What's In a Name?

I frequently use pseudonyms at restaurants and other places where I have to first I place my order and then wait for my name to be called when my item is ready. When asked, "What is your name, ma'am?" I almost always answer "Sara." Nevermind the fact that my name indeed is not Sara. But it is the name of my sooper-doooper close friend from college, and thus, that is the name I give. I have to resort to a pseudonym out of pure neccessity. Sometimes, it is downright embarassing to watch people stutter and stumble whenever they even try to pronounce my given name. So I cut them some slack and give something easy.

Entering new environments is always a challenge for me. Most recently, I have tried to teach the Psych staff how to pronounce my name ... with varied success. I have gradually truncated my name from "Tejaswini" to "Tejas" to "Tej." Inspite of my attempts to be easy and helpful, the nursing staff, associating me with being Indian and thereof with the Taj Mahal, now thinks my name is "Taj." Oh, the humiliation.

On the flip side, I think I'm quite taken to being called "Tej." Its short. Simple. And not easily confused as the word "contagious" -- which, in the hospital environment, is of particular import to me.

This evening I stopped by Claire's to grab dinner. I was standing in line behind a thin, blond haired woman with a baby who was busy giving her order. As I stood nearby contemplating my choice for dinner, I heard her give her name: Sara. Uh-oh, I thought. There goes my name. Two seconds later, the clerk asked me for my name. The only thing that came to mind was "Sara + Tej = Sage," you know, like the herb. Like Basil. Or Oregano. Only cooler.

And of course, being well known for my wisdom, simplicity, and humility, the name Sage is entirely appropriate. It tickles me silly.

Wink.

At the end of the day, its not the doctor's careful auscultation of a patient's belly that makes the patient feel better; its the simple belief that someone honestly listened to their concerns.

Isn't she beee-u-tiful? She is newly mine. I purchased her off of a graduating fourth year who has now gone on to a better and brighter future as a neurosurgeon. Now what remains to be acquired is the discipline required to learn how to play her. I stopped at "The Saints go Marching On" when I tried to teach myself piano twelve years ago. Hopefully, I will progress much further this time around. I mean, its not like I have that much else to do with my time, ya know...?

Consider this:

Our bodies metabolize nicotine into a molecule known as cotinine. Why is this significant? Look carefully. Cotinine is an anagram of nicotine. Cool, huh?!

Quote of the Day:

"We go to med school for the same reason why people run marathons. We don't do it because its easy. We do it because its epic."
-- Kiera Levine, YSM IV

Wisdom of the Attending:

Lamotrigine [used to Rx bipolar disorder] is contraindicated with depakote. Risk of Stevens Johnsons syndrome.

A poem written by my Mom:

Twinkle Twinkle little Tejas-star
How I wonder Who You Are?
In the Midst of the Wild World
Still Up So High
Like a Diamond In the Krishna's House!

On the Nature of Being Crunchy

Crunchy. The word smacks of the bohemian, appropriately so. My resident LL [who did her first residency, in Pediatrics, at Stanford] uses the term to describe the classic Santa Barbara – hippie-organic-loving-wannabe-Indian-yoga-master type of person. I have secretly decided that the term applies to me.

I am currently reading a very crunchy book on energy psychiatry, written by a psychiatrist who trained at UCLA. As far as I can figure, the premise of the book is that the nature of our lived reality is largely a product of the interaction between positive and negative forces of energy. Surly moods and the gallows of depression can be a product of interacting with very negative people, constantly rushing to get things done, over relying on technology, refusing to forgive people for previous transgressions, not sleeping properly… and the list goes on. The book then proposes multiple strategies to cultivate positive energy – and this is where the crunchiness sometimes gets a bit extreme. Nonetheless, it makes some really great points :

• “… try to treat yourself and everyone else with love. It’s a constant process of tuning in: finding people who support your spirit, trusting your gut-centered decisions to guide you. Then you won’t end up in a relationship that looks right but feels wrong….. When you’re with trying people, aim for the high road; find common ground rather than inflame negativity.[Pg. 27, Positive Energy]”

Nothing said is ingenious or novel. Indeed, at some point in our lives [most notably kindergarten] we all learned these lessons, and deep down inside, we probably all know them. Yet some how, somewhere, we all forget….wait, scratch the all inclusive “we.” Lets do that again: At some point in my life [most notably kindergarten] I all learned these lessons, and deep down inside, I probably all know them. Yet some how, sometimes, I still manage to forget…. So its nice to be reminded now and again of one very simple dictum: Be positive. Hey! That’s my blood type!

How to Get out of a Boring Conversation

ID: 22-year-old Asian Indian female presents with mild psychosis after experiencing dinner-party-induced boredom of five hour duration.

CC [Chief Complaint]: Patient states, “I was soooo bored.”

HPI [History of Present Illness]: Two friends invited Patient to a dinner party on Friday evening. Patient claims that the only thing the guests spoke about was [a] how rainy the weather has been, [b] t.v. shows that pt doesn’t watch and can’t watch because pt has no t.v. and [c] how horribly bad Dr. S is as a professor. Patient denies contributing much to said conversation because “I was bored and wanted to shoot myself.”

PMH [Past Medical History]: Patient has a history that is significant for social ineptitude in the setting of group situations. Patient frequently invited to dinner parties but does not show up or disappears mysteriously. Patient generally considered “nice” but “a very private person.” Sometimes seen talking to self.

FH [Family History]: Patient has one brother [older, 2 years] whom patient instructs on social skills. Brother, thereof, known to be a social disaster. Mother is talkative, very social, and famous. Father is quiet and reclusive.

SH [Social History]: Patient generally found in library or running around East Rock park.

PE [Physical Exam]: Non-contributory.

Impression: 22-year-old nerdy girl seeking prophylaxis for certain ennui.

Plan: The writer suggests that midway through a boring conversation, the patient should say, “Hey, this is a pretty boring conversation. Its so sad that most conversations at parties are so dull and insipid and somehow manage to hide the fact that most people you meet here are fascinating and wonderfully interesting.” And thus begins a far more interesting conversation….

Consider this:

• Alcohol abuse reduces life expectancy by 10 years.
• Half of all fatal accidents involve alcohol.
• You can die from alcohol withdrawal. Interestingly, unlike alcohol withdrawal, heroin withdrawal is not lethal. For heroin withdrawal, life sucks and you think you’re gonna die. But you get over it.

• Steroids and other immunosuppressants can contribute/cause delirium. What is the one exception in which you actually increase rather than decrease the dose of steroids when your patient is deliriouis? Lupus cerebritis.

Doctor Dictionary

Allexithymic – adj. Describes a patient who doesn’t know how they feel

Derealization – the perception that you are watching your life as if were a movie. It’s the feeling that you are seeing yourself from above and behind. Happens to people with migrane.

Psychotic – this word is an adjective. It is not a diagnosis!

Perseveration - n. Psychology. Uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder. The tendency to continue or repeat an act or activity after the cessation of the original stimulus

Tricks of the Trade - from LL, my resident
Q: How can you tell if a person is having a fake seizure?

A: Watch their pelvis carefully. If the pt is thrusting their pelvis to make their limbs shake, you’ve got a faker on your hands.

Q: How do you make adolescents talk to you? [Technique]

A: Take them to the exam room. Take your chair, slump back, slouch, act disinterested and tired. And then in a tired voice say, “so…. Why have you been …dadada?” ... and then slowly pull them in. I think the trick is to not pull any power plays over them; doing so only leaves you with a world-class rebellion.