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| Today was one of the best clinic days I've had in a while. The best days are when you challenge yourself to think past your normal scope. When you feel a little uncomfortable. When the attending asks you questions in front of the patient, and you have no choice but to say... "i'm not sure." Joanne and I often talk about how the same types of cases sometimes come in bunches. i had two patients with asymmetric discs today. both patients had a negative family history of glaucoma, but both their races are a risk factor. the second patient had left eye C/D changes from 0.4 to 0.6 within 2 years, and a slight IOP increase, but no field loss/NFL defect/notching, rims still obeyed ISNT, etc. All we did was take pictures, pachy (thick corneas) and say "monitor yearly," but walking back to my car at the end of the day, I was still torn about this treatment plan. If it had been my dad, I would be ordering a bunch more tests, b/c that type of change ain't NOTHING. i'm learning how nebulous of a disease glc really is.
Both patients also had vitrealretinal tufts which I missed (to my credit, I did find a bunch of atrophic holes, lattice, WWOP..). Lots of rapid-fire, point-blank questions from Dr. Litvin, about all this disease/retinal abnormality stuff, as well as my choices for choosing contact lens powers, effective adds, etc. NO attending has ever questioned how I test ranges before. In short, I realized how much I suck, compared to where I need to be to be really successful. And it feels so GOOD!! It's like being sore when you get back from the gym. I'll take an instructor who pushes me, even if they dislike me, over someone who is "nice," but not concerned enough to get in your face. Come to think of it, my best instructors have been residents.
Anyhow.... I should probably sleep.
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| forcing yourself to not care must be the hardest thing ever.
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| only 6 hours left to sleep.. is this really wise?? haha. going back to the normal sleeping schedule is always difficult after sleeping 8-9 hours for 4 days straight because of BREAK!
this is the second year in a row i didn't buy anything on Black Friday. either there are no good deals, or this is a sign of maturation. i like to spend money on things 1) i will get a lot of use out of 2) for which i can think of specific situations/incidents/ways it will be used 3) which will last for a long time 4) which can be incorporated into my life (as opposed to sitting on the shelf, or hanging in the closet.. ) 5) which require a reasonable amount of management (cost+time) 6) which are versatile and 7) which provides a return worth far more than its price tag. i'm less likely to buy things on a whim.
ultimately, i can lead a simpler and more meaningful life by carefully considering what i bring into it. fewer possessions, but all high quality, useful, and long-lasting, vs. having an assortment of things which may come in useful, but rarely, and are more likely to fall apart.
i suppose that same concept an apply to a lot of things in life.
separate topic:
i always find myself questioning the meaning of events that occur in my life. whether large, or small, an occurrence can give me this special *feeling* afterwards. like somehow, i knew that it was significant. somehow, it penetrated a lot of the bullshit that happens from day to day and reached some place in my core. at times, it's frustrating to think there exists no REASON which i'm supposed to uncover or FIGURE OUT, only my OWN reason i must look inside myself to find. capisce? probably not.
off to bed...
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| i dOn't knOw hOw tO lOse yOu.
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| trying to get something accomplished today.....
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