for so many reasons.

The hours? Suck. Absolutely suck. 80+ hours a week for weeks? I have lost sight of who I am as a person and I find myself irritable and annoyed all the time.

The viral illnesses? Back-to-back URIs got me coughing my lungs out at night and blowing my nose all day.

Inpatient medicine? Not for me. I suck at it, and although I've gotten better, it's definitely not my strong suit. I miss EM.

The attendings? Don't get me started.

Every service attending overturns the previous week's plans. Every overnight attending overturns the day team's plan. We're constantly restarting and discontinuing the diuretics. There is no standardization.

The last week was the worst. There was no service attending; almost every day of the week was covered by a different attending -- the plan for each patient changed NEARLY TWICE A DAY. It's been madness.

This system is so broken.

And this final night? The absolute worse. I'll let you in on that in a few, when I'm less frustrated and more rational.

Cannot wait for this to end.

Only 3 hours left of my 24 hour day and the theme of the night has been:

Eclipse glasses need to meet ISO 12312-2 international standard. If you are a welder or have welding equipment the hood must be Shade 12 or higher!!!!

Most general welders equipment from a hardware store is less than Shade 12.

Please take care tomorrow, I'd like you to be able to see me the next time I see you in my office.

Solar burns to the macula cannot be repaired. The inflammation can be controlled but the scars are permanent.

Anyways.

"Hostile" pt comes in (front desk lady's term) and I see pt and try to soothe the ruffled feathers. Pt has already been seen for current symptoms by ophthalmology practice. Bunch of tests but no cause given and no treatment.

I do different evaluation, figure out the issue can be treated (at least partially) with glasses with prism (different type of lens for muscle misalignment). Pt says they never had any of this stuff done before by other docs. (Lots of docs don't like doing binocular vision testing)

They compliment my jewelry while I'm working to find the right prism for them.

End the encounter with pt telling me about their rodeo wild days when they were young and comparing bird skull jewelry (my earrings to their necklace)

I go out to the manager, set down the pt file and say "sorry, the "hostile" patient likes me, I'm their doctor now."

TL;DR: sometimes people are frustrated/angry because they need help and other's have failed them.

I picked up the book again today. I got to chapter 27 where a German virologist discovered the cause of cervical cancer was HPV-18 and HPV-16 (90% of cases) and how studying Henrietta Lacks' cells lead to the HPV vaccine.

I just received my last HPV vaccine (it's a 3 injection series over 6ish month) a few days ago.

It feels very strange to be so connected to this book. I'm a patient actively benefiting from research done on her cell line. I'm also a doctor who had informed consent drilled into my brain from day one. Not just informed consent but making sure the patient *understands* their rights to information, the diagnosis, treatment options, the ability to refuse any and all treatments, the right to a second opinion. On and on.

Page after page of this book is laying out patient privacy violations, broken ethics, a lack of record keeping, and complete disregard for the next of kin. That's the point though, all of this was legal from the beginning until the 80's and 90's in America.

It's a lot to grapple with. Research doctors injecting patients with cancer cells, taking blood from the Lacks family but never bothering to tell them why. The millions of dollars made from cultivating her cells.

I don't understand why this wasn't required reading for any of my classes for my biology degree, my medical ethics minor, or at any point in my doctoral program.

Informed consent was taught as the forgone conclusion but in reality had only been enforced federally for medicine and research for 30-40 years before I started my doctorate.

My manager (has a child on some spectrum and is very vocal about child advocacy and resources) was helping tech up a pt (who apparently also has a child with spicy brain). So I guess they were talking about it???

But I didn't know that. So I walk in totally stoked bc this Pt's first trial of custom specialty contact lenses got them seeing 20/20, like on the first try! Bc sometimes I'm good at my job. (Moving on)

So I'm like "how are the contact lenses? :))))"

And they mcfucking respond with "I was just talking to (the manager) about you, 'I bet Dr. (me name) is neurodivergent! She's quirky" (affectionate)

And I'm like "...ahah well um they weren't super big at diagnosing things when I was a kid so I was just called weird. Or yeah, quirky *jazz hands*"

So yeah I'm not officially diagnosed as anything except something that needs an ANXIOUS reflective vest, but apparently *whatever* I am, I am *not* masking it anymore like I did as a child.

(after that we talked about introverts in highly social jobs and how I have to go home and melt in silence for a few hours after work.)