FOMO vs Right Place/Right Time

So my weekend plans have changed and tomorrow I’m going to a Girl Scouts end of the year party as my cousin’s Plus One.

If you think that is lame, 1. I don’t care and 2. I’ve been VERY excited about meeting the creative and unusual young women of my cousin’s daughter’s Girl Scout troop ever since Elisabeth (my cousin) shared this memorable post:

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Also, the party is at an aquarium and I LIVE FOR AQUARIUMS. (Aquaria?)

I’m having the not unfamiliar sensation of my life being a bit on hold. It’s in the nature of grad school- you don’t really have time or money to do things like travel, your weekend plans are always a bit tenuous when you’re studying for Defcon 1 level exams on a regular basis, you don’t have a career ladder climb since you’ve made the often insane-feeling choice to opt out of what could be some of your prime working years, gambling on the chance that more schoolin’ will result in you being such an expert in your chosen field that people would be insane not to hire you despite your relative lack of experience.

Anyway, this weekend I was supposed to drive up to VA (roughly six hours there and another six back) to see my family and to celebrate my best friend’s birthday and bridal shower, and I ended up backing out yesterday at the last minute due to illness. When you work at a hospital, an upset tummy could mean relatively little (which I think in this case it’ll turn out to be since I feel quite a bit better, though still weak, after sleeping for twelve hours last night) but an upset tummy can also mean C Diff, which is all over the place and is just THE WORST.

So I apologized profusely to Lydia for being a crappy maid of honor, and begged my mom to come down to see me here this summer, and put on my jammies and resigned myself to, as I find myself so often having these days, a low key weekend. Le sigh.

Backing up a little, there was yet another awesome thing I missed last weekend, one that I knew pretty early on that I would not be able to logistically coordinate. My family members, not having dietetic internships to complete, got to converge in Mexico this past weekend to celebrate the wedding of my cousin Kate.

She and Francisco tied the knot in a pyrotechnic blaze of glory.

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Haha so glamorous! In reality, I think it was just a lovely gesture towards Kate’s father, my uncle Andrew, a lifelong pyromaniac.

The actual wedding ceremony was special and solemn and took place in a WINE CELLAR IN A HACIENDA IN THE COUNTRYSIDE. Puebla, Mexico. I mean come on. Francisco just haaaaaaad to be from the most beautiful place in the world, right?!

gorgey wine cellar

Here are the parents of the bride, Nan and Andrew (Nandrew!), just being the cutest.

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Here is my mom, who looks so good you’re probably all, “What, did she have you at fourteen?!” I KNOW RIGHT. Hope I get her genes. Work them legs, mom.

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Annnnnnd my glamazon sister, because she doesn’t start backbreaking nutrition school til *next* year, she got to go too. More beauty, y’all.

gorgey malindi

In all seriousness, I wish I could have gone but am also tickled to live in the Internet age where I do actually get to see pretty high quality photos and video of the goings on. Including a charming video of the flower girls walking down the aisle that somehow my aunt took upside down! Who knew that was even possible on an iPhone?!

Though last weekend I stayed stateside, I did have fun. Took a Saturday beach walk which was quite a bit livelier than my usual after-work desolate strolls. I saw this young fella making the most ambitious sand castle I have seen… ever.

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I went to a Greek festival with Elisabeth and ate really great Greek salad, dolmathes, and many unpictured delicious pastries.

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Then we admired the decor and Elisabeth and I both laughed a lot, fairly inappropriately, at this…. Greek bobblehead?! DOESN’T HE LOOK LIKE TED CRUZ THOUGH!

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I also did some more lovely beach walking on Monday. Like, two hours of just listening to softly crashing waves and letting my brain go. We had a lecture in biochem about how sleep sort of “washes” your brain and cleans everything out and I think it happens when you walk quietly on the beach too.

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While taking this stroll a small part of me was like, “Hm, this is nice and would possibly also be nice with a boy, and it wouldn’t be some huge commitment to join OKCupid just for the summer and meet some nice people to hang out with in my temporary town” but then another part of me was like “Ugh, but how about that lady who got decapitated by that dude she met online dating?!” and I opted out. Anyway, the truth is that I really like my own company.

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I am content right now. I’ve told some of the RDs who’ve been teaching me, I feel like I’ve already learned in two weeks at the hospital this summer more than I did for my entire health department internship last summer. I feel like a plant getting water. 40 hours a week seems like nothing- I’ve been staying extra to do things like attend a breast feeding peer counselor training at the health department, lead by the awe-inspiringly smart RD/lactation consultant who works in the NICU.

I’m also really satisfied with my home life. Obviously going to the beach whenever I want is marvelous and still kind of mind boggling- like, I think about going to the beach, and then I’m at the beach. What?! My roommate is a gem and we both largely keep to ourselves but also enjoy chatting about our days. We each also have our own bathroom, an unimaginable luxury! I also joined a gym, one cause I started doing some YouTube kickboxing on a rainy day and realized I was going to make my neighbors hate me and two cause I like feeling strong. A really nice personal trainer taught me how to use a rowing machine properly and it kicked my booty in the best way.

And in a bigger sense I feel like I’m getting to like myself and my true nature. Yes, other people would have moved heaven and earth to fly to Mexico four days into their internships and turn around two days later and get back to the US, flying through who knows how many airports with who knows what kind of time margins. Other people would be frantically meeting up with people in their new town. God love those social folks. Me, I like people a lot, and like hearing their stories, and think that will make me a good dietitian and hopefully also a good friend/potentially a good partner to the right kind of person. However, I’m relived I’m at a place in my life where no one is forcing me to apologize for being the way that I am. I like taking walks on my own!

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Anyway, I want to reflect on this clinical internship so I have some memories to look back on as I move forward in my career. And so yall can hear what I’ve been up to!

  • Thus far I have done my rotations with two dietitians. Week 1 was with the dietitian who covered general medicine, some pulmonary patients (not the ICU, but for people who have, say, chronic COPD or are post lung surgery and are relatively stable), and behavioral health (the psychiatric hospital). Week 2 (which I just completed) was with the dietitian who covered renal (people with kidney disease; they also put some people with complex conditions on the renal floor since the staff is used to managing a lot of things at the same time) and rehab (the hospital for folks recovering from surgeries on muscles and bones and things and also people recovering from strokes and traumatic brain injuries)
  • The rehab hospital is AWESOME! They have a big gym and it has the stuff you’d expect in terms of fitness equipment and mats and so on, but they also have a variety of sections that simulate real life experiences and how to navigate them. A hotel room, an ATM, a gas station, a fast food restaurant, getting in and out of a car, climbing stairs, etc. It’s really big, but I didn’t want to take too many pictures but I had to share my favorite area, the BEACH! Stands to reason that if you live in a beach town you’ll want to know how to navigate the beach. Sand is obviously tricky! Getting in and out of folding chairs is a pain for people in perfect health!

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Along with the sand, they have several other practice surfaces on which to ambulate/roll: bricks (deliberately spaced in a way that can trap the end of a cane, as old bricks are wont to do) and cobblestones, and astroturf.

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  • The rehab hospital is also great because the doctor 100% respects the dietitians judgment and lets her make the decisions and write the orders when it comes to nutrition. Obviously if you or anyone you know works in a hospital, they’ll have their opinions on doctors and their general disdain for non-MD’s. It sounds like there’s a range in our hospital- one of the dietitians I’ve been shadowing loves some of the doctors but says one of them “thinks I stir the muffin batter”, oy. But in general the rehab hospital has really great collaborative care. The nurses are very cool too- I got to see the wound care nurse in action changing a dressing and it was amazing! (Apparently students in the past have fainted, hahahaha. I recommend if you ever work in a hospital that you be cool with blood and gore, which I apparently am, hurray!)
  • The behavioral health hospital is also great! Like most people, I had visions of One Flew Over the Cuckoo’s Nest, and I was pleasantly surprised. It’s split into small units, and the people in the units have meals together in a little cafeteria, go to rec therapy together (which sounds SO FUN- they do crafts and coloring and so on), and have access to lovely courtyards with flowers and sunshine sprinkled throughout the area. The psychiatrists’ notes are really in depth and it’s clear they’re getting good care. Having met with the patients, I can assure you that you have probably met someone who’s spent some time in a psychiatric hospital and had no idea. They aren’t that weird! There’s something kind of comforting in the fact that someone can be having a hard time in their life, dealing with a lot of stuff (and reading people’s files can be heartbreaking- a lot of people’s admissions have to do with crappy family histories) and people can go to this hospital and get the help they need during a time of critical illness and then move on with their lives. Also, this hospital offers electroconvulsive therapy- ECT, which yes, you might know as “shock therapy”- and apparently it is an absolute lifesaver. I couldn’t tell you if any of the patients I met were on ECT, but one of the nurses was telling us that it’s amazing, they see people who have just been totally unable to function and ECT just manages to completely reset things for them. Which I guess, if you think about it, it’s like a heart defibrillator, but in your brain. Apparently hospitals from all over the state send folks to this hospital because they offer ECT.
  • I toured our dialysis unit and gosh it was interesting. The nurse who took me through was SO SMART and you manage so many skills working in dialysis- physics, chemistry, and medicine! Take care of your kidneys, yall. They are small and mighty. We have these huge machines that try and still can’t do the great work of our God given blood cleaners. (Your kidneys also do a bunch more for you, including regulating your fluid balance, producing hormones and active vitamin D, etc.)
  • Evvvvvvvveryone we see in the hospital is on Ensure or some kind of supplement. It does not seem too fun :/
  • Gastric bypass surgery is an object of fascination in popular culture, but can I recommend other methods of weight loss? Cause yikes, people come in with some really scary complications.
  • I have never washed my hands as often as in this hospital. C diff, as mentioned above, is around and it’s real nasty. There’s a special protocol for folks in those rooms, which includes washing your hands, not using hand sanitizer (apparently C diff spores can live for 100 days outside a host, which is about as sobering information as I’ve ever heard). One of the RDs also sterilizes every computer she sits down to work at (we have an office, but spend most of our time in the units, floating between the different pods of computers that doctors/nurses/therapists/whatever use as needed).
  • Electronic medical records are fascinating. There’s so much information in them that it’s kind of overwhelming and it’s tricky to know what information you should narrow on for your own nutrition assessment. I’ve learned that you can usually count on nephrology to get a good weight (which is important for kidney patients because they retain a lot of fluid), and if it says someone has a pressure ulcer you should always look for a note from wound care because sometimes if it looks like a pressure ulcer it’s not actually a pressure ulcer. Also, doctors tend to assume everyone with low albumin has malnutrition, and THAT AINT TRUE. Bless them and their minimal nutrition education.
  • Apparently some people refer to the registered dietitians on the clinical nutrition team as “dietary” and they hate it so so much it’s almost funny. In our hospital we have nothing to do with food service. We don’t cook. We don’t deliver meals. We don’t take orders for room service. Take note, readers, if you haven’t already figured this out from my colossal amount of course work, dietitians are the NUTRITION EXPERTS. We can calculate a patient’s calorie, protein, and fluid needs for their disease state, and predict what deficiencies they might have. We can dose a patient with a tube feeding and, depending on whether we have the certification, even place a nasogastric tube (from their nostril down to their stomach) to feed them. We can dose a patient with an IV feeding. We can interpret a patient’s lab values- for example, as said above, albumin (a protein in your blood) is an indicator of inflammation, not malnutrition. Though if needed we can also assess whether a patient is malnourished using more appropriate criteria. We can educate patients on particular disease states (tell me, can you list high phosphorus foods that a patient with renal disease should avoid? A dietitian can! Consult one!)
  • Thus far I have had mostly adorable and nice patients. I know this is not the norm (who can blame someone for not being at their best in the hospital?) so I’m girding my loins for more drama.

So yeah, that’s what I’m up to now. Anyone wondered anything about hospital life? Whether it’s like Grey’s Anatomy? I’ll do my best to answer any questions!

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