Blog Posts

Do Anything

Note: Let’s try something, every time my mind yells a swear word I’ll write “frick” and every time I zone out I’ll mention it, both in italics. Other stuff in italics will be inner thoughts. Prepare to enter my mind. Sorry.

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Do anything. When I’m feeling extremely unmotivated, this is my only plea. Do anything. I’ve had days where I am so zoned out, it’s difficult to type “written by: Laura”. (That happened a week ago…) Frick. I’m zoning out now. I don’t know why other people annoy me so much. Zone out I feel inadequate. In comparison, I feel inadequate. Yeah, yeah, don’t compare. Moreover, my flaws are another’s dreams. Yeah! Well, same here! I don’t like me. What I do like, I feel like I can’t mention, because then people make faces and say I have a big ego. What I don’t like I can’t mention either, because then I’m told I’m exaggerating. That I don’t appreciate what I have. Frick.

When I’m in a bad place. Let’s say in a funk. (I don’t want to say depressed, because some people get uppity about the use of that word. Plus, I haven’t been to a psychologist since about half a year, so I don’t have a professional to confirm that.) Anyway, when I’m in a funk, Zone out, frick I –my mind zones out a lot and also does some not so nice things. The first is that it curses. I curse? In my head? I don’t know.

Example, Zone out if I zone out, the moment I realize I was doing something and zoned out, I’ll hear “F**K!” in my head. I don’t tell people about this or the other thing my brain does. So, often, people will think I’m exaggerating when I say I’m down, can’t concentrate, or anything negative. They’ll quote how smart I am or some accomplishment of mine. It could be grades, or how organized I seem, something along those lines

What they don’t understand, is that I have to be that “great”. I have to be super organized and a try-hard when I can, because I know how horrifying it is to sit in front of a blank computer screen with my mind just as blank. Frick *Remembering the last time this happened* I know how bad it gets, so when I am okay, I need to be better! To make up for what I know will come. Because my funks are a cycle. Zone out Or a roller coaster. Who knows?

Zone out Ummmmm But most people only see the “good” parts of me. They see when Zone out I work on assignments or give presentations (for context, I just graduated university in May and now I’m in an internship that also has a ton of assignments and grades). They don’t see when I get home from a business trip out of town and flee to the bathroom to quietly sob before wiping my eyes and pretending nothing happened.

They see me watching YouTube on the couch all afternoon for days in a row and call me lazy. They don’t know that it’s either that or stare into space. Sometimes I believe them. I think, why am I so lazy and unmotivated? Why don’t I just work on what I should? I tried this last week. In my defense, it does work sometimes. Sometimes, I don’t want to get to work on homework, but once I start, it’s okay. I get into a rhythm and I’m fine. Last week, I just succeed in getting progressively more self-loathing and blaming myself for not starting. Think: staring at a blank computer screen.

Do anything. That’s what I tell myself in those moments. Even if I should be working on an essay or a case study (*cough cough* me right now…), I allow myself to work on whatever I want or am motivated to. Doing anything, even if that anything is making a faux Christmas tree out of tissue paper (featured picture) or writing this blog post, is a million times better than last week when I started “working” at 3pm, and “worked” until 12pm because it took me that long to type up four paragraphs on lactation. Frick.

Blah. This building I’m in doesn’t have working air conditioning. An— Frick!! I was looking up the temperature where I am, but got distracted by my friend texting me. Twice. Frick. Frick! Stop it brain! Umm, so yes. It’s about 84 degrees outside, and hotter inside this non-air-conditioned building. And I’m cold.

You think my normal posts are long and rambly? Yeah, well, my mind is worse. What was I going to say? What am I doing? Yeah, do anything. That’s it. Zone out. Man! Um, so yes, do anything, guys. Doing something is better than nothing. Unless it’s harmful. Then try not to do that.

Thus, the second thing my mind does: it flashes scenes of me hurting myself. After seeing a flash like that usually I get uneasy. Other times, I feel desire. For the more gruesome ones, I tend to feel scared that one day my body will actually go through with something I’ll regret.

A common one is smashing my hand against a wall. I don’t know why. I know I’m not in the best place, but I don’t want to hurt myself. Well, maybe I do want to do that. <— Example of an intrusive thought that just popped into my head uninvited. Fine, yeah, I don’t love myself and I do want to hurt myself, but not severely! Not noticeably! That’s a good topic for other post: what I feel I deserve and how I punish myself.

I don’t want to publish this. Zone out. Zone out again. I’m afraid of getting put in an asylum for the mentally ill if I were to admit self-harm desires/behaviors. Frick. Plus, it seems personal. I’m sleepy. Don’t want to be awake. Video idea! You know how some people talk about all those things they do to stay positive and happy? How they say things like I get up and stretch, open the blinds, and feel the sun on my skin and appreciate the universe? Or some crap like that? (No hate. In my better days, it’s those hokey pokey things that really do help.) Well, what if someone made a video/tip sheet of the habits of sad people? My first one is: Daily morning ritual, wake up, realize you are now conscious, grumble, curse the world, declare you don’t want to be awake, and throw the covers over your head before falling asleep again. Do not wake before 1pm, if it can be avoided.

This post is getting out of hand. Bye.

 

Note: It’s a couple of days later and while I’m still terrified of posting this for the darker involuntary desires I mentioned, but I figure I don’t have enough people who read this blog for it to be a problem. I hope. I’m fine, guys. I don’t self harm or anything like that. I’m open to professional help. Not to being committed to a mental hospital. Got that? ‘Kay, now bye.

 

Why am I not enough? (Remembering to put on a fake face to survive in the “real” world)

I’ve had problems with depression and anxiety …also probably paranoia and anger management at least since 8th grade. Everyone has traumas. Mine happened when I was 10 years old. It was no one’s fault. Who was I to be angry at then? I think humans need to blame someone or something or else all that anger gets internalized. At least that’s what happened to me.

 

Brief Overview of my Life Growing Up

I’m not ready to write about what happened. I don’t want pity. What I want is to explore its effects. At 10 years old, I learned that loved ones aren’t a given. They can be there one day and not the next. (No one passed away, if you’re wondering.) But I learned no one is a sure thing. Not even my parents. However, through this turbulent time I still had my teachers and classmates. I learned that was my constant.

Middle school years

That’s all that I carried with me: my school friends and academic success. (More so my friends, but at the end of the day I chose academics and switched schools.) 8th grade. New school. I don’t know why since I’d always been the kid who had a friend by the end of the first day of school, but I didn’t make any friends that year. I didn’t feel the need. I wasn’t interested in talking to other people. So I didn’t. Academics. That’s all I had.

High school

I tried, but by now it wasn’t just a lack of desire. It was full-blown anxiety. I couldn’t bring myself to talk to anyone. I’d only talk when teachers called on me in class. Even then my heart worked overtime from the stress of being called on. Academics. That’s all I had. Not having friends, I dreaded school breaks. Winter break, spring break. The worst was summer break. My mind would over think. I’d get into existential crises. At 15 years old, I knew I needed a distraction. I needed a purpose. Without school, my life, I feared death. Or maybe I feared not living.

I lived (arguable choice of words) like this for 3 years. By senior year of high school, I began to wonder. What if I didn’t treat academics as my life. What if I did poorly? I felt my parents weren’t proud of me with all A’s. (My dad praised anything and everything, while my mom questioned my A+’s for not being 100’s.) Would they freak if I got C’s? So, I stopped trying. I tanked my GPA in the last year. Began failing tests. (I’d never failed an exam before then.) And. Nothing. Happened. They were disappointed, but they didn’t lecture me. Just told me to try harder.

Or maybe they did care. I don’t even know how I felt. I’d say I didn’t care, but I did because I was worried that they didn’t care. I was nervous watching my grades drop and them not bat an eye. I wanted them to care. I wanted to matter to my parents. Not that I didn’t. I knew, intellectually, that they cared about me, but at the time I needed to proof to believe it. My dad’s praise was so frequent it meant nothing and my mom’s was nonexistent. Positive wasn’t happening, so I sought negative attention.

But I didn’t get it.

Then I went to university

I’d made a friend during those last two years in high school. I’d stopped trying so hard to keep my grades up and still passed. My priorities shifted. I learned the wonders of human connection. School didn’t matter. I had friends! Maybe it was my depression or paranoia or broken trust in family stability (no one got divorced either, in case you guys are wondering). Whatever it was, I could not feel or believe that my parents loved me. I knew that as a fact. Not as a feeling.

But I knew my friends liked me! And that feeling was indescribable! A feeling! That itself was surprising! I was numb all throughout high school. The only time I felt anything was during that short-lived flirty time with the boy I snuck off to the library with (blog post on that here). Often I remember anger. But that was it. Anger or nothing. It was like I wasn’t alive. Emotionally, at least.

But in university, I made friends and felt emotions. The most important of which was happiness. I’d had that spark of nervous flirty happiness with the boy in high school, but not like this. Not from friends, and later happiness all to myself, from myself. I found freedom in university. I wasn’t always at school or at home surrounded by people. Being watched all the time. Or not, but that’s what the paranoia told me. I had my own space. It was scary at first. I still struggle to do things by myself. I don’t think I was ever allowed to be alone growing up (bedroom doors were not allowed to be closed in my household and I didn’t go out with friends, much less on my own). University was life changing.

I learned what happiness is. I learned what friends are. I learned who I am. When no one was watching, I knew who I was and amazingly, I liked myself.

What did books matter when I was learning all of this?! They didn’t. And while I was learning who I was, I had to decide on a career. (Blog post about how I came to that decision here.) And now I’m here. In Puerto Rico. A place I knew nothing about when I decided to move out here for a year. Much less did I know anyone here. All the interns in my program were strangers. Now, I wish some of them still were.

I’ve learned that people can be mean and care only about themselves. I’ve learned people can be indifferent or too interested. I’ve learned people can be angry. They can be distracted. They can be cruel. And they are hypocrites.

I knew these things as fact before. But now I know them as feeling. …It makes me wish I didn’t have emotions again. It’s an empty wish and a common one of mine, to go back to the numb high school days. But in those moments with friends, some with romantic interests, and others through my own personal accomplishments,  I’ve learned what positive emotions are and I believe they are what makes life life. Only being able to feel anger, which later morphed to sadness, is not life.

When I was in high school, it was a numb, unfeeling depression. In university, with happiness, I learned sadness. Harsh, deep sadness. The peak of which occurred in my senior year of university. This year I lived with a great friend of mine. And I hurt her. Before her, I always had a facade up. An act. It wasn’t to be cruel. It was to be kind. I didn’t want to expose others to my sadness. But with her…

Life Changing Friendship- Learning to Trust and that it’s Okay to be Myself. Flaws and All!

To Mariah I gave all of my trust. I let go completely. I let her in as far as she wanted to go. And she went far. She saw me at my worst. I’ve never been that depressed since. Even though she’ll deny it, I know I ruined (or at the very least) inconvenienced many of her days. We spent Thanksgiving (2017) angry with each other and that weekend trying to drag me out of bed, literally. I made her suffer. It wasn’t on purpose; it just goes with depression. With depression and anxiety and paranoia and anger issues and what ever other labels exist for all the not positive aspects of my personality.

But she refused to give up on me. We’re still friends. I know that woman would do almost anything for me. And I don’t know what I did to deserve her. I don’t feel like I deserve her. It’s rare, someone like that. So loyal (against their own good even). And I was spoiled.

Post Graduate Nutrition Internship- Learning to Distrust and that it’s NOT Okay to be Myself. Flaws Should be Well Hidden.

Now, I’m here in Puerto Rico working on a dietetic internship (when I doubt I want to work as a dietitian for the rest of my life) almost attached to the hip with my internship partner. I go from rotations where I’m supervised and evaluated. Hello, paranoia and anxiety! Oh, there you are anger! To an apartment where everyone has beef with at least one other person. The environment is toxic. Doesn’t help my depressive tendencies.

Sorry I can’t be positive and supportive 24/7. I still try. It hurts, but I try. Thing is, I can’t give what I don’t have. Every day I feel more paranoid, more anxious, angry, and sad. Or then I’m manically happy! But one misplaced comment and I’m underground again trying to dig myself out. Or not. Sometimes I don’t ever want to surface. (Related blog post here.)

I let myself believe, due to my experience with Mariah, that people can be trusted 100%. I can let go and be my completely flawed self and not worry about the repercussions. But I now know how truly lucky I am to have someone in my life like that, because that’s not the case with anyone else. I already had trust issues. Maybe everyone does. However, I was healing. I was learning to trust again.

But now, I feel as if there is nothing to learn. From my experiences here, no one wants the real me. No one wants my flaws. I am, as I always feared, an inconvenience. I have to pretend to be only the best parts of myself, because that’s the only parts people care to get to know. That’s understandable to me with the preceptors who supervise and evaluate us, but I mistakenly thought it wouldn’t be the case with my fellow interns. I was hopelessly optimistic. And I was wrong.

I have to learn how to fake it. Something I wasn’t 100% successful at during my customer service-y job as a cashier during university breaks (2015 to 2018). I could do it, but only for so many hours a day. Here, I share a room, I go to rotations where I am supervised and evaluated 5 days a week with my internship partner plus travel to the site and work on assignments outside of those 8 hours with her and I come home to an apartment where people aren’t happy to see each other.

 

Constant People, Constant Need to Fake It (to fake sanity/happiness)

The only saving grace is that I feel that genuine care and friendship from my roommate. But, he’s still another person I am around every day. In university, I had space. I had freedom. Now, it’s back to how it was when I lived at home. Constant people! But higher stakes! The only time I’m alone is when I go out by myself. Remember my friend anxiety? Don’t forget depression! To motivate myself to go anywhere is difficult enough. To not change my mind is another thing. Depression tells me it’s not worth it. Anxiety tells me it’s all going to go wrong anyway, so why try?

I don’t wish to blame my hard times on these mental health issues, but I know they are a big factor. And I feel like I have to keep them to myself now. My struggles and thoughts should remain my own to not affect others. Even then, there’s nothing I can do about my energy or aura. If I’m that depressed and empty inside, it doesn’t matter how big I fake smile. I’ve lost my ability to act believable. Thank you Mariah, for making that ability obsolete in me and damn you.

I’m truly going to have to fake it and hope I make it. Seven more months until the end of this internship. Wish me luck, please.

 

 

Note:

Featured image is of me last Halloween (2017). I’ve always loved goth fashion, so I enjoyed expressing myself that day through dress, hair, and makeup. I use it as the image for this post because it represents how I feel at the moment. I am in no way saying goth culture equates to sadness or anything like that, but that’s how most people seem to take it. And I feel like this is how I come off to people without make up and even when I do put on non-goth makeup. I feel like no matter what I do outwardly, all people see is my obvious sadness or negative aspects of my personality. And what can I do about that?! (Nothing overnight!) Why am I being punished for that?! Isn’t the depression, anxiety, paranoia, distrust, anger, and self loathing punishment enough??

Week of November 5th- Intensive Care Dietetic Internship Rotation (Freakin’ Phonies! I Miss my Diverse America)

I’m tired of thinking of this week. Here’s the basics: I spent the week actually trying to small talk with the preceptor. She is a busy woman, essentially left us on our own after the first day. Made a big deal of keeping a clean lab coat and of cleaning the mud off our uniforms (it was raining and me and Gia got mud on our uniform). On Monday, the preceptor told me she liked my evaluation notes. She asked how old I was the next day and was shocked. Said I’m a baby when I answered 23. Feel like she didn’t treat me the same after that. Less respect.

Anyway, they gave us breakfast and lunch at that hospital, so that was nice. The preceptor gave us a ride to the train station after the rotation which saved us an hour bus ride. Nice. But on evaluation day, she rated us on pretty much every category “needs supervision”. Like I said, she was super busy and left us on our own most of the time. If what she said were true, our patients would be even more ill than when they began. Lies. She also said I needed improvement on my appearance. Yet, she used me as the example to Gia on how to do her hair (slicked back and tied up). How does that make sense?

Oh! And she told Gia that she understands there was a language barrier because we are from the U.S. … Gia was raised in Mexico. Gia told the preceptor that. Just because she went to university in the U.S. doesn’t mean she’s American and her first language is English! What the heck! Also, why does being raised in the U.S. mean I don’t know Spanish?! I may not be an expert, but I’ve done what I can to be decent! (7 years of Spanish classes beginning in high school) I sure as hell can speak it and understand it!! What language barrier?! Geez! I’m sick of being judged for being American. It’s not my fault my parents chose to move to the U.S. when I was 7 months old! That’s just my life. And I’m not shunning my culture. I came to do this internship in Puerto Rico to be able to practice my career in Spanish! I want to be able to use my education to help both English and Spanish speakers! More if I was able!

I don’t appreciate the racism! Because that’s what it is! As far as I remember, there was not a time where I didn’t understand what the preceptor said, or in anyway insinuated that I had a barrier with the language. That’s a judgement about me based on my being American and, as far as the appearance needing improvement, I do believe my nationality had a hand in that poor evaluation. The preceptor practically told Gia as much! She told her that she knows in America dietitians go to work in Crocs and generally don’t put as much importance on their appearance. What!? What a naive expression!! Ugh! I did my hair, retouched my makeup like it was a nervous tic, and did everything I could to work on that this week. For nothing! I might as well have not tried!

I’m sick of this. I’m tired of being judged for not being from here! The first word out of my mouth and people know I’m not from here. They always ask, where I’m from and as a follow up question, if I’ll be going back after finishing this internship. Why? So you can do whatever you please to me, knowing you’ll never see me again?? Seems like it! I’m sick of it!

Oh, and we have to wear a skirt during clinical rotations. I know mine fits comically long. But… this preceptor. Geez. She mentioned the fact that I don’t wear pants due to religious reasons. … Um. No. I didn’t wear pants, because the clinical uniform is a skirt. Believe me, I would gladly wear pants instead of a skirt, nylons, and heels we are forced to wear to hospitals!

I’m tired of trying. I’m tired of caring, only for it to all go out the window at the first sound of my voice. I have come to believe that all people are racist. Not always in a mean way, but almost always at least in an unconscious way. We like what we know and are weary of those who are different. I miss America, where there was always a little bit of different. So much so, that it was commonplace. I had teachers and friends whose parents (or themselves) were Vietnamese, Mexican, Korean, Texan, European, African American, African, Indian, Turkish, Bulgarian, Lao and more.

Yet! We all considered ourselves American. We were all different, yet similar. From my experience, we all appreciated our differences and wanted to learn about each other’s customs and different ways of life. Someone taught me a little Hindi, another taught me the joys of seaweed and sticky rice. I miss that sharing. I miss the diversity. I miss not sticking out for being different. I wish I was home. (Or at least not being judged here.)

 

Week of October 29th 2018- Obgyn Dietetic Internship Rotation (Favorite Clinical Rotation Yet)

Monday, October 29th– Another Rotation, Another Dead-End Day

I know I do this to myself. I know I’d be less stressed if I didn’t procrastinate. But that doesn’t stop the procrastinating. Today we went to the hospital in this town about an hour and a half from where my internship partner, Gia, and I reside in San Juan, Puerto Rico. If you haven’t read the drama about us getting down here. Read last Friday’s blog here. The rotation itself is fine. We are evaluating pregnant women or women who’ve just given birth. This is the first rotation that did not train us at all about how to do the evaluations. The dietitian who’s supervising us (our preceptor) just gave us an evaluation form and took us up to the floor. For points, she did tell us where to find some basic information in the medical file. This isn’t the interesting part of today though.

Now, I know spies read my blog. Despite me telling them not to and her agreeing not to. So, because Karen is most likely still reading my blogs, I don’t feel at the liberty to tell y’all the really interesting part of the day. I’ll just say this: the grand majority of us don’t want to be here. The preceptors (dietitians who supervise us in one of 20+ areas we rotate through), they make us feel small and worthless. We are educated people. Every one of the ten of us interns have at least a Bachelor’s degree. Three also have a Master’s degree. We aren’t stupid. And even if we were, we’re human beings. Why treat us like we are a beaten-up Roomba?

It sounds weird, but that’s what it feels like. They look down on us and give us just the kick needed to get us going and no more. Then we are on our own. Picking up after their messes. And being told we went in the wrong direction when they didn’t give us any instruction other than do something.

Oh, and those assignments due on Friday? We explained to our Trauma preceptor that we aren’t in town due to a rotation this Monday through Friday. She very kindly gave us until Saturday. At 8am. Our rotation ends at 4:30pm on Friday. … I hate my life. Now I have to rent a car and drive us back Friday right after the rotation. …….I hate my life.

Tuesday, October 30th– The Best Part of Today was the Impromptu Pasta I Made

Preceptor was out today. So, we had a substitute supervisor. Since he does things differently, it doesn’t matter if we followed the instructions from our preceptor yesterday to the letter. He would correct us. Oh well. We only had two patients. Seems most of the Ob/Gyn floor is pretty calm this week. (Please don’t jinx anything!) Afterwards Gia and I walked back to the Airbnb we are staying at and took an hour-long break before starting to read the new guidelines for diabetes management during pregnancy that we have to present together this week.

In the middle of it I made some delicious pasta with some $3 meat, some salt, pepper, butter, and a lime. Oh! And sour cream! That finished it off! That was great. I’m learning how to cook with whatever’s at hand. That’s super useful. After this impromptu meal, we finished the presentation on the diabetic guidelines and I fell asleep against my will. I planned to work on this brochure I have to make, buuuuut…. Nope. My body demanded sleep.

Wednesday, October 31st– 5th Halloween in a Row without Giving Out Candy to Trick-or-Treaters

~Another wonderful day in Puerto Rico!~ That was sarcasm. *sigh* I want to go home. But instead, I woke up and began looking for pictures of pregnant women exercising. It’s for a brochure I have to make. It’s not some weird thing I’m into! Anyway, soon after, I got dressed and walked to the hospital with Gia. We were assigned two patients which we finished evaluating before noon. Then the preceptor gave us the choice to either take up another patient or work on our assignments. Assignments, DUH! However, I fear she’ll take that choice as does not show initiative. Oh well. I needed it. I finished that kinky brochure…erm… I mean, that brochure on physical activity in pregnant women. *ah hem* and got an outline of the case study presentation done.

Another trick question from the preceptor: she told us we could go home for the day to continue working on assignments. I trust no one. I don’t want her to cut my hours. I do NOT want to explain that to the director. I’m on a tight string with her as it is. So, currently, I’m typing this at the hospital. Gia left about half an hour ago and I still have another half hour before 4:30pm when we are supposed to leave. Afterwards, I plan to pass by the grocery store to buy some Halloween candy. It’s my favorite holiday and it stinks that I don’t get to hand out candy. …For the fifth year in a row. ☹ That’s my favorite part about Halloween. I know it’s not the healthiest thing, but the children get so happy! Plus, since my family never spent too much on candy to give to random kids (AKA trick or treating) I usually gave them something else. A couple years I gave out balloon animals and another I gave away my collection of Goosebumps books. (Kind of regret that second one, but hey, I gave the gift of reading that year.) Ahh, happy children. I haven’t been blessed by that on Halloween since before I went to university. Maybe next year… 6th year’s a charm?

Thursday, November 1st– Taking the Time to Educate a Patient

Things got a little crazy this weekend, so actually it’s November 5th when I’m writing this. But that’s okay, ‘cause you’ll get only the more important information. Today I got a patient from the labor and delivery floor. This is different than the maternity ward where women go when they’ve already had their baby or before they give birth. A woman isn’t expected to suddenly give birth there. They are in the labor and delivery floor! Luckily, that didn’t happen to my patient today. Because of patient confidentiality, I’ll just say this: my patient had gestational diabetes and seemed interested in the medical nutrition therapy AKA what to eat to make you feel better when you are sick. That’s the essence of a clinical (hospital) dietitian’s job. Interest in our services is rare. Most people look at me funny and ask if I’m going to put them on a diet when I tell them what I studied in university. It’s not funny. Not then, not now.

Anyway, she was interested, so I gave her some generic handouts then, after a moment, asked if she’d like me to come back after I calculated her diet and show her how I’d divided her carbohydrates for the day. (Carbohydrates are recommended to be distributed consistently in patients with diabetes to avoid severe spikes or dips in blood sugar [glucose].) She said yes, and after finishing my work for the day, I wrote out a little how to guide on carbohydrate counting with her diet as the example. All by hand on a blank piece of paper. *phew! Minimal white out, so a success. I went back to show her and briefly explain it to her. I hope it helped.

Later that night (read: the whole night) I worked on a grant proposal due for my internship. I had a crazy change of heart and mood which gave me the energy to work through the night on it.

Friday, November 2nd–  Last day at Ob/Gyn …I wish I’d gotten a hug from the preceptor

Today, the preceptor told us we’d just have to present the new diabetes nutrition care guidelines to the staff and then we could leave. This was great news for two reasons: able to travel back home to San Juan early and so that I could sleep a bit before working on the assignments due for the Trauma rotation. But…She gave us patients. Trust no one. She also gave us our evaluations. Which is nice since most of the preceptors don’t. Blah, blah, blah I need more leadership skills, I’m quiet, blah!

Welp, that was over! I wanted to hug the preceptor. She’d been so nice. This was the clinical rotation I’ve enjoyed the most. The staff wanted to learn from us. It wasn’t just doing assignments to do them. I regularly used the handouts from previous interns to educate patients. The case study I presented was on lupus and I know it was probably the first refresher in a long time about that disease for the staff. (Lupus is not unheard of, but it’s not common.) I felt good about the work I was doing there, so I wanted to do it and I wanted to do it well.

Ultimately Gia and I went back to San Juan in an Uber. Expensive, but worth it to sleep a couple of hours on the way. With that, our out of town rotation adventure in Ob/Gyn was over!

Saturday, November 3rd– After Two All Nighters, A Day of Sleep

We got back around 8pm on Friday and I arrived to Gia’s apartment to work on the Trauma rotation assignments from last week due today at 8am. I worked all night. Second all nighter in a row. Gosh. After turning it in, I fell asleep around 2pm and didn’t wake up until 6am on Sunday morning.

Sunday, November 4th– First Volunteer Event of the Internship and Water Shut Off

No immediate pending work. So, I spent the morning anxiously relaxing. I was still buzzing from the last couple of all nighters and assignment panic, so I couldn’t truly relax. At 3pm Gia and I went to a diabetes volunteer event we’d almost forgotten we signed up for. It worked out though, because Karen couldn’t get the shower water to turn off, so they had to bring a professional to shut it off. Until Monday. After the volunteer event, Gia and I worked on a hand out for next week’s rotation: Intensive Care. *~* It took until 1am. So tired.

 

 

* * *

Notes: Sorry it took so long to post. As you have read if you made it to this point, it was a busy weekend. And it gets better… Next week Gia and I go to the Intensive Care Unit (ICU) Rotation. Since it’s Tuesday as I write this, here’s a teaser:
  • Gia and I are forced to talk to the director. Remember she had said she needed to talk to us last week? Yep. Here’s that talk.
  • Gia and I play in the mud. Actually, we just kind of sank in it. In our hospital skirts and heels. XD That was hilarious!
  • I have a casual conversation with Karen for the first time in a couple of weeks. Before essentially telling her she’s being too loud when she starts ranting to Gia (who came over to give me a sheet of paper). And it’s only Tuesday when I write this!

Week of October 22nd 2018- Trauma Dietetic Internship Rotation (A Very Apt Name)

Another ~fabulous~ heartbreaking week during this dietetic (nutrition) internship. My internship partner, Gia, and I are in the middle of clinical rotations at the moment. This week we have trauma! (In all forms of that word…)

Monday, October 22nd– Evaluating patients in an Intensive Care Unit (ICU) for the first time

First day at the new hospital. Quick rundown, when I say this is our Trauma rotation I mean we are evaluating patients with physical traumas. This could be due to a car accident, gunshot, stabbing, fall from stairs, severe burns, or something similarly damaging. So… real sick patients. Most can’t eat by mouth, so they are tube fed (to their stomach or intestines) or fed through a tube to their veins (IV). I say this often, but I’ll keep saying it: if eating well is important in healthy people, it’s that much more important for those who are sick. The sicker they are, the more important nutrition is.

This day we evaluated two patients in the intensive care unit (ICU). They were unconscious (due to sedatives) and it was my first time evaluating a patient this critically ill. It wasn’t so bad though. I just had to calculate their tube feeding/IV feedings and make sure they were getting the proper amount of calories, protein, carbohydrate, and fat. I hope they are doing okay.

Tuesday, October 23rd– Calculating Diets Manually. Geez, I Appreciate Technology!

Today we were assigned two patients on the intermediate floor. Since these were still trauma patients, they were still in pretty bad shape. Stab wounds don’t heal overnight, you know! Well, most patients on this floor are on tube feedings, but the ones we were assigned were eating by mouth. And, since they weren’t so sick as to be sedated, most were awake and conscious. My patients both required an interview and diet calculation. The interview depends from hospital to hospital, but tends to be something like this: Do you have any history of disease like diabetes, or high blood pressure? Have you had any recent changes in weight? Are you experiencing any gastrointestinal (GI) problems like diarrhea, constipation, nausea, or vomiting? Do you have any difficulty chewing or swallowing? Are you allergic to any foods? Are there any foods you don’t like?

Welp, I asked those questions to the patient then was told to calculate their diets. At the other hospital where Gia and I did our first clinical rotation, we had an excel sheet that adds up the calories and macronutrients (carbohydrates, proteins, and fats). The dietitian at this Trauma hospital that we are working under (our preceptor) wasn’t having it. Nope, she said we had to do it by hand. How? Using basic nutrition facts.

A portion of bread (for example, a slice of bread or 1/3 cup of rice) has 15 grams of carbs, 3g of protein, and 1g of fat. Carbs have 4 calories per gram, proteins also have 4 calories per gram, and fats have 9 calories per gram. So, add up the calories per each (15g carbs*4 plus 3g protein*4 plus 1g fat*9) and you get the total calories for that food item (81 calories in the example). Or that’s the idea (because not all slices of bread are made equally). Welp, we had to do that for the whole day. Figure out how much bread, grains, meat, milk, and whatever else our patients should eat in a day. All on a sheet of paper with a pencil. Man, technology is nice.

Wednesday, October 24th– Will my heart turn to stone, or will it shatter?

Several happenings today. We got assigned three patients. I got one from the ICU and two intermediates. One diet calculation. That wasn’t the problem. I’m not a licensed dietitian nutritionist yet (that’s why I’m doing this internship to be able to take the licensure exam). BUT, I care about my patients. I want to do things right for them. So, I ask questions. I had a patient with diarrhea. I had some options as far as supplements that would help alleviate it. I’m an intern. I’m supposed to be learning. So, the dietitian preceptor asks me which supplement I’m going to use. I don’t know. I tell her I’m stuck between two. And she briefly explains them when I can’t.

Then she asks me again. I still don’t know. I guess. Wrong guess. Now, she asks me what dose (how many supplement packets per day) and if I wasn’t sure which supplement was best, I sure don’t know how much to give! I told her it depends on how severe the diarrhea is, and I don’t know the starting dose. Blah, point is she tells me to look it up. I do. But now I’m angry. I understand she was trying to help. To get me to learn this on my own, but that’s the frustrating part. I thought I wasn’t on my own. I thought she was supposed to teach me. I don’t need her to look things up. If that was the point of the internship, there would be no internship. It’d be pointless! It feels pointless…

After this day I get back to my apartment and sing on the couch for about two or three hours straight. I’m just trying to cope. Then I call my dad to coordinate the finances for next week’s rotation which is out in the sticks (a city about an hour and a half away). I end up talking to my mom afterwards and completely break down. I tell her about all the struggles fighting for the well being of my assigned patients and how there’s only so much I can do. At the end of the day, the decision is my dietitian preceptor’s. If I can’t convince her, I have to live with a choice I don’t agree with. Sometimes this is minor, but other times it’s not. I was doing okay as I told her these things. I was angry, but okay. Until I told her about my patient at nutrition support last week. The one I evaluated then he passed away that same day. I was sobbing. That still hurts. It was just a conversation I had with him and his family, but it hurts.

Thursday, October 25th– Last day at Trauma

It was a short rotation. Just four days, and today we spent the day with a speech pathologist. Why? Well, because you need to be able to swallow to eat which means we should know a little bit about that. It was okay. Brought up a few past demons. But that wasn’t the worst. It upsets me to no end when medical professionals have little or no bedside manner. I originally wanted to be a nurse. In high school, when I started learning about medicine, I learned it all in the point of view of a future nurse. It’s nothing complicated. At least I don’t think it is. I’m talking about saying hello to the patient when you walk in their hospital room. Not shaking their leg or talking excessively loud to wake them up so you can ask them your questions. It just bugs me. And the thing is, it’s been a similar experience with all of the health professionals I’ve worked under in this internship.

When the work day ended, Gia and I went to the health department to get some materials for tomorrow. I have no idea what we are doing tomorrow. All we were told is that we will be in charge of running an information booth focused on nutrition for older adults. Today, someone mentioned patient/participant evaluations or interviews. What? Ugh. I have no idea. But, that’s nothing new in this internship. We stopped by the grocery store to pick up snacks for the week then headed back to our apartments. Since then I’ve been a little piggy trying a little of all my snacks and watching YouTube. My newest obsession is watching stand up comedy. *sigh* A girl can dream!

Friday, October 26th– Internship Director Called Gia and I Selfish

Didn’t sleep. I had to work on an assignment for the internship. So, I stayed up all night to complete it and pack. Today we had an activity planned in the next town over. So, Gia, her roommate Uuie and I got to the department of health at 6:40am in order to print off our assignments and leave at precisely 7:00am. The nutrition activity we had was setting up a nutrition information table with food models and MyPlate (the nutrition guide for healthy eating from the United States. Go to MyPlate.gov for more information). It ended a lot earlier than I thought. 12pm and we were loading the department’s van to go back. Except Gia and I had planned to stay. Our rotation for the coming week is in this town and we don’t have a car. Well, we let our internship director know this morning. I’d forgotten to let her know beforehand.. She was livid. She didn’t tell us to go back with the other interns to the department of health. Instead, she told us to call her at 2pm.

We did. Or, Gia did. I’m grateful she spared me of the director’s scolding. The director told us it was incredibly selfish and wrong, the choice we made to use a department vehicle for our own gain. (The department of health driver took us to the town in the department van.) I didn’t think it was that serious, but from what Gia tells me, the director was more than serious. My take on that is she should have told us to go back. She could have done that. We would have gone back. Lost the money we’d put down on the Airbnb for the weekend. I just wanted to get away. I hate my life here and more at the apartment I live in where everyone hates each other. One weekend. I wanted one weekend away. But that was selfish. Sorry director.

I slept from 4pm to 11am. Don’t want to be awake.

Saturday, October 27th– Boring day at a new Airbnb

I woke up at 11am, but we had to be out of this Airbnb by 1pm. Gia and I ate leftovers from lunch yesterday and grabbed our stuff. The hosts gave us a bag of bananas and then a ride when they saw us waiting in front of their place. We were taken to a nearby plaza where we waited at a Burger King until the other Airbnb was ready for us to check in. There we unpacked and worked on homework. Boring day. I can’t fully enjoy this week after being reprimanded by the director. I’m tired of being corrected and made feel small.

I did research for a grant proposal for an organization I was a part of during university. It would be amazing to give back to that community that helped me so much. If only I could get through this internship.

Sunday, October 28th– Mosquito War and War Movie

Woke up at 7am because I was itchy. Did I mention this new Airbnb only has one room and one bed? Gia didn’t want to sleep in the same bed but changed her mind for some reason. Probably because I told her I hadn’t planned on high blasting the A/C (there’s only one A/C unit and it’s in the bedroom). She’d planned on sleeping on the couch, but I get very cold easily and really hadn’t even planned on turning the A/C on. Whatever. Point is, she caved and slept on the bed with me. I passed out, no covers. Woke up to mosquito bites. Left the bed so I wouldn’t wake her as I vigorously scratched them. More mosquitos in the living room.

Woke Gia up to get the duvet she was sleeping on top of. Covered myself in it like I was hiding from the bogey man. Heard the little monsters buzzing around my duvet shelter, just waiting for me to come out. It was so hot under there. I popped one arm and my head out. Five minutes and four bites on my arm later, I’d had enough. I went to the tiny room and blasted the A/C. Didn’t care that it woke Gia. I covered myself in the duvet and watched YouTube in that frigid room. Effective. Peaceful.Then we went to the grocery store to buy some food and for me, some bug spray. UGH. There’s more of them now. I can’t think like this. And Gia thinks I’m crazy because they don’t like her blood. They usually don’t bite me. …this just proves showering is a bad idea.

I tried to work on my assignments; I really did. Kind of… I just don’t want to. I’m interested in the grant, but I don’t feel like working on it. It’s a lot of work and I’m stressed with all the other assignments we have to complete. Ehh. Gia and I watched a movie to finish off our stressful weekend. It’s a long movie, but I think it’s motivational. Unbroken follows Olympic athlete  “Louie” Zamperini through his experiences during World War II such as being adrift at sea for over a month and his time in prisoner of war camps in Japan. It’s gives me the feeling that if a fellow human can live through that and defy his circumstances, how can I not get through this? It’s just an internship. This isn’t war. I can do this. Or, if I can’t, I’m going to do my best and die trying. (Hopefully not die… though sleep deprivation and stress are serious issues.)

Note:

I drew the featured picture on Friday as Gia and I waited for 2 ‘o clock to strike in order to call the internship director. Any Doctor Who fan will tell you that Oods are creatures who literally hold their hearts’ in their hands. I feel like that now. And in the sketch, I’m trying to shove my heart back in. It’s not working..

Week of October 15th 2018- Nutrition Support (Beware of Burnout)

My life is stress. I know this. I feel like I should be prepared for this. But no matter how much I’ve lived through, I feel as though I’ll never be ready for what lies in front of me. Maybe I never will be. I definitely wasn’t ready for this week.

Monday, October 15th-First Day at a New Hospital- Nutrition Support

New rotation! Another clinical area, this time Nutrition Support. For those who are new to my blog, I am doing a dietetic internship with the Puerto Rico Department of Health. This consists of completing assignments from the Health Department itself plus going to different hospitals or community locations to experience a week or more in about 20 areas over the course of one year. Each rotation has its own dietitian preceptor that is in charge of us. They essentially guide us in that area and give us more assignments/ work to complete for them.

This preceptor had us define 36 medical terms that relate to nutrition support. Nutrition support is exactly like it sounds. When a person can’t eat in the traditional way (by mouth) hospitals support their nutrition by feeding patients via a tube to their stomach or intestines or through a vein (using an IV or catheter, basically a tube attached to a vein). There’s much more to it than that, but I hope that gives y’all an idea.

Our first day we turned in the vocab and saw our dietitian preceptor do patient rounds. 11am, we were on our own. We were given a patient to do a case study and that was it. No further instructions.

Tuesday, October 16th- Learning TPN Calculations?

So, we got all of Monday to work on the case study. After a while we went to ask the preceptor for further information on how to do the case study and she gave us our patients’ laboratories and told us we needed to interview the patient. My patient (which I essentially got randomly, since we didn’t get much information about who was whom) was so ill, even the preceptor didn’t go evaluate him. She told us he was on death’s door, and wasn’t about to go in and ask him how he was doing. …great.

Today the preceptor dashed through an example of a TPN (Total Parenteral Nutrition) calculation. This is the math a dietitian does to figure out how to “feed” a patient through their veins in order to meet their total needs for the day. My internship partner, Gia, and I had done this during our general clinical rotation at another hospital, but were both completely confused by the end of her “teaching” us.

So, after going to see the daily patient rounds it was about 11 am and we got the rest of the day (until 4:30pm) to work on our three calculations that were part of our homework. We spent the day puzzled trying to figure out how to calculate things the way the preceptor did. I was sleep deprived. Don’t remember from what, but I was running on about two hours of sleep and couldn’t think enough to figure out the math. Gia went to ask the preceptor and came out even more confused.

Wednesday, October 17th- All Nighter for Nutrition Support Homework

What did we even do at the hospital today? I don’t remember. So, I’ll tell you about something that I didn’t mention about Tuesday. At the beginning of patient rounds, our dietitian preceptor turns to me and Gia and, almost like an afterthought, says something along the lines of “Oh Laura, your patient died”. … Okay. That was it. Then we went up to see the day’s patients. When we were in the hallway that led to my deceased patient’s room, the preceptor mentioned the family was still there as the medical staff were preparing his body for removal. …Alright.

I didn’t say anything. Later, the preceptor told me the nurse she works with had told her to give me a new case study, but she’d decided not to, because that’s part of life. That’s what happens. At that moment I said, “Yes, I know. He’s my third.” That I know of, he’s the third patient that I evaluate that I later learn has passed away. Even though I just had a conversation with them, it’s an odd feeling to know that one day you were talking to someone trying to help them eat/ get better and the next… there’s nothing to get better. They’re gone.

Thursday, October 18th- All Nighter for Department of Health Assignments

Since this week we had a meeting at the Health Department on Friday, our rotation at this hospital was cut short. This meant all of our assignments were due on Thursday. I typed up those calculations we didn’t really figure out how to do, the case study that we were also not 100% clear on, and the summary of an academic article about TPN. Gia and I worked on it all night. I was able to sleep one hour before waking up at 6am to take the train to the hospital. That hour was glorious. I felt renewed.

After presenting our case study and turning in our work I’d planned to sleep about 5 hours to then finish another case study I had to present during the meeting on Friday. I felt awake though, so I didn’t sleep. I worked on the case study and told myself I’d finish by midnight and then I could maybe sleep two hours before working on a grant proposal that was also due on Friday. Nope. I barely finished the 20 page case study and power point presentation that went with it by 6am. I didn’t take mindless breaks. I laid on the cold floor to wake myself up. I was running on an hour of sleep. But I finished my terrible work. I didn’t even get to begin the grant proposal.

Friday, October 19th- Presenting Clinical Case Study

6am. Meeting started at 7am. Printer issues. Chaos. I presented with a shaky voice and without an idea what I was saying. It was disastrous. At one point the director of the program (I was presenting to her and my fellow 9 dietetic interns) asked me a question and I was so tired, so beaten, that I responded the truth. She asked me why I’d decided on some supplement for my case study patient and I said, “honestly, because my preceptor told me to.” This was my first patient. Ever. This was during my first day at the general clinical rotation way back in September. I listened more to my preceptor than to myself. She’s the one with the experience. She was supposed to guide us. *Sigh* Trust no one. Make your own decisions.

Saturday, October 20th- Sleep Blissful Sleep!

I fell asleep at 8pm and woke up at 1pm today. It was so needed. When I woke up Gia and I went grocery shopping. Mostly ramen. Both of us hardly ate this week. That’s not okay. Hardly any sleep or food plus a ton of stress meant we were working ourselves empty. I didn’t even have pasta at home and subsisted mostly on ramen.

Luckily, this hospital feeds its employees and for the four days we were there, they fed us too. That was the majority of our food. Even there, I’d only eat a scoopful of rice or the meat. Because of the stress, I just wasn’t hungry. I bought a cookie and it tasted bland. Things were getting bad. My body didn’t care much for food. To avoid that, I bought pasta and tortillas. The most basic of foods for me. The easiest filling things to eat. I don’t want to go through a week like that again.

The rest of the night Gia and I worked on a powerpoint presentation and handout due on Sunday. Yes, our preceptor for the next week told us it was due on Sunday. …Okay. So we got it done, because I really don’t want another week like this one.

Sunday, October 21st- Catching Up on Priorities

Woke up at noon and then went to the store to buy some ink. Gia recently has printed a lot of my assignments because I’ve been having issues with the printer at my apartment. So I felt like I owed her. After that we wandered around the mall. I bought some food, but since I’d made an effort to have a filling breakfast (eggs and apple juice) I was stuffed. Gia put the fries in her bag and I did the same with my chicken nuggets. We wandered some more when I saw that the flower stand was there. (I posted a picture of the flowers I bought from there on instagram a few weeks ago. Links to my social media below!) Today I bought some yellow daisies before returning to our apartment complex. Gia went to her apartment and I to mine. Since then I watched a bit of YouTube and began writing this blog post.

Oh, and that grant proposal I didn’t finish? It’s due in two weeks now. Catch is, passing grade is an 85. This week is another intense rotation: Trauma (aka, critically ill patients). Plus! Gia and I were just notified on Friday that we will be going to another city (about an hour and a half away) this coming Friday to put up a little information booth about nutrition for older adults. OH! And! Next week our (five day) rotation is in that city. Ah! And we don’t have a car. We might just stay from this coming Friday till next Friday when the rotation there ends. But… how will I turn in the grant proposal? (It’s due as a hard copy.)

 

Who knows?! Isn’t life fun?! I should be going crazy, but I’m taking everything in stride. Either I can get through this internship or I can’t. Simple as that. I’m going to do what I can, because I can’t do more than that. If my best is enough, great. If it’s not, then I wasn’t meant for this. That’s okay. There’s much more to life than a  single career path.

Take care, friends. Eat well and sleep. Nothing is worth your health. I learned that this week.

Week of October 8th 2018- WIC Rotation (I Don’t Want to Step Into Another WIC Office Ever Again in my Life)

Monday, October 8th- Avoiding People During the Three Day Weekend

It was a three day weekend. Why? Who knows? It’s Puerto Rico. I’m just going with it. It’s good though. I got to laze around Friday afternoon, Saturday, and Sunday. Usually I pull myself together just enough to do my laundry on Sunday and get ready for the next day. I didn’t have to do that this weekend, but on Sunday I did have to finally crawl out of my cave of a room (my roommate was gone for the weekend, so it was glorious). Some other interns wanted to meet up to talk about rotations we’d been to and for general advice. I’d already promised I’d go, so I wrestled on some jeans and a bra and marched over to the little grocery store eating area where this meeting took place.

Really, I’d been essentially in hiding since Friday afternoon. I would sleep early (10 pm-ish) and get up early (7 am-ish), solely to avoid people. …Having my own room would be a disaster. Anyway, my roommate, Axyl, finally came back today, so no more hiding. Today, I did laundry, cleaned my side of the room, and worked on an assignment. Oh, and I brushed my hair. That was nice. Tomorrow begins our individual rotations at WIC. Mine is out in Santurce (the next town over, you could say). Bright and early at 7am. ~Yay.~

Tuesday, October 9th- I was told we’d talk about assignments today, then got berated for not having said assignments done before today. What?!

First day at WIC. I arrive for the preceptor (dietitian supervising me) to berate me for not working on the assignments sooner when she herself had not mentioned them and when I asked her the week before (Friday, I believe) she told me I did not have to complete anything by Tuesday and that we’d talk about that then. UGH.  She could have said, I have no more information for you, have at it, and I would have finished it by the time I arrived today. UGH.

So, I spent the day freezing in the exaggerated A/C and working on assignments. I saw her interview a patient and that was my day. Better than Wednesday where I spent it looking up options if I were to quit this internship. I found a variety of universities with pretty much open admissions to Master’s programs. So, maybe it wasn’t entirely counterproductive….

Wednesday, October 10th- No Motivation, Just Sleep

I went home as usual from the WIC office. A bus ride and train ride. Approximately an hour trip. And I watched You Tube for a bit, until I got sleepy. I decided to take a nap before working on my assignments. My roommate came into our room, made a comment about me being lazy. I decided to prove him right, and slept. 8pm-ish, I slept until the next morning. I didn’t see the point in being awake.

Also, I did not work on my clinical case study or grant both due next friday, or on my clinical binder due this friday, or even on the WIC assignments also due this Friday. Those assignments were: a 15 minute long presentation, a case study, a short article, a facebook post, and a bulletin board. None of it. I worked on none of it. I slept.

Thursday, October 11th- Why can’t people talk right?! Be straightforward!

Dietitian preceptor tells me to focus on the case study, that I have to have that done by today, when I had asked her on Tuesday when I had to turn all of the assignments in and she’d said on Friday. Liar? or Spazzy? I don’t know. She also told me I’d be observing a class led by another WIC dietitian at 9:30am. But! At 9am, she tells me in a failed nonchalant way that well, I was supposed to give the class, but since my powerpoint isn’t finished…

Hold up! She had NOT told me my powerpoint was due today! To make things worse, she’d told me to focus on the case study! But double wait!! I did have my powerpoint done!! Well… a rough version, but I wasn’t going to tell her that. I said, “Oh, but I am finished with my powerpoint.” Real nicely… So, she gives me 15 minutes to set up in the conference room, and now I’m supposed to present my presentation to the WIC participants. That’s crazy! But I did it, and she criticized my powerpoint for having too many words on it. UGH.

Friday, October 12th- Got an 83% on my Evaluation for WIC. Failing in my Internship Program is 79%.

Welp. Since I did not get to finish my case study, hadn’t done my clinical binder, or any of the other WIC assignments (the article, Facebook post, or bulletin board) I did them this morning. And I mean this morning. I started 9pm on Thursday and worked straight until 6:30am when I took an Uber to the WIC office. I kept working at the site. I finished everything but the bulletin board by the time I was in the office. So, I focused on that. (Picture featured above)

Yeah, there were a couple grammar errors. Yeah, the dietitian nit picked me on stuff that was directly from the Academy of Nutrition and Dietetics (the most official and correct source as far as nutrition goes) then dropped it when I told her where I got the information from. That’s ignorance! Why is it wrong when I say it, but okay when it has the official Academy seal?! It’s the same information!

Anyway, she evaluated me and told me my bulletin board was my best assignment and that it’s understandable since I have a problem with the language. URHROIHSFUSA!!! WHAT?! Excuse me?! They were grammar errors due to a time crunch. Don’t push your judgemental view of foreigners on me! That made me angry. As one of my strengths she did state the fact that I am in control of my emotions and that she could never tell if I was upset. GOOD. Because I was. Constantly!

She also said I lack leadership and confidence because I have a quiet voice and refer to the computer questions a lot during patient evaluations. DUH! I don’t work for WIC!! I don’t know the questions! And so what if I have a quiet voice!! UGHGHHGHGH. That also made me angry.. More strengths she stated is that I was very cooperative and took criticism well. Ugh. I went home and caught up on sleep. 8pm to 12pm on Saturday, I slept.

Saturday, October 13th- Karen. Stop Reading my Blog.

Karen, a fellow intern, whom I told not to read my blog, does read my blog. Sorry I can’t tell you guys about my weekend. If she had respected my wish for her not to read this, I would feel open to sharing. But, I don’t. K, you’ve broken my trust (again), but I won’t sink to your level. You will remain anonymous here. But I’ll never believe you if you say you don’t read this. If you want to know what I say or write about you behind your back, ask me. Because it’s the same things I say to your face. The only thing I haven’t had the heart to tell you to your face is how your terrible spanish grammar makes me cringe. That’s it! Everything else, you know. So stop snooping around and get your own life.

Sunday, October 14th- Another Day I won’t Divulge because Karen Reads my Blogs

It was a beautiful weekend and I found hope about staying here. How? I won’t say. Why? Karen. K, butt out of my life. I don’t want you in it.

So what if I’m on my Period? Yeah, I said the P word!

Nausea, abdominal pain, dizziness. Concerning right? Until I tell you it’s due to my period. Which I wouldn’t. Because it’s not professional to talk about such things. So what? I have to do my work as if I’m not a second away from puking all over it?

On my last day of clinical rotations a week before writing this, I got my period. I was gulping down tons of warm saliva, nauseous, and seconds from vomiting. I felt the world shift as I viewed patient files; I rocked back and forth quietly groaning as my uterus shed its lining and I did this all in (literally) bloody tights. (My dietetic internship hospital uniform requires a skirt and skin colored tights.) Oh, and on an empty stomach, since I was so nauseous that I couldn’t get down more than a spoonful of soup and a couple swallows of water.

Even though there’s an explanation for symptoms like nausea and abdominal pain when it’s due to a woman’s period, those symptoms are concerning and important to be addressed! YET! Women are expected to do the same good job she usually does when she’s not in pain and bleeding as when she is. AND, she is not to mention these extra obstacles. Because it’s not professional. It’s too personal. Unwanted information.

But I wanted to mention it this day. I’d had a situation before when I’d told a boss I was on my period (I asked to go home early before I felt obliged to puke on a customer) and she looked horrified I’d brought up such a hush hush topic. So, this day I simply told the preceptor (the dietitian that was supervising and evaluating my work at the hospital) that I had been nauseous and dizzy all day. I told her the nausea was normal. Then she asked if I’d been to a doctor yet. When I said I hadn’t, she suggested my dizziness could be due to the stress of being in this dietetic internship.

(Sarcasm)~Isn’t it great that ailments can be from physical or mental origins? Isn’t that fantastic?! Even better is the fact that society judges mental ailments.~ If I have a “legitimate” reason for being nauseous like, let’s say a stomach virus, then yeah, I’m sick. Stay home. Blah. But if I’m nauseous because I’m nervous (say before a big speech or exam). No mercy. I should get over that. And, of course, not mention it. That would make me seem weak, soft, not put together. Not competent.

And, just as bad, if I’m nauseous because I’m on my period (a physical origin! The uterus shedding its lining!!) in that case I’m not supposed to let anyone know about it either! I’m expected to keep quiet and pretend nothing is wrong when I’m (literally) bleeding!

 

Why?

 

Why does our society value the physical and cast aside mental and women’s physical issues? Why? Those matter too. Those have important implications. They are barriers. Why are physical ailments excused from going to work or school, but mental and women’s physical issues expected to be worked through and not spoken about?

I finished that day at the hospital early. Got all of my patients evaluated. In pain, bleeding, hungry, nauseous, and dizzy, I finished. The preceptor just saw that I finished. That’s all that mattered to her. That’s all that matters to society.

But, remember, that having a mental diagnosis or being on your period are on the same level as a physical illness. Treat it as such. They aren’t anything to be ashamed of. So, talk about them like you would about breaking your arm or getting a cold. Unapologetically, because there is nothing to apologize for. And when you get your usual load of work done, be proud.

Breaking my dominant hand affects my ability to write. Why wouldn’t I be proud of being able to write legibly with my dominant hand being broken? Likewise, being depressed or on my period affects my work (motivation and execution). Why wouldn’t I be proud of being able to get through my usual workload for that day?

Even if society won’t give you that credit, give yourself some credit! You deserve it! Keep fighting anything in your way. I don’t know you, but I’d be proud to know you aren’t letting anything get in your way of your success. 🙂

 

Weeks of August 27th to October 5th 2018- Why I Haven’t Daily Blogged in Over a Month (With Audio)

Above is an audio recording of me reading this post. About 7 minutes. Not perfect, but I hope some of you enjoy it. 🙂

My goodness! It’s been too long! I truly hope everyone is well. So, what have I done for the last …erm… lemme check… month and a half? Nothing much. Except begin rotations in my dietetic internship and question my life, but that last part is normal. I’ve gotten angry, I’ve, recently, made crying a part of my weekly routine, and I’ve felt incredibly worthless and insignificant. I could tell you guys why, but that’d take at least three blog posts. So, I’ll recap in one long post.

 

Rotation 1: Elder’s Center (Community Nutrition)

It was okay. As my first rotation, I was ready for nothing and had no expectations. My internship partner, Gia, and I were told to write up an intake form and then were expected to complete the assessments and evaluate the elderly participants. I’d done this once. With a college student. Very different. We ended up doing the evaluations together (Gia and I) and got upset at each other for it. It was the first time we had to collaborate on something like this and, well, there were kinks.

Later on that week we were also instructed to give a presentation on MyPlate to a different Elder’s Center. After lots of activity/interactive ideas were tossed because the event would be to 100+ people not 30, like we originally thought, Gia and I spent a whole afternoon making a ginormous drawing of a sample MyPlate. It came out really well! And I loved having an excuse to draw. Gia doesn’t share my interest in these creative arts but partook in the merry poster making regardless. 😊

This week was all about learning to work together and hitting some bumps along the way. (Side note: The way home was about 2 and a half hours by bus and train. All but maybe one day we also met up to work on assignments together for the next day, spending a grueling 12+ hours with each other daily. We’re friends, but phew! that was trying!)

Rotation 2: General Clinical Dietetics (Clinical Nutrition)

*SIGH* It’s been eternal. I hope to give y’all the short version. First week was general orientation and review. That was nice. I was positive. I didn’t mind having to calculate diets and tube feedings or evaluate case studies. It was kind of nice. Made me feel smart.

Second week. General medicine for me, surgery floor for Gia. First two days the dietitian who we are with (from now on called our Preceptor) is super helpful and goes with us to do the interviews with actual patients. Third day she let’s Gia loose. AKA alone. Good luck doing patient interviews with a whole two days of experience! …that was sarcasm. I was terrified, and the preceptor could tell, so she went with me one more day. After this we were on our own looking at patient files (yes, they do paper filing here) and interviewing patients.

Third week. Oncology floor for me, general medicine for Gia. Our preceptor tells us we should be much faster and, in not as many words, better by now. She asks back any question we ask her and is generally unhelpful. I understand the tough love bit. Haa… do I understand it… But! It wasn’t helpful here. These are people’s lives! I mean, I’m not going to kill anyone by giving them more kale than they need, but you feed someone with diabetes a strict diet of bread and sugar I bet you there’s going to be some health implications! This stuff matters. I don’t want to play with people’s health.

So, I’d ask anyway. Only to hear that the preceptor had told Gia that we should study more and look things up (by this she means on the internet). Why would that ever be my first choice, when I have an experienced dietitian right in front of me who is supposed to be helping me gain clinical knowledge?! I already studied. Or at least that’s what my Bachelor’s degree says. I know, I know, lifelong learning. There is no end to learning and studying, at least not if you want to stay relevant and competent, but my point stands! Our preceptor blocking herself off from being an accessible, trustworthy source only instilled distrust in me.

I will admit that by her asking so much of us, I am much more conscious of every patient file, medical history, lab value, and most minute details (I’m only human), but it also instilled that nagging insecurity and distance from her. Which maybe is for the best, because I guess I can get that experience and clinical knowledge on my own if I work in a hospital for years. (Which, at this point, isn’t likely.)

Moving on, fourth week. Surgery floor for me, oncology for Gia. Preceptor expects us to be, essentially, fully independent. She doesn’t even take Gia to her new area! My heart breaks and I (finally) cry due to the rotations. Arguably, our jobs as dietitians matter in every floor of the hospital. Healthy or not, but especially if not, it matters what we put in our bodies. But in surgery? It could be the direct link between someone developing holes in their intestines or bleeding internally. Serious stuff depending on what surgery or health complication the patient has.

I couldn’t handle it. And that’s why I began writing the Why I’m Not a Doctor series on this blog. I couldn’t handle me, basically a dietitian in training, having to go teach patients what diets they have to follow for the rest of their lives. And you might say, “yeah, yeah, diet shm-iet”, but if someone had a kidney removed, or part of their intestines removed, you better bet it matters what they eat! Teaching them what that should be is crucial!

I don’t feel nearly qualified enough for something that important. But I went in there and taught (read: gave handouts to) several patients with truly life altering surgeries and broke soon after. I wanted to be better for them. I wanted to be as knowledgeable as they deserved and I know I could be in time, but I’m not now and I don’t know when the next time someone who is knowledgeable will help them. It hurts to want to help, but not be able to. At least not to your fullest extent. Plus, one of the patients I’d evaluated the week prior in oncology died this week. So, you know, EMOTIONS.

Now it’s week five. We have to do something called staff relief responsibility. Essentially do the work of a dietitian on the floor we chose for that week. AKA exactly what we’d been doing, but alone. (The preceptor still checking our work and signing off all of our evaluations and diet plans, of course) Soooo, yeah, pretty much the same thing. I chose general medicine (anything to get out of surgery) and Gia, who I think is completely insane for this, chose surgery. Neither of us wanted oncology which happens to be the floor our preceptor is in charge of when she’s not teaching interns.

I’ll miss our little study room reserved for us interns and some of the sweet patients who I hope are doing well in their own homes instead of the hospital I met them in. There are many things I won’t miss. Hopefully the rest of the year (internship) is not as emotionally grueling, but I doubt it.

 

Either way, it’ll make for some interesting stories.

Stay healthy, my friends.

 

P.S. And yes, that was the short version. I warned y’all!

I Missed out on being a Pharmacy Technician because I Didn’t Take the Certification Exam. Then I Enrolled in the Wrong College within my University: Why I’m Not a Doctor Part 2

In the last part of this dreary saga, I recounted my high school days in clinical rotations including my best and worst experiences shadowing doctors with my socially anxious personality. One of the best things of that experience that I didn’t mention was how close I got to eight of the girls who were in clinicals with me. Though each one shadowed a different doctor/area we rode in the same car and had lunch together. It was my first friend group in a long time and it was beautiful. So, when 12th grade came by, though I had already decided to pursue a career as a neurologist and knew I’d benefit most from the EKG and EEG class, I followed my friends to a pharmacy technician class.

Let me clarify that I had absolutely no interest in memorizing medicines or anything that went along with that class. But I had my friends. And that was better for me. Thing is, I have no idea who wanted to take this class. None of us five (the rest either graduated or didn’t take anymore clinical classes) seemed to have great interest in the class. We spent most of it taking dismal notes and goofing off. The class was one of those easy to pass classes that required minimal studying. So, I got through the class and told myself it was okay. I’d just study once I graduated and then take the certification exam during the summer to become a pharmacy technician and get a well paying job while in university.

Well… that’s clearly not what happened, or I wouldn’t be telling this story. Before 12th grade I was an excellent student. Though I procrastinated all throughout high school, I don’t think I turned in a single thing incomplete or late before 12th grade. I always gave myself just enough time to finish assignments well enough to get an A. But, I was going through some stuff.

Stuff too lengthy to get into right now. 9th grade to 11th I coped by making my life about my school work and grades. I didn’t have friends. Not a single friend in 9th grade. I sat alone every day at lunch. It was miserable. Then in 10th grade, I joined AVID (the class that helps students apply to university) and I gained a social circle of sorts (I personally didn’t have a friend, but I had a group of people I felt safe with). 11th grade I clicked with (as I call them) my clinical sisters. 12th grade I was still struggling, but I had friends: my clinical sisters and a friend from AVID. I tried something I’d never considered before. I stopped making my grades a priority. I wanted to do poorly.

So, naturally I learned nothing in my pharmacy course and became a mediocre student. I failed my first exam that year. Got my first C, I think in all my years of school. This whole change began in 11th grade (same time I began writing poetry) but it really exploded in 12th grade. It dropped my GPA noticeably. I still graduated with something around a 3.5, but haa. I hate emotions. Okay, so now you guys know, I screwed up my GPA if I had any hopes of being accepted into a medical school like Johns Hopkins or an Ivy League like Harvard. (I’ve got a story on that for later…) And on top of that, by not taking the Pharmacy Tech exam, I also screwed myself out of an entry level job that would have paid me between $12 to $15 an hour. That’s really good coming out of high school where the minimum wage is $7.25!

***

Without the money to afford an out of state school, I was left with public schools in my home state (Texas). (Or an all girl’s school in Pennsylvannia… but that is also another story…) I ended up going to the university my AVID teacher, Ms. Dar, went to. She’d taught me so much and I trusted her, so it seemed like a safe place by proxy.

But, I made a mistake when applying. I was the first person to go to university in my immediate family and while I could have asked Ms. Dar who would have, very willingly, helped me, I didn’t ask for help. Understatement of the year: not asking for help when I clearly need it is a theme in my life. By not asking for help, I cluelessly chose the wrong college at my university. Majors are divided among different colleges at universities. I didn’t know that at the time. I applied considering studying to be a neurologist. But… that wasn’t the question I was asked when I enrolled.

I was asked what college I was enrolling to. I skimmed the little drop down list momentarily debating if medicine would be under the arts and sciences college or the human sciences college. Well, medicine is the study of human anatomy and physiology, so I deduced I must be applying to the college of human sciences. I am a procrastinator. I must have been rushed. Or maybe I was too lazy to look it up. Or maybe I did look it up to no avail. I didn’t know how to navigate my university’s website at the time (I think I still don’t 100%).

Thing is, I made an educated guess and it was wrong. I ended up with the soft sciences that have something to do with humans like addiction and recovery, nutrition and dietetics, human development and family studies, and assorted human related careers like personal financial planning, restaurant, hotel, and institutional management, and family and consumer sciences education.

OOPS. That wrong click changed my life. And it’s why I’m here in Puerto Rico as part of a dietetic internship instead of in med school.

 

~*~*~

 

Well, that was a long part 2, but I’d forgotten how life changing that last year of high school was for me. I hope you enjoyed reading about my teenage blunders and I hope you come back for part three. I may write it for next weekend, or the one after that. Depends if I get inspired by something else. Let me know if there’s a particular topic you’d like me to write about or if you’ve ever been through a similar experience in the comments below. I can’t be the only one who has gone through all of the educational portion of a career or certificate and just thrown it away by not taking the exam. …right?

Either way, I’d love to hear your stories and ideas for future blog posts from me. 🙂 Thanks for stopping by my little corner of the internet!