I'm tired...

I am officially on my last month of internal medicine in residency. Some of you already know what that means...for the bulk of you, however, I'll explain it. Internal medicine rotations are difficult. You're on call every third night, you try to learn lots of obscure information, and you fufill the title that you are given...."resident." More plainly stated, you live, eat, and breathe hospital. You get your days and nights mixed up because the call room doesn't have a window. You know Marge's dog's name (she's the cashier at the hospital cafeteria.) All the days seem to run together into a big exhausted clump of sick old folks and alcoholic young ones with an occassional witty remark from an internist thrown in for good measure. ahhh..

Last night, I was on medicine call and I did something I have never done before, and I really hope to never do again. I didn't realize how tired I really was. I was up admitting some guy with abdominal pain at 1AM. When I was fininshed with the admission, I picked up the phone to dictate a note. A dictated history and physical usually takes about ten minutes and is two pages in length. After you're done dictating your patient, you get to go home. I must have been awfully comfortable in my chair on 4 West. I remember dictating this guy's current history, family history, social history, exam, labs, x-rays...*yawn...* I have to hand it to myself...the guy was a boring patient, especially in the middle of the night. He had constipation! Who comes into the hospital at midnight because they are consitpated? I know the answer to that. A bored someone, that's who.

ANYWAYS, I was dictating along in my soft warm chair with my decaffinated beverage at my side, going through this gentleman's normal labs and normal x-rays...and then I honestly don't remember anything until a nurse came and poked, me in the shoulder.

"Doctor Sprengeler?"

(jerking awake) "Huh?"

"Um, I hate to intrude, but are you sure you know what's going on? You just dictated that your patient was scared to go to school because Mister Caleb makes her go pee pee in the big potties."

...

Yes, you guessed it. I actually fell asleep while I was dictating. And I was dreaming. AND, I was dictating my dream right to the hospital transcriptionist! Bring on the ambulance chasers, this doc has gone officially insane.

Good thing I still had the receiver of the phone in my hand and I could go back and delete what I had dictated. The assessment and Plan section of poor Mr. Constipated's history and physical started out making sense....place an NG tube, pain relief, zofran....but suddenly, things changed. My dictation/dream morphed him into a little girl who wanted to sit on the potty chair instead of the big potties in the preschool room. Oh dear.

It's after eleven. I should be in bed.

A trip to Enger tower

Tonight was particularly productive. Mike and I both got home from work early, so supper was done by 6:00. Then it was off to a garage sale, where we found EXACTLY what we were looking for: a hutch and sideboard for the dining room, in good shape, for under 50 bucks. Score. After that, we went to Enger Tower (see pics), where Julia pretended to be a princess. She has been watching this Rapunzel Barbie movie lately, so I think that's where she decided that princesses live in cold drafty towers. :)
We also made it to Menard's, where we bought new hardware and white paint for the hutch. We found everything on Papa's "Menard's list," the list he builds on over months... We found everything from a new curtain pull, to sand for the sandbox, to a new garbage can, to a new cord for the vaccuum that Julia decided to rip to shreds.
After Menard's, it was a trip to the DQ. Julia and papa shared a blizzard. I made an amazing discovery: the marshmallow sundae. Being conservative ol' me, I *always* get the small strawberry sundae. I always have. Well, they were having a sale on Sundaes, and I wanted to get Mike a funny thing because he gave me his usual, "I don't care" response. So, I bought him a Marshmallow Sundae. Who would order a marshmallow sundae when they could get hot fudge or carmel or STRAWBERRY??!? I kind of lump it in the same category as the Nerd Blizzard. Why would you do that? When it came, I tasted it for fun. It didn't even look like anything was on top of the ice cream.

.....

Holy Hannah. it was delicious! I felt immediate pangs of guilt. How could I abandon my tried and true Strawberry Sundae for some indulgent imposter? It was sitting right in front of me, clueless about my new-found guilty passion for sticky marshmallow sauce. I still don't know what to do about this. I think I will have to avoid the DQ for awhile. You see, I will automatically order the strawbery sundae as usual...but next time, I will know that I actually want something else.....something forbidden and gooey...something a five-year-old would want. Not a mom. Moms don't order marshmallow sundaes.....

Or do they?

A trip to the park

I am behind on blogging. These pics are from Easter Sunday. Mike and I took the girls to the park. It was the first weekend to break in the wagon. sigh... We'll have to wait a few more days to break in the wagon again since there are currently SNOWFLAKES flying outside. Ahhh Duluth. Mayday! MAYDAY!

...alone

Tonight, my mother-in-law came and drove her son and grandkids back home to St. Cloud for the weekend. Yep...that's right. Mommy has to stay home and work. I didn't think much of it...Mike will be going to a conference in the cities and Grandma will watch the kiddos (yay Grandma!) and I will go to work as usual...blah blah blah.... the usual drill...

It didn't sink in until they had been gone for about five seconds.

I have the house to myself. I'm alone. Alone. ALONE!!!!!

I walked through the living room, listening for the usual squeals and crunches and crashes and thuds. Nothing. Not a peep except for the occassional pant from the dog.

I went straight to the Easter basket and helped myself to a piece of Julia's candy. I ate it on the couch, in the living room. (We NEVER eat in the living room...Julia knows the rules. We had to adopt this rule to protect our poor carpet after we had kids.)

Next, I let Psymuhn walk into the dining room and I pet him. Mike really hates it when he outsteps his boundary of the kitchen/dining room doorway. Psymuhn was standing with his front legs in the dining room and his back legs in the kitchen and I wasn't yelling at him. I felt naughty. What the heck? I might as well go all-out "bad Mama." I took a stroll into the kitchen, opened up the fridge, and took a big ol' swig of milk right out of the carton. Mmmm. I haven't done that in a long time. I almost stuck my finger into the container of fruit dip...but I didn't want to take this too far just yet.

Next, I washed the dishes and swept up the kitchen floor. I decided to take the dog for a walk. Ten seconds later, I had my shoes on and Psymuhn and I left for an hour-long walk. I didn't have to put three coats, three hats, and six mittens on. I didn't have to unfold the huge stroller. I didn't have to pack a bag that included diapers, wipes, kix, a water bottle, and band-aids. All I needed was a leash! Beautiful! And the best part? When we got home, the kitchen was exactly as I had left it! No one had come by and dripped mister freezie juice all over the place. Psymuhn wasn't licking the floor around the high chair. It was after eight o'clock and nobody was melting down because it was past their bedtime.

I took another swig from the milk carton.

By now, you know where I'm going with this. Those of you who have children are smiling right now. Those of you who don't....just trust me. Kids are worth the work, but good Lord, am I glad I never think about how much work that really entails. I also know that before we had kids, I never really appreciated a few minutes alone.

I am going to sleep in the middle of the bed toinght.

Although it was a whole week ago already, Easter Sunday was a fun time with two little blonde girls. We dressed them up like dolls for church, decorated eggs, and had some visitors! (Sorry gramma Beth and grandpa Dick...I forgot to take pictures of you guys.)

Handpainted eggs

The Particular One paints her egg "just so"

The Happy One eats a snack whilst she watches the Drama

The Easter Bunny came!

Ooooooh!

All dolled up for church. Mama is a lousy picture-taker. Mary actually kept her headband in longer than her sister.

SQUISH.

Good Friday

I guess I'll have to finish the story about the church and soup later on. I know...it's a cliffhanger. I will finish the story later when I have more time. Crap. I said it, so now the rest of the story resides in the Pile. The "I'll do it later when I have more time" pile. You all have one and you know it....the half finished scrapbooks, quilts, basements, knitted sweaters, paintings, garage projects...etc. Well, the story has been moved to the Pile and it's there until further notice.

I have something else to report on tonight.

I had a couple of "a-HA" moments today. The moments you get when something clicks in your brain. You memorized something long ago and didn't really understand it....and suddenly, "A HA," you GET IT. Today, I realized that coumadin didn't protect you from a heart attack. You need plavix or aspirin because acute coronary syndrome starts from an inflammatory cascade brought on by a crack in the plaque and PLATELET aggregation. Hence the plavix. Coumadin works on factors II, V, VII, and IX, and therefore doesn't have anything to do with platelets. Whoa. A HA!

My next A Ha moment is more serious, but also more important. I took the kiddos to church tonight all by myself because their dad was stuck in the pharamacy. I was also slated to ring handbells and sing in the choir, somehow maintaining a toddler and baby at the same time. Luckily, Holly and Luke were there at church to help us. Those two are a gift from God, I swear. The just step in and act like surrogate parents whenever I need them. Anyways, I was supposed to be at church at 6:45 for choir rehearsal. At 7:02 when we walked in the door, Holly and Luke were there to take Julia for me. Julia stayed with them through the whole service. Mike showed up a little later and helped me with Mary.

Our Good Friday service is pretty somber. Lots of hymn singing and the reading of the entire Passion. At the end of the service, the lights all go out and the pastor slams the Bible on the altar. It creates a defeaning sound, followed by silence and darkness. It's a pretty profound moment...the usual post-service joyful organ music and jibber jabber of the little old ladies is replaced with an empty, dark void.

It was at this moment that I heard Julia sniffling like she was crying. I was holding a hungry Mary, so I left Mike to get Julia from Holly and Luke. Mike and Julia took a LONG time to come out. I stood in the narthex for about fifteen minutes making small talk while I was waiting for them. When they finally came out, I was preparing a tiny little "mom-rant" about why they shouldn't dawdle at the end of church...mary is hungry...we are up past the girls' bedtime...you know the drill....

He looked like he was about to break down. This was weird...I have never seen Mike cry in public except for when the girls were born. He shot me a Look and said, "I'll talk to you when we get home."

When we arrived in the house and put the girls to bed, I asked him again about why he and Julia had taken so long to leave church tonight. It turns out that Julia wanted to go up to the front of the church after the end of the service. When Mike asked her why, she replied,

"I want to go up there and give Jesus a kiss and tell Him thank you. I want Him to know that I'm sorry that He had to die.."

...

Mike walked her up to the front of the church and Julia proceeded to "look" for Jesus. She walked up behind the altar and looked under the chairs. When she couldn't find him, she decided to kiss the old wooden cross that was brought in for Good Friday.

That's what was taking them such a long time to leave. It never ceases to amaze me just how much my "not quite three year old" daughter understands. It is humbling.

ambition

I must have been feeling like life was under control last January. I don't know what posessed me to do this, but I signed up to host one of the weekly "Lenten soup suppers," which occur every wednesday night in Lent at our church. This job entails preparing the church basement for dinner that starts at 5:00pm. It means that you agree to make a cauldron of homemade soup to feed a 75-100 people. It means that you bring seven pans of "bars" to feed them dessert. The church supplies a big thing full of peanut butter. You're on your own for the rest. Sounds like fun, right? Besides....the median age at Mount Olive Lutheran Church is at least 70. I don't think most of our members can even lift a huge pot o' soup. I felt guilty. If I didn't feed them, who would? I don't want the old folks to starve. Peanut butter sandwiches get stuck in their dentures! So much for trying to run from my Catholic upbringing. The Catholic Guilt is there. Still there. I signed my name on the dotted line that cold January day.... March 25th was a long ways off, anyways. I will probably have tons of time in March. Yippee.

...

Well, it had been a very busy March. I was on the pediatrics service at St. Mary's, which is usually a nice relaxing rotation with 2-3 admissions a day, lots of time to read and learn, and a cup of coffee with fresh apple fritter promptly at 10:30 every morning. Not so this month. I think God decided that I didn't know enough about sick kiddos or something. Instead of peaceful relaxing nights and time with my own kiddos, I spent my evenings and nights admitting sick kiddos...right and left. I think I set a record for the number of peds admissions overnight. 12! People didn't believe me when I told them I admitted twelve kids in one night. I had two other nights of admitting eight kiddos each. Then there's the fact that yours truly made the call schedule for the month...apparrently not my strong suit. Two weeks ago when I looked at the schedule, I noticed that I was on call Wednesday, Friday, Sunday, Tuesday, Thursday.... Call every other night for five days in a row. Oops. What idiot would do that? um....

Somewhere in the middle of all this call, we got a letter from the IRS: You screwed up your 2007 taxes and you probably owe us at least $10,000. Yippee! Excellent news. Then, the resdiency decided to subject me to a series of nasty meetings (see last week's blog).

After five days of every other night call, I was pretty shot. Everything I encountered was suddenly hilarious, especially Dr. M, the tall red-headed lovable nut ball attending doc that I did all of these peds admissions with. On a late Tuesday night after five or six kids with gastro entered our service, he joked about me needing to go home and bake a cake. Suddenly, I had this sinking feeling in the pit of my stomach: BAKE....uhoh... BARS....SOUP....100 people.....eee gads. I checked my calendar: I was signed up to host dinner for a hundred people TOMORROW night. It was 11:30pm and I was just remembering this. Oh dear.

I called Husband, who was sitting at home, awaiting my arrival. (I had called him an hour ago and said, "just fifteen more minutes, honey...) Our conversation went something like this:
S: "hi Honey!"
M: "grunt. When will you be home? I'm tired."
S: "I need you to do something for me tonight."
M: "I already turned on the electric blanket."
S: "Could you throw a turkey in the oven? I need it for soup for church tomorrow night."
M: "(still groggy) What?!"
S: "a turkey. There's one in the downstairs freezer. Just run some hot water on it, pull out the paper things inside, and throw it in a pan and bake at 325."
M: "damn woman. Let me get a pen and write this down."
S: "thanks." *click*

...

I was home an hour later to find my patient, exhausted, devoted husband chopping carrots in the kitchen that smelled of Thanksgiving. He had tears in his eyes. I was alarmed only for a minute...then I noticed the huge bowl of diced onions on the counter.

Since I was waiting for an admission to come in from Ashland, WI, I decided to stay up and make the soup. By 3:00AM, the turkey came out of the oven and I chopped it into a million pieces. The minute I was finished, my pager went off and it was back to the hospital with me.

...to be continued....