the real world part 1

i just deleted an entire post because it bored me to tears. yes to tears. i'm sitting here crying, i'm so bored.

i've been thinking - as of late - how different my life will be in 4 short months. just 4 months and my day-to-day life will become something entirely new. i'll be a professional, holding a doctorate degree, a real solid person in the world - no longer an ephemeral academic. i'm not good with change. at one time in my life massive changes could easily precipitate all-out panic attacks. this was back before i learned that i could control my panic attacks. or at least have the illusion of controlling them (without medication, thank you very much). i've been so immersed - so totally and completely submerged in my education that i don't know what i'm going to do when school ends. my education will never end, i hope to continue learning till the day i die. but my formal education - at the hands of professors - more than likely ends in may.

what am i going to do? i've decided that i'm going to explore the things i've wanted to do for a long time, but i've kept putting them off because vet school has been so all-consuming. in undergrad - for those of you who don't know this about me - i rode on the equestrian team (i rode english - equitation and jumping). in my spare time, i jaunted around large pastures on a friend's horses. very occasionally, i went foxhunting. now, i can't clearly remember the last time i rode. i sold my beautiful saddle ages ago - why let it gather dust in the closet?

i used to read voraciously. i still read - but not nearly as much now as i once did (my overfull bookcase points to this truth). i love music and going to shows. i've managed to attend concerts sporadically - but due to the drive involved with many, i see far fewer than i would like. (although i got to see the avett brothers again last night and DAMN are they amazing live).

i've always wanted to learn to ballroom dance. my grandparents were professional ballroom dancers, long before i was born. i've also always wanted to learn to play an instrument - the piano or violin. i've decided i will pursue one or both of those things post-graduation.

this smacks of a new years resolution post - but it isn't. this is a post-vet school graduation resolution. i'm going to stop wishing i'd done those things and do them. after all, time grows ever shorter, eh? also on the list: have a family of 2-4 children, finish reading all the "to-read" books on my shelves, own an off the track thoroughbred to take more riding lessons with, spend more time with my other family members and husband.

i'm so ready to have a real life.

would love some feedback - please!

greetings from sunny, balmy florida. christmas day was lovely but the day after was even more beautiful. blue skies, gentle breeze, a gorgeous early spring (winter?) day all around. if this is global warming - i LOVE it.

so, i'm in a dilemma - and i'm asking for opinions. i have a few regular readers - some in the vet scene, some not - but i want to know what others think. within 20ish days, i have to decide whether to stay in the match or withdraw. if i stay in, i will rank 6 places: 4 academic internships, 2 private. these will be 6-7 day work weeks, long hours, low ($25,000) pay without possibility of a 2nd job as a relief vet elsewhere, and no real vacation. due to lack of funds and my senior year being diabolically busy (boards, matching, plus my rotations) - i haven't visited ANY of these places and thus have no idea how or if i'll fit in or even like the place. BUT these internships will be incredible learning opportunities, i will really develop as a diagnostician - as well as refine my ability to treat and manage diseases in both acute and more long-term situations. i will be able to pursue a residency if i want to do so after one of these internships - but i can also work for a while. doing a competitive, top-notch, structured internship will make me a better doctor right off the bat. all are a 5 hour drive away from home, which means my long-suffering but patient and wonderful husband will have to commute 2 days a week to teach classes so that he can keep his stipend. thus, he will spend tues, wed, and thursday of every week away from me. lastly - and least importantly, i'm competitive and driven as hell and want to prove to myself that i'm good enough to capture one of these positions and excel.

my other opportunity is taking the internship offered to me already (outside of the match). it pays $30,000, i work a week then take a week off which means i can work as a relief vet nearby and make an "extra" $30,000-45,000 per year. it's only an hour and a half drive from our current home - only 3.5 hours from our real home, so husband can keep his stipend and assitanceship, have an easy commute, and come home to me at the end of the day instead of staying away (although mostly, i won't be at home because i'll be slaving away as an intern). i'm also not so far from my family - either of them. i love the place, i love the staff, i felt welcomed - i felt like a part of the team. it was a fantastic place for me - and the clinic is beautiful. it pays well, it's a good fit for me personally, but it's not competitive for residencies and may require that i do another one later if i decide to pursue that course. further, it's not structured at all - so teaching opportunities outside of being a real doctor are few. there are no structured case rounds, no journal club, no rounds of any sort - yet. the organization is a bit lacking at times, but it's something i can live with - i think.

so...i'm opening the floor to my few but faithful readers. what do you think - whether you're a fellow vet student or not?? i'm torn still. my heart seems to know the answer - but my head is trying to be stubborn and pragmatic...i'd like to hear how others feel.

christmas thanks

i didn't do a real thanksgiving post. i think i just bitched about being tired and upcoming boards and being sick. so i'm going to take a moment and actually list the gifts life has given me.

1) my husband - patient, forgiving, loyal, and supportive through 4 years that have sorely taxed us both in many ways (ahem- vet school). after almost 9 years of marriage (yes, nine!) - i am still sad when i'm the first one home. i am still happy when i hear a car door slam and know it's him coming home. i still like to surprise him at school and take him to lunch. he's still my best friend and the person that gets me through the rough patches.

2) my family - flaws yes. outweighed by what they give me? most definitely. without my family, i wouldn't be who i am today - the good and the bad. i feel incredibly lucky to know that if i ever needed anything, if i was ever in trouble - whether of my own making or otherwise - i have not one but TWO families to whom i could turn. not only was i born with an incredibly close family - but i married into one that over the years (11 of them all told!) has become a part of me. they are as much a part of me as the family to which i was born.

3) my friends - those that i would call my close friends are numbered in single digits (family members excluded). but those people that i do call true friends are as dear to me as family. i know - in a moment - they would be with me, should i need them. miles separate me from some of them - but our hearts are never separated.

4) the opportunity to be a veterinarian - i am blessed with enough motivation and intelligence to pursue a rigorous degree in a rigorous program in a country with only 27 vet schools. despite having to take out a massive amount of financial aid to pave the way, in 4.5 short months, i will be walking across a stage to receive my DVM degree. i never imagined i could or would do it, but with the support of my husband and family, i'm almost there.

5) my country - despite its shortcomings, i wouldn't choose to live anywhere else in the world. i'm proud of my country and all that it stands for - i think we are - as someone once said - "like a shining city on a hill."

enough maudlin ramblings for the evening?

i'm going to do it

i'm going to tempt the black fates that mock human arrogance. i'm going to utter a phrase that no one with any common sense would utter for fear of jinxing themselves.

i have not YET been bitten. i've had close calls with animals - dogs and cats that is. i've been gnawed on by plenty of parrots - big and small. it hurts, but it's something to which i'm accustomed. parrot beaks don't frighten me much. but as for dogs and cats - not one has sunk its fangs into me. YET. but i know it' s coming. i try not to worry about it too much. and on a day to day basis, i rarely think about it. i've absentmindedly palpated a large dog's abdomen before while discussing disease processes with an owner - and nearly had my arm removed - but i dodged the bullet. i've examined a painful, glaucomatous eye and pulled my hand back fast enough to evade the quick, sharp teeth of an annoyed blue heeler. i've yanked my hand back just barely fast enough to avoid needle sharp cat teeth on more than one occasion - though the teeth skimmed me and ripped my glove open. yet, the actual teeth sinking into flesh hasn't happened.

it's not something i'm thinking about and worrying about daily - it certainly doesn't prevent me from doing thorough physical exams or being hand's on with my patients - but every now and then, i suddenly think - "hey, i'm gonna get bitten. probably more than once in my life. and it's gonna hurt like hell."

that scares me a little.

goings on and what-have-you

i'm at the in-laws for "christmas" - since all but 1 of husband's four siblings are married - getting together all on one day becomes more and more difficult. this year we elected to all get together on dec 22nd and have christmas. my MIL decided that since it wasn't really christmas then no traditional christmas dinner (turkey, stuffing, etc). instead, she made filet mignon, twice baked potatoes, hot rolls, and all the rest. i can't say i missed the turkey too terribly much. but then again, i am having it on tuesday when we head down to florida to see my side o'the family. my filet mignon was sooooo delicious.

in other, definitely not-christmasy news, i ran my new 3-legged pal (norman) by school to have him looked at by my favorite professor so that she could prescribe him some pain meds. she did a brief physical on him (something i had never done, apparently) and pointed out that he had a raging heart murmur (4/6). chyeah. seriously. i slotted him for an echocardiogram and it turns out that norman has early-onset hypertrophic cardiomyopathy with systolic anterior motion of the mitral valve. i know, i know - you're thinking -- WHA?!

hypertrophic CM is a fancy way of saying that his heart, for some obscure reason, has decided to asymmetrically thicken (no, it had nothing to do with the trauma that broke his leg). no one knows what causes this disease, but it's much more common in older cats. the thickening causes the valves in the heart to stretch apart and open so that regurgitation through the valves occurs. on top of that, for some reason, the valves that separate his left atria from his left ventricle get sucked into the aorta when his heart contracts. so yeah, he's on heart medication now and will live a truncated life that will probably end 1 of 2 ways : with heart failure or with a thromboemoblism that will paralyze his rear legs. oops. i meant rear leg. luckily, atenolol is cheap. not great news. but he's happy and healthy now and going to live with my BF, her husband (my brother in law), and their other 2 animals.

i suppose that it's for now.

angels of death

angels of death
as my friend over at all but 1 has noted, veterinary medicine can be a bit sad sometimes. you fight hard for your patients. sometimes you win those battles, but in emergency medicine (and oncology) - often you lose those battles. yet in that inevitable truth lies a great beauty. veterinarians can offer dignified, painless death to our patients. human doctors can (legally) not. this post is not meant to be an argument for or against human euthanasia. (sidenote: when i was young, i remember hearing my parents talking about the big debate over euthanasia and the elderly. and all i could wonder was why did people care about youth in asia? end of sidenote). to discuss human euthanasia would require navigating tricky emotional and political waters - and i don't dare tread there (mainly because i believe there are multiple "right" answers to that debate - kevorkian NOT being one of them). anyhoo, as i was saying...

one thing i got to do multiple times on my externships was offer the merciful sleep of euthanasia. i also performed quite a few - considering i've only done 1 that i can remember as a vet student that actually involved an owned animal. it was a new experience for me - being the only person present as the owners said goodbye to a beloved family member. and while it was heartwrenching, it also made me profoundly thankful that i don't have to navigate the channels and trenches of human euthanasia. few people question the job that so often falls to us as animal doctors. animal euthanasia is an accepted - dare i say - embraced tradition with which few disagree (although there are dissenters). and i'm grateful for that.

there is nothing (in the animal world, that is) quite as sad as seeing a 17 year old cat with multiple diseases stop eating or drinking but still drag on and on, somehow clinging to a shred of life. or worse, to see a young, otherwise healthy animal in agony with a broken spine . it is sad to have to end the lives of these loved ones, but it is a gift too - however much (as vets and as pet owners) - we struggle with it.

i euthanized one of my patients while on externship, and i cried with the owners as if he was my own. he was a 15 year old cat - a big, black ex-tom cat, previously healthy, with sudden onset of diabetes. it was secondary to some other disease - possibly pancreatitis, portal triad syndrome, hepatic lipidosis, or all 3. he was a very, very sick kitty. despite insulin therapy, antibiotics, and fluids, he did not get better. his owners made the difficult decision after 2 days to stop treatment. i cried when i carried his lifeless body back to make him a little coffin. but the owners thanked me for my obvious caring, my involvement with them, my calm and confident nature...and in the end, they thanked me for ending their kitty's suffering.

as much as it sucks to lose one, i'm so thankful that i have the option -that owners have the option - to stop the suffering of a their animal. so while we sometimes (especially in emergency medicine) feel like the black hooded figure with the scythe - i prefer to think of us as the benevolent angels of death - guiding animals to the afterlife (whatever that may be).

it's the end of the world as we know it...
apropos of nothing - i've lost 10 pounds. i now weigh about what i did in high school (124lbs). i think i've either picked up a worm of some sort from my patients or i've just been working so much, i haven't had time to eat. still, it's odd. the weight has just kind of dropped off of me. i'm not complaining, i'm always pleased when i randomly lose weight...

i just read nevil shute's book 'on the beach'. i was supposed to read it my freshman year of high school, so i'm roughly 15 years late on that. i can't remember how i passed the test in freshman english without actually reading the book - i was never one for cliff notes. passed it i did, though. maybe i skimmed the book - but honestly, it didn't even seem vaguely familiar on this reading. it was a good book, if a bit subdued. i liked how it dealt with the subject of the apocalypse so deftly and with so little melodrama. on the other hand, it might have been a little too low-key - in some ways, it lacked emotional punch.

in the theme of end of the world, the husband and i saw 'i am legend' tonight. i'm not sure what prompted me to choose it. perhaps the lack of the other remotely interesting movie-going fare - even in the independent movie scene (which is sorely lacking here in kvegas). some advice: save your money. it really wasn't worth the $7. the first 2/3rds of the movie was actually rather worthy - tense, clausterphobic, interesting. the scenes of empty, desolate, shelled out New York were arresting and spooky - if you could ignore the laughably bad - and i mean out loud laughing - CGI effects. i mean - christ - with all the money that was poured into this movie, you think they could have at least had scary monsters. these CGI fakes were so transparent and ephemeral as to be amusing. not frightening in the slightest. i was surprised at how good will smith's acting was - i've always kind of seen him as the fresh prince of bel-air. ultimately though, he couldn't hold up the slapdashed ending. really - the ending seemed so phony and so out of nowhere that i have to wonder if it wasn't tacked on after bad test audience reaction to the real ending - as depicted in matheson's novella (which, despite having a fascinating premise, sucked).

so...tomorrow heralds a day of christmas shopping, cleaning, and preparing for the holidays away from home. i wonder when my nuclear family (brothers, girlfriends) and i will start celebrating here at home and stop driving to florida. seems like a long way off - but it's getting harder every year to get away 650 miles for a week...

what else, what else? i can't believe i'm saying this - given my constant awareness of my mortality/the brevity and weight of life/etc - but i want the next 4.5 months to FLY by me. and i mean fly. i want to wake up and find out that it's may 6th - and i'm graduating vet school the next day. i am so ready to be a doctor, to be working, to be out of school for a while and doing something different. it seems a ways off to me now but only because i so urgently want it to be over so that i can move on with the next phase of my life. but i know - in my heart of hearts - it will be here all too soon. isn't that how life works? days last forever yet pass like a sigh...

answers come when i'm not looking for them...

i'm home again and restless. it's 1:20am - and i'm not used to being this awake and having nothing to do. i'm officially on break until january 2nd. boards are over. the matching/internship application deadline is past - everything is turned in - finished. i'm free. for the time being, that is. and what to do - what to do? well, other than shop for christmas presents, clean, pack, and get ready to frolic off for a jaunt to home, then florida...

i think i neglected to mention that the cat whose leg i amputated on my externship is now residing in my household (temporarily, i hope). the owner didn't want to pay for surgery so he relinquished the kitty. he was named grayson, but i changed it to norman (after norman bates). this kitty is a hair on the psychotic side - bipolar, at the very least. he goes from loving to be petted to growling. of course, his stump probably hurts...so i'm going to wait a bit before i make any judgements about true temperament. pictures will be forthcoming, once i've charged the camera battery.

i might have raved about how much i enjoyed my externship. seems like i did, eh? i had my exit interview today - and i think, if i so desire, i could return to that clinic for an internship. and it just might be the answer to all of my concerns. the ALMOST perfect answer. it pays $30,000 (compared to $20,000 - 27,000 at any of my other choices). i love the city - the little i saw of it during my time there. you work a week, then you have a week off - during which you can do relief vet work at local clinics and earn an extra $35-40,000 a year (relief work pays very well). it's a mere hour and 45 minutes away - allowing the husband easy commute time should he need to see his advisor for dissertation consultation, also allowing him to keep his stipend/assistanceship and teach 2 days a week (=$20,000 extra a year). imagine - we could be making $90,000 a year in just 5 months time. on top of all this, i loved the clinic and staff. i had access to excellent diagnostics - we had ultrasound, digital radiography (with access to the radiologists at my school for review/collaboration), 2 surgery suites, monitoring equipment for anesthesia, and excellent technicians. furthermore, specialists in ophthalmology, internal medicine, orthopedics, etc are present or available much of the time. and i LOVED emergency work. i found it (despite the odd bad case - see the post below) to be very rewarding. even though i lost some of my most difficult cases - the owners of these animals were so wonderful and so grateful - it made the sadness easier to bear.

there is a downside to all this upside, though - the organization was a little lacking and the clinic tended to run out of important stuff- like heartworm tests and green blood tubes and diff-kwik stain for blood smears. but those things - eh. you find stuff like that anywhere. my only real concern is that this internship wouldn't be super-competitive if i decided that - after all - i did want to pursue further training and do a residency. i might have to do another internship later on - at an academic institution or a more well-known referral center.

what i keep coming back to is this - i loved it there. i relished what i was doing. i felt challenged and excited and fulfilled. isn't that what's most important? i could see myself being very happy in that environment. it would be a good decision for not just myself but for my husband - which is very important, too.

yes, it might just be the answer after all...

sometimes i wonder...

this externship ends in a couple of days. it has been an exhausting and emotional 2 weeks. i've worked anywhere from 14-24 hour days. i've managed intensive cases - including a diabetic cat with pancreatitis/liver failure/portal triad syndrome and an old dog with vestibular disease - all on my own. it's been terrifying and exhilirating at the same time. i'm so afraid of making mistakes, of missing something, of not saving an animal because i wasn't fast enough or smart enough. but i loved it. LOVED IT.

but...i digress. i came here to talk about the fact that sometimes i wonder if i'll be able to do this. veterinary medicine. why? you might ask - since i so obviously love what i'm doing. i'll tell you a story then - to illustrate what makes this job so hard.

yesterday, a husband and wife came in with a 6 month old miniature pinscher. it was sunday - which = crazy around here. and i mean CRAZY. the pinscher presented for ADR (ain't doin' right) for a couple of days. i was swamped and overwhelmed, but i took the case because the otehr 2 doctors were equally busy. the puppy was obviously ill. i could hear seriously increased lung sounds, wheezes, a heart murmur, the skin would not return to its normal place when i pinched it because the dog was so dehydrated, and the mucus membranes were BLUE. that means its gums - which should be pink - were BLUE. it was obviously extremely ill. it also developed blow-out bloody diarrhea while it waited for me to examine it.

when i finally got to the puppy, i realized how sick it was. and i told the owners - who were belligerent already because they'd had to wait (in an emergency hospital, no less). they also informed me that they had 20 other dogs at home and just couldn't afford to do anything about this puppy. i told them that we needed to do bloodwork and chest radiographs to find out what was causing the sounds in the lungs (fluid, i guessed). i talked to the owners about the murmur, i talked to them about heart failure. i TOLD them that the dog - with blue mucus membranes - would not make it through the night. they declined every test in the book - they even declined fluids. we did a snap parvo test and a fecal exam in the hopes that we would find something. the owners absolutely and totally refused any sort of diagnostics or treatment, despite me practically begging them to allow me to conduct radiographs. they asked me if the dog would make it through the night again - and i said that i doubted it. i even went so far as to call them at home and beg them to come back for a lasix injection to help the supposed pulmonary edema.

they left, and i heard nothing. tonight, when i came on for the night shift, i called the owner to ask how the puppy was doing. the owner proceeded to yell at me - the puppy had died - as predicted by myself and my mentor. he called me a greedy asshole - saying that my recommendations were strictly for me to make money. AS IF. i'm getting paid $500 for this externship. he took the puppy to the vet the next day and allowed bloodwork to be conducted. at which point the vet "diagnosed" rat poisoning. just in case you're wondering - there is no definitive diagnosis for rat poisoning. you can do a clotting profile - which can increase your index of suspicion. but you cannot say for sure that the dog got into rat poison (barring finding it in the stomach on post-mortem). regardless - at least i was right about the lung sounds and heart murmur. hemothorax (blood in the chest) and increased blood turbulence due to the fact that the dog was bleeding out ... (rat poison causes decreased coagulation).

still, it hurts. it hurts that the little dog died because its owners were negligent. it hurts me that i couldn't really do anything about it. i wish i could. i offered, they declined. i couldn't do it for free. and still, i feel like the bad guy. veterinary medicine (and human medicine) is a sticky area. you want to give away health care for free - but you can't. it's a hard fact of life. still...

sometimes i wonder if i can do this the rest of my life and not become embittered...

they call me doc

the technicians at my externship - that is. i'm having so much fun and doing so much that i never, ever want to go back to vet school. for the first time, i see it - i see what it's like to be a doctor - to have people look to you for answers and to trust that you know the answers. this last week has been amazing. the overseeing doctors have turned me loose to take cases and treat as i see fit. and i'm confident. and i love it. i really really really love it.

i did an emergency spay on a pregnant dog (1 fetus was dead, 1 alive) in renal failure, tomorrow i'm amputating a cat's leg, i've sutured up lacerations, diagnosed and correctly managed blastomycosis (on my own, no less!), diagnosed a cat with severe anemia and given a life-saving blood tranfusion, repaired a proptosed (popped-out eye) and sutured the eye closed to let it heal...and so many other things.

i've been working anywhere from 14-24 hour shifts (one notable day started at 9am and ended at 9am the next day) - and i cannot get enough. it's rewarding and it's sad and it's hard and it's everything i thought it would be and nothing like i thought.

i don't want to go back to finish my senior year. especially since our boards are over now, and i've been out and called doctor. i just want to stay out...

only 4 more rotations to go...

and another one goes ... and another one goes by

meh. i went - i saw - i thought until my brains came squirting out of my ears and disgusted the person unfortunate enough to be sitting next to me. it was a test - like any other. granted, it was a looooooooooooooooot longer and a looooooooooooooooooooot harder. but it was still a test.

rather anti-climactic, i have to say. i didn't ace it/knock it out of the park/pass with flying colors, but overall, i'm happy with my performance. god, it was long. and exhausting. and now i have to pack and get up at the rear-end crack of dawn to drive an hour and a half to start my oh so fun externship. i love veterinary medicine (seriously, i do).

it's over. i have cleared the hurdle (unless of course, i failed).

T minus 14 hours and counting

till i take the biggest exam of my life.

i'm suffering an immense amount of anxiety lately - even more than usual.

i am paralyzed by indecision, as of late. i went to blocksbuster last night to choose a movie, and it took me over half an hour. i roamed the aisles, and the more i looked and tried to decide, the more stressed i became. i was actually uneasy and anxious about selecting a movie. rather indicative of my mental state lately, i must admit.

last night, lying in bed, waiting for sleep to come - i tossed and turned - filled with a nervous, coiled energy. it felt like worms were wiggling beneath my skin, i kept changing sides, sighing, and doing that thing with my hair that i recently acquired. or have i not mentioned this yet? i sucked my thumb for a way longer time than normal people. WAY longer. till i was about 12, i think. and it wasn't just thumbsucking, i would always twist my hair around my index finger while doing it. i'm not sure what made me break the habit, but at some point, i decided i was too old to be doing it, so i gave it up. however, in the last 7 months or so, i've picked up the habit of taking a chunk of hair and lightly pressing the ends against my upper lip. i haven't the faintest idea what brought it on (other than stress, of course), but it's become rather annoying in that i do it all the time. i read somewhere that gentle hair pulling/follicle stimulation releases serotonin and generates a sense of well-being. i've always had an uber-sensitive head, in that i scream if someone else brushes my hair and i can be put into a hypnotic state by having my head rubbed. but still, this habit is just getting out of hand.

ANYWAY, none of that was the point. as i laid in bed last night, i kept running through all that is going on in my life currently and it pushed me to the brink of panic.

first, i can't decide about the internship vs job thing. i feel totally paralyzed. i'm torn because of money, time commitment, further damage to my marriage, all the things i've already talked about. further, as i said 3 posts ago, vet school cost a lot of money - and i need to start paying some of that back. the burden of our student debt adds a whole other dimension to my worries. couple that with the fact that whatever happens - job or internship - i am going to be moving soon, to a new city, with new opportunities...and i'm a basket case. i don't deal well with big changes - and a few of them are coming my way in the next few months. i've been in vet school for the last 4 years. it's consumed me. i don't know who i am without it. i spent a couple of hours last night surfing the AAVMC job site for veterinarians. i saved about 20 jobs to which i'm interested in applying. and then i realized what all this really meant. i'm about to be an adult. not just an adult but finally and truly a professional in a professional field. people are going to expect me to know things, to tell them what to do - to make firm decisions and be accountable for them. real life is scary. and it's getting scarier by the minute.

i wish i could just relax but this nervous energy is radiating from me constantly. it's also making me unbelievably grouchy.

anesthesia ended on friday. it was a great rotation while it lasted, but i was happy to see it end. i didn't lose any animals under anesthesia, unless you count my last surgery on friday - which had to be euthanized on the table. after it's all said and done, i feel much, much more comfortable with anesthetizing patients now. i actually kind of know what's going on with the machines, and i'm not scared anymore. so it was a good rotation.

now, i'm officially on vacation. unless you count the fact that i have to start my externship wednesday morning. but i'm looking forward to it. i'm going to a large emergency/referral hospital in a nearby town. i expect it will be exciting. hopefully also a great learning experience. and hopefully, once my board exam is over and done with, i can shed some of this nebulous anxiety.