. it drives me nuts when people/things/systems are not efficient. i have gotten into fights with friends over this. i see someone doing something in a way that just wastes so much time, and i point it out to them. i'm just trying to be helpful, but with my tone that is generally drenched in sarcasm, it doesn't come across that way. most people do not appreciate my helpful suggestions. but then again, i don't appreciate their wasting of precious, precious time. 
when someone uses a calculator to recalculate something that a computer has already calculated.  
when someone drives a route that is clearly slower than this other, faster route.
when someone repeats themselves constantly on ICU rounds.

it's probably, simultaneously, my most useful and annoying character trait.
annoying, for all of the aforementioned reasons.
useful, because i get ish done. for real.
Nick says i get more done in one day than most people get done in a week. 
i could go on with this efficiency thing. 
but it's counter-productive in getting you folks to find me charming. 

spring makeover

posted on: Monday, March 25, 2013

notice anything different around here?

i gave this space a bit of a makeover.
simplified. brightened things up. and changed my name.

the name change has been something i've been pondering for a long time now.
when i first started blogging, i picked "em=me" as a play on words based off a nickname i had in college. i had no idea that blogging would be something i would really get into, or that i'd still be doing it nearly 3 years later.
OR that i would feel like my blog name was so narcissistic.

more than narcissism though, em=me just didn't seem to say anything about me or what i blog about...except that my name is Em.

enter the doctors fleming. again, it's based off a nickname. something our friends occasionally call us when they're feeling fancy. but i feel like it does a better job of describing what i actually blog about: being a doctor, and being married to one.

so there it is. the why behind the what. i'm still working on the design elements. doing a lot of googling on html code, and enlisting the help of some incredibly talented friends. like Heather, from Paper Please, who designed my header that (seriously check out her Etsy shop. you may see someone familiar...) and my social media buttons.
you guys have no idea how long i have coveted social media buttons. too long.

i may be a good doctor (emphasis on the "may"), but blog/site design is not my forte and i feel like a genuine idiot 99% of the time trying to fumble my way through it. so if you're clicking around and something doesn't work, don't be shy. point it out. let me know.
i'll try to google how to fix it.

and now, a snapshot from our weekend:

sums us up pretty well, i think. dark, smoky honkytonk bar. blurry image with a finger over the lens. grinning like fools.

the doctors fleming, everyone.

feeling older, but not wiser

posted on: Tuesday, March 19, 2013


i posted a version of this post yesterday.  and i took it down, after i realized that it's hard to share your experiences about medicine on the internet, with all the sharks and lawyers lurking around.  especially when you're talking about how you're human, and you are capable of making mistakes.

it's a hard thing, to share my life without potentially implicating myself.  so i reworked it a bit, and decided that some parts are still worth sharing.  especially that Harlem Shake video.  i mean...


it's a weird thing to realize that people who have much more experience than you do, are still capable of making the wrong decision.  it's weird to learn the fallibility of your mentors.  you end up feeling simultaneously more and less confident.  more confident, because you learn that your hunches are worth trusting.  less confident, because you learn that you're just as good, if not better, at times, than the person to whom you're directing all your questions.  it's scary, because for the first part of residency, you look up to these mentors, thinking that they are the Holy Grail.  that one day, you too will be as smart and wise as they.  but the truth is, they're human too.  just like you.  just as capable of error.

one of the great things about residency is that it buys you this time.  time to learn and make your mistakes while someone else is bearing the brunt of the responsibility.  double-checking your work.  co-signing your charts.  the further i progress through residency, the more i don't want it to end.  i crave this cushion, this little umbrella of protection i have.  because all too soon, it's going to be just me.  me and my decisions, and the patients we affect, hopefully for the better.

sorry the subject matter of this blog has taken a turn for the super heavy these past couple of weeks.  to be honest, i've found myself incredibly thankful for this space, and for the exercise of sitting down to put words to my thoughts and emotions about the things i've encountered.  y'all's feedback is incredible too.  thank you so much for that.  i even put on real clothes today (well, yesterday. when this post originally went up. today...pajamas).  an outfit post could have been possible if i had a tripod, or a friend to take pictures for me.  but alas, you're stuck with this morose drivel.  maybe tomorrow i'll put up a Harlem Shake video or something.

oh what the hell.  let's do it now.

el jefe

posted on: Thursday, March 14, 2013

let's take a trip back in time
to when Waylon was a baby
and i was a hippie.

yesterday, that lil pup turned one.
and if you follow me on Instagram, you know that he's huge now
but i can still pick him up. because he's skinny.

and oh yeah.
they named me Chief Resident.

so that's my big news!
if you're having a hard time understanding the significance of being named Chief,
allow me to direct your attention to Grey's Anatomy.
Bailey was named Chief. well, first they gave it to Callie, but she sucked at it.
so then they made Bailey the Chief. 
even my mom uses Grey's Anatomy references to understand my life.
when i told her, she was all "you're Bailey!"

my program has 6 Chief Residents.
2 Chiefs reign over 4-month periods of time.
i'm third Chief. so i'll take over next year in February.
which is perfect, i think. i get to enjoy my 3rd year,
then take on a big leadership role just as i'm gearing up to graduate.

being Chief Resident is kind of a big deal in the medical community.
it's the kind of thing people put on their resumes for the rest of their careers.
a very well-respected position.
i'm incredibly honored to be thought so highly of. to say the least.

that was probably way too much information.
but now you know.
thank you for all of your congrats on Insta yesterday!
you guys sure make making announcements fun.

speaking of announcements, RIP Google Reader, amiright?
i've jumped on the BlogLovin' bandwagon and would love for you to jump too.
(there's an icon right over there----->)
i usually read blogs on the Flipboard app for my iPad
and i'm loving seeing the actual blog pages on BlogLovin'
this is not a bad move. not a bad move at all, i feel.
in fact, it's inspired me to do a little spring cleaning.
so expect a fresh new look around here in the (hopefully) near future.


posted on: Wednesday, March 13, 2013

intern year. circa May 2012

i started working in the Burn ICU last Friday at 6am.  i had just left the hospital at midnight the night before, after finishing up an ER shift.  in hindsight, i probably should have just slept in a call room.
but i wanted to sleep next to my hubby.

needless to say, things were a bit of a blur that first day.  i didn't know the rules.  i wore the wrong scrubs. and they videotaped rounds as part of a research study.  sleep-deprived and frazzled on wasn't pretty.

Sunday i was on call.  i got to the hospital at 6am, rounded with the team, then everyone left around 11am.  and i was by myself until 6am the next morning.  but didn't leave the hospital until noon.

i was so tired.  and the patients were just so sick.  it's incredibly overwhelming.  i think this is something i'll have more collected thoughts about once i'm through it?  but for now, i've been thinking about how doctors make mistakes.  i definitely made a few during that 30-hour call.  some of them had bad consequences.  to say i'm torn up about it would be an understatement.

i know that i'm human.  but sometimes i think my patients forget that.  doctors aren't allowed to make mistakes.  the general public has precious little tolerance for the fallibility of doctors.  and while i appreciate being held to a high standard, the pressure gets a little too intense sometimes.

last year, during my intern year, i had high hopes that i would learn everything i needed to know to provide the best emergency care anyone could ask for.  as i neared the end of last year, the panic set in, as i realized that i would never be able to learn it all in three years.  "that's why they call it the practice of medicine" said my mentors.  you never stop learning. never perfect it.

but something changed between last year and this year.  last year, i was "just an intern".  if i screwed up, it was okay. expected, even.  if i nailed a procedure or diagnosis, it was a party.  confetti was thrown.  there were pats on the back.  parades in my honor. 

this year, i'm expected to know what i'm doing.  there are no parties thrown if i get it right.  just a "good job".  because that's what i'm supposed to do.  get it right.  now i'm the one trusted with caring for these incredibly sick burned patients all night long.  i'm the only doctor in the hospital taking care of them overnight.  if i can't hack it, i've got at least a 20 minute wait until another doctor drives in from home.  it's scary as hell, i'll tell you.  and there literally isn't a minute of time that goes by during that on-call period where my heart isn't pounding and i'm telling myself there's no way i can do this.

medicine is a profession where you get promoted before they're sure you're capable of doing the job.  when you finish intern year, you're awesome at being an intern.  that's why they let you pass.  but you know nothing about being a second year.  that's something you learn on the fly.  you go from being very closely supervised to doing things 100% on your own.  it's a hell of a jump to make.

and we make mistakes in the process.  i make mistakes in the process.  and i have to look family members in the face and tell them "i did this."  there's no glory in that.  it's not glamorous.  it's incredibly hard. 

it's also motivating.  it makes you read more.  learn more.  you want to make less mistakes.  anything to avoid that feeling of having to tell someone it was your fault.  i know it will never completely go away.  i'll never stop being human.  i will. make. mistakes.  but the fewer the better.  because even if the public forgives me, it's so incredibly hard to forgive myself.

so this is a bit of where i'm at these days.  i got a bit of good news yesterday, but i can't share it until after tomorrow.  cliffhanger, i know.  just be patient. (:

one more go-round

posted on: Monday, March 4, 2013

i know, i know.
i said i was done with the EuroTrip posts.
but last week was just so horrific, that this weekend,
i found myself curled up in the fetal position needing to find a happy place.

i wasn't going to dwell on it, but hell.
i hate vague blog posts.
so here's the scoop:
last week, i had a huge test on wednesday
it's our Emergency Medicine In-Training Exam
like, prep for the EM boards, while you're in training.
my residency program places a huge amount of importance on doing well.
no pressure.

the day before the exam, my catalytic converter literally rusted off my car.
sounded like i was driving a semi down the road. no exaggeration.
so i dropped off the car at the mechanic
and planned to take Nick to work the next morning
so i could drive his truck to my exam.
everything was going according to plan
until i pulled up to the gate at Fort Sam Houston
and the guard refused to let my vehicle on post
because my (read: NICK'S) vehicle inspection sticker was expired
by like, 9 months.
so i had to drive down the road and park in a McDonald's parking lot
beg the manager not to tow me while i took my test
and call a fellow classmate to pick me up and take me to the exam
all this happened like 15 minutes before the exam started.
not stressful. at all.

that was the worst of it.
but then my car wasn't ready that afternoon
so i had to rent a car for a couple of days
in order to make it to work.
it was just a huge pain in the ass, is basically what i'm saying.
so so stressful.

Nick was in one hell of a doghouse, i'll tell you.
and i know i'm cursing a fair amount in this post
but it is nothing compared to what actually happened in real life.
being a military member and an ER doc does not help one talk like a lady.

so you'll just have to forgive the fact that i'm a horrible videographer
and forgot that iPhone videos should really be filmed horizontally
and that Nick and I are ridiculous
and deal with this.

it's the last hurrah.
and it makes me happy.
hopefully this week, there will be more of the happy
and less of the the "seriously? this is happening. this. is happening now."
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