A doctor and a patient walk into a bar...

A doctor and a patient walk into a bar...

September 26: Thursday

Most weekdays, like today, are full of meetings, while many of my nights and weekends are spent in the emergency department. I’m getting the hang of the flow and culture at each of the three different emergency departments in which I work. I’m developing a nice rapport with the residents and the nursing staff, which grows with each additional shift I complete. As with any new job, there is a steep learning curve and some growing pains but I’m two months in and starting to feel more comfortable in my role here.

 September 27: Friday

There are two types of hospitals: teaching hospitals, and regular hospitals. Teaching hospitals have medical students and residents, who work under the supervision of the attending physician. As an attending at a teaching hospital, there are additional responsibilities of coaching and guiding the trainees, and of course making sure the patient is getting all appropriate and necessary care. As a new attending, I wasn’t sure if I’d like working with the residents. I was kind of dreading it, actually. To my happy surprise, I’m really enjoying it!

When a resident sees a patient, they are responsible for putting in the laboratory and imaging orders, writing a detailed note on the patient, calling consults, and handling the patient’s admission or discharge from the ED. Each of those steps are potentially very time-consuming, and take away from the best part of being an ED physician: sitting, talking, and being present in the moment with the patient.



The doctor-patient relationship is a unique experience, and we often do not have the time we’d like to develop that bond. Even more so in the ED, as patients flow through our doors at a quick pace. Often times we’ve never seen the person before, and will never see them again. When the residents are handling the brunt of indirect patient care, I can spend more time directly with my patients.

We get the benefit of seeing people from all walks of life throughout the day. Just yesterday I saw adults, children, geriatric patients, a prisoner, international tourists, people on drugs, and each from different socioeconomic statuses and with different stories to tell. Every age, every race, every color, every orientation, every creed. 24/7/365.

Now, the medical care does not change. All patients will have any necessary testing and medical evaluation completed. No, what I’m talking about here is having the time to make an actual connection with another human being. One who is ill or injured, and has come to me for help. I get to take the time to really listen to my patient’s concerns and ailments. I feel less rushed, as all the other patient-care related tasks are being attended to. Connecting with my patients, albeit stiff briefly, allows me to be the kind of caring and compassionate doctor that I want to be.

 

The patient’s chief complaint listed on their chart may not end up being the real reason why they have shown up in the ED. A patient who used to come to the ED in Fresno each evening with chest pain was actually just lonely at home, living by herself. She always had the requisite medical testing to ensure she was not having a heart attack or other acute issue, but really, she just wanted someone with whom to chat. Another patient may come in with ankle pain after a fall, and be ready for discharge 5 minutes after their x-ray doesn’t show anything broken. But after sitting with them for a brief while, one may learn that the fall was because their significant other pushed them, and now the real issue has been unearthed and can be addressed. These types of stories crop up in every variation. And even if the patient’s complaint is something minor medically, I like to hope and imagine that the patient realized and appreciated that I took the time to really listen.

 

Perhaps the time constraints inherent in medicine, which prevent us from connecting with our patients, is the reason there is rampant mistrust of the medical community these days. We no longer really know each other. A patient is a stranger, and will remain one, unless we have the time to learn where they are coming from, and figure out how to help. I don’t know the solution, but at least during these teaching shifts, I have the opportunity to give my undivided attention to my patients. In an age when EDs are getting ever more crowded, and we’re pushed to see more and more patients per hour, I’ve come to treasure the resident shifts as a time to really connect with my patients.

 

Oh, and I like working with the residents, too. Which was what I meant to write about. Kind of went off on a tangent with the doctor-patient relationship there. Oh the joys of writing stream-of-consciousness...

September 28: Saturday

We’ve completed our bar! I can’t stop staring at it. Looking back at those plans on paper, we never could have imagined how special and beautiful it turned out!

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September 29: Sunday

I can’t believe September is almost over. The month flew by and I’ve been busy. Writing and working out has fallen a bit by the wayside recently. Meh. I’ve been missing the forests and the mountains – which is unexpected as I typically think of myself as a beach person. Perhaps I should look into working with the National Park Service here in San Diego, as so much of my time in Fresno was spent with them.

 

September 30

Sitting in my backyard, enjoying the weather and fresh air. My hands are aching from having just pulled out all the dead vines and brush from the garden. Sadly, none of our squash grew. The plants themselves became quite large and had a ton of blossoms, but no squash actually appeared from the flowers. We planted a huge variety, including blue hubbards, giant pink banana squash, zucchini, peter pan squash, and cupcake squash. Of all the varieties – NOTHING. Not a single squash. Sigh. We’re troubleshooting pollination issues, bugs, and the soil itself. Most likely it’s a pollination problem, but we never had any issues in Fresno. Perhaps we needed to hand-pollinate the blossoms, like we do with the corn. A fair amount of powdered mildew and aphids have taken root as well. And the soil is clay-based and quite dense, which may have contributed as well. Back to the drawing board...


 Recipe: woodworking, staining, & tile work

The bar is complete! We had no idea when we started how the project would turn out in the end. We’re thrilled and proud of the work we did. We’ve learned a ton about construction, from buying wood to staining it, and also about tile application and techniques involves when using mastic and grout.

Staining the wood

For the frame of the bar, we used pressure-treated yellow pine. We applied two coats of honey colored stain and a semi-gloss varnish to finish the bar and seal the wood. The darker color for the frame seemed to be a classic color choice, and we felt that the dark tones would highlight not only our collection of tiles, but my husband’s laser-cut woodrigami designs.

The bar top and the drink shelf are 1 1/2” inch thick rubber wood butcher block. We cut the block on a diagonal to fit the L-shape of the bar, and my husband used a jigsaw to carefully cut out the insets for the 4x4 posts from the frame. We then stained with a natural sheer wood stain and finished it with 3 layers of high gloss varnish.

The variety of sizes and shapes of the tiles made their application a little unusual. Our tiles ranged in size from 1”x1” ceramic tiles, to 4”x4” stone tiles, to hexagonal pieces, to a large, sugar skull piece we purchased on one of our first trips to San Diego many years ago.

I ended up going with a type of mastic called Omnigrip Premium Tile Adhesive. The thick goop was applied with the flat end of a trowel, and then schmeared across the vertical surface using the serrated edge of the trowel held at a 45 degree angle. I wore nitrile gloves to protect my hands from any irritation, and protective glasses to protect my eyes from any splatter.

After drying for 24 hours, a white, sanded grout was applied to fill in the gaps.

I absolutely love seeing the tiles on display like this. It’s simultaneously organized and yet beautifully chaotic, with all the different colors and shapes and memories.

Woodrigami

My husband is incredibly talented and has created an art form he dubbed woodrigami.

His creative, laser-cut plywood art pieces were conceived by combining two of his passions: woodworking and Japanese origami. Our bar proudly features 9 of his intricate and gorgeous designs.

Want to see the rest of the collection and own a handmade woodrigami of your own? You can follow him:

The finished product!!

Cheers!

Have you attempted or completed any construction projects recently?


Fires & blackouts

Fires & blackouts

MCI & Evacuation Drills

MCI & Evacuation Drills