I’m sitting here in the A terminal of Dulles Airport, putting my feet up during a rare moment of rest in the last couple weeks.


On April 8, I disconnected my Comcast connection (hooray), loaded my bags up, and drove away from home. No worries, folks, this wasn’t some manic spree, but rather, a well-calculated, if somewhat foolhardy, trip to the Pacific Northwest and Vancouver (Canada’s Pacific Southwest, maybe?), then on to la France for an away rotation.


The PNW was amazing. I hadn’t spent any time in that corner of the country, except for an interview at OHSU which was just Portland, and pretty in-and-out at that. This time, I had a whole week! Met up with my friend L in Portland and we had many adventures, including riding bikes down stairs in Portland (map reading skills), discovering the concept of an ice cream flight, which, omg, best concept ever!, hiking through muddy terrain to the most gorgeous waterfall I’ve ever seen, getting my first speeding ticket at the ripe old age of 30, and eating an expensive seafood dinner at the sort of place where the waiter puts the napkin on your lap. Personally I’ve always preferred hole in the wall digs (the more literal the better) but no denying that the food was excellent.



We also went to the AAN conference in Vancouver, while we were up there. Really good stuff, although somewhat overwhelming. I mostly went to clinician educator talks and career planning things, which means I know very little about movement disorders right now, but hey, that’s what fellowship is for, right.


And now, on to Grenoble, to study and work for a month with the neurosciences center there. What an amazing opportunity — one of my attendings knows someone there, and we just … Set it up. Remarkably easy. I’ve been to Paris once, and the rest of France never, despite taking French for a decade and at one point being fluent. My circadian rhythm is going to be all screwed up, but my brain’s gonna love it.


A bientôt, mes amis!

Anticipatory Grief

Entering the final few months of residency. It’s a really weird, mixed feeling. On one hand, being done with residency is definitely something to celebrate, even for those (like everyone in my class) going on to fellowships and further training. Residency is harder by far than anything I’ve ever done — intellectually, emotionally, physically — and I admit I’ll be glad when I sign out my pager for the last time.

But the flip side of finishing residency is the leaving of everything. Leaving my fellow trainees. Leaving the safety net of having someone else help with decision-making. Leaving my home.

After a little back and forth, I decided on a fellowship that is not offered at my home institution, meaning that I have to leave no matter what. That was a tough decision in itself; at one point I actually thought about doing a different fellowship just so I could stay. (Yes, that was silly. But that’s how much this town has got under my skin.) But now I have to find a place to live in this new city where I’ll be for the next couple years, and I kind of don’t want to? Because signing a new lease will mean I really am leaving my current place, and that I am committing to place A instead of place B.

The decision-making logic that went into my choice of where to go for fellowship was pretty convoluted, and in retrospect, not all that sound. I made the same bad choices about a decade ago and still regret it. I keep trying to pretend that it’s great! I’m excited! New adventures! in the hope that saying it enough will make it true. But here I am, on a bright Sunday morning in March, trying not to cry.

Studying for the RITE

Every February, neurology residents around the country dust off their #2 pencils in preparation for that worst of exams: the RITE. The Residency In-service Training Exam is a brutal, 8 hr scantron affair covering ALL OF NEUROLOGY. I’ve taken a lot of exams in my day; the RITE is the worst. Maybe it’s the 500+ questions written by attendings who want to show off their smarts and lack of real-world knowledge. Maybe it’s the “pictures” so blurry they must have been printed on a dot-matrix, then mimeographed several times, before being hand-copied by a horde of Egyptian scribes.

But because I don’t want my program director to realize how dumb I am, I’ve spent the last two weeks looking through old exam “discussion manuals” (i.e. answer keys; they reuse the questions) and review guides prepped by prior residents. The reviews are pretty amazing, like this gem from 2013:

2016-02-10 10.24.50

Yes, Virginia, dread of cats is a testable topic for neurology residents. And let’s not forget the one question every year that is like “What is the billing code for a 40 minute subsequent encounter? 99132, 99133, 99134, or 99135?” This is high-yield, vital information! Exactly what you NEED to know as a neurologist.

Ugh, back to the books before I fail this sucker.

30 for 30

With literally hours to go on the 30 for 30 challenge, I’m done! I was pretty delinquent on keeping up with reviews, but here’s a summary of my reading habits, courtesy of GoodReads. You can see Longest and Shortest Books there, but here are a few more worthwhile categories:

Best Book of 2015: Casual Vacancy, JK Rowling

Runner-Up: Americanah, Chimimanda Ngozi Adichie

Worst Book of 2015: The Martian, Andy Weir

Runner-Up: The Hundred-Foot Journey, Richard Morais

Most Atypical Genre of 2015: Vignettes (The Frozen Thames, Helen Humphreys)

Most Atypical Format of 2015: Podcast (Enchanted April, Elizabeth von Armin, via the BBC Drama of the Week)


What should be my challenge for next year?

A one-act play

Staff message from clinic nurse: Mr. Scrooge called, he has some questions about his follow-up appointment. Can you give him a call?

** ring ring **

Timid Female Voice: Hello?

Me: Hi, this is the Scrivener calling from University Hospital. I’m returning a call from Mr. Scrooge?

** hang-up sound, then silence. Our new VoIP phones don’t have a dial tone, just soul-eating silence. Dial again….

** ring ring **

Hearty Man Voice: Hello?

Me: Mr. Scrooge? This is the Scrivener, returning your call.

Hearty Man: Oh yeah! It’s about my wife. She’s not your patient, but she has a follow up with The Ghost of Christmas Past next week, and she wanted to cancel it.

Me: Uh… You’ll have to call the Ghosts’ clinic and tell the receptionist. I can’t do that myself, they are a different department.

Mr. Scrooge: Oh, ok. Can you tell me their phone number?

Me: Well, according to Google, it’s 867-5309. Sure, I’ll hold while you find a pen. 8.67. 53. 09. No, nine, nine as in … as in cat o nine tails

** Co-resident gives me the side eye **

Me: Cat. Not at, there is no at sign on a phone. Nine. Oh, hold on, let me just transfer you.

** attempt to transfer the call on the new VoIP phone, accidentally drop the call **

Me: Mr. Scrooge? Are you still there? No? Well humbug to you too.


Merry Christmas, all!