no way this could go wrong:

My job is weirdly structured. There's two oncologists, one resident, two technicians, and me in the oncology department. Usually the oncologists are upstairs doing research (but swing by to advise on the cases), and the resident and the more senior technician run the service.

The junior technician and I would love to be involved and consistently try to help, but the resident and senior technician prefer to do everything themselves.

This is wildly frustrating.

This week, both the resident and the senior technician were away on vacation. You can imagine how this went:

The junior technician and I had a really interesting week. It's kind of hard to learn how to do your job if you only get occasional sidenotes on how to do it, which is what happens when the senior people are around...since it takes too much time (? or something?) for them to teach us what they're doing.

So, we both spent the week learning on the fly how to do things like reconstitute and administer chemotherapy. Gaaaaaaaah. You guys, when the big kids get back, I am sitting them down and explaining why this was a terrible idea.


This one afternoon, the technician was diluting out gemcitabine for one dog while I was mixing up another patient's zoledronate. This conversation happened:

Technician: "FUCK! I think I mixed this wrong."

Alacrity: "Wrong how?"

Technician: "I was only supposed to add 300 mg to the bag, but I added all 400."

Alacrity: "Oh. It's cool. We can just figure out the new concentration of the solution, and then recalculate the patient's dose."


Alacrity: "Why am I only supposed to get 2 ml of zoledronate back through the filter, but I'm getting 3 each time? Something is wrong."

Technician: "Yeah, this is all fucked up."

Alacrity: "This is like Beavis and Butthead in chemistry lab."

(hysterical, panicked laughter)


bike commuting tips: accoutrements edition

So, it's September.

This means that it's been two months since I sold my car, during which time I've been moving across the country, starting my new internship, and commuting by bike!

Here's a list of handy items to improve your bike commuting experience:

1. Helmet.

I wear a Bern helmet. There's some debate as to whether or not you're statistically safer on a bicycle when you're wearing a helmet, but I'd rather have an extra layer of protection for my brain just in case something unexpected happens.

I've bonked my (helmeted) head on the ground during unscheduled bike/horse dismounts, and I am convinced that a helmet is a wise investment. Make sure it fits correctly, and replace it if you fall on it or drop it from a significant height.

2. Fenders.

Ohhhh you guys fenders are going to make you so happy when it's raining. With fenders, your wheels won't throw muddy water up onto your clothes. Enough said.

3. Rack(s).

I have a rear rack. Some people have a front rack. Some people have a front rack and a rear rack. You can tie and/or hang shit on your rack(s) so you don't have to stuff it awkwardly in a backpack.

Some people prefer the backpack, though. You do you.

4. Gloves.

You know what's cool about gloves? They keep your hands warm when it's chilly (unless you get the fingerless ones). They look awesome. And...if you ever fall onto pavement or gravel, you'll tear up your gloves instead of your palms. 

5. Rain pants.

Arriving at your destination mostly dry > arriving at your destination with rainwater running into your underwear.

6. Rain jacket/poncho.

See above, re: rainwater running into your underwear.

7. Waterproof/water resistant shoes.

It's pretty amazing how thoroughly wet you can get when you're riding your bike in the rain. Don't neglect your footwear, or you'll be squelching for the better part of your day.

8. Bike locks.

Locking your bike is a whole separate subject for another day, but for starters, I use two locks of different types (U-lock and chain lock) to lock my bike. Both keys go on my key chain, and both locks nestle in one pannier when I'm riding.

9. Pannier(s).

A pannier is a pretty sweet receptacle for whatever you might need to carry with you throughout the day. I have a pair of waterproof Ortlieb panniers that attach to my rear rack, and so far they've done a solid job of carrying:

- Groceries
- Stacks of journal articles
- Extra scrubs
- Lunch
- Extra jacket

I like that my panniers are easy to detach and carry around, and they can carry absurdly large volumes of stuff before the balance of my bike starts to feel weird.

10. Bike lights.

Bike lights help 1) you see in the dark and 2) other people see you in the dark. Both of these should happen as often as possible. Safety!

during medicine rounds:

We're discussing a patient in kidney failure with a heart murmur:

Internist: "Yeah, you have to turn up her fluids."

Resident: "But I'll push her into heart failure!"

Internist: "So?"

Resident: "'So?' You don't care?"

Internist: "I'm a cardiologist, and I don't care. That's why the good Lord invented furosemide."

my gaydar is broken:

Hello you guys!

I hope the summer is treating you well, and that you are enjoying plenty of sunshine and outdoor adventures.

I'm adjusting to my new town and my new internship. This oncology-specific internship is completely different from my rotating internship, and the adjustment has been a bit rocky. Also, the fine inhabitants of this town have completely destroyed my gaydar.

I've met a large number of women who look like this:

or this:



You guys, I went to Smith. I understand that gender identity, gender expression, sexual orientation, and biological sex are all best represented and understood as a set of continua.

And yet...this is blowing my mind. Hooray for diversity! Hooray for destroying my preconceived notions of queerness! Learning!

in the ICU:

Alacrity, to criticalist: "Okay, so what are your feelings about-"

Criticalist: "I'm a man. I don't have feelings."

Alacrity: "-so, what are your man-feelings about giving contrast if the patient is azotemic?"

in which i am sassy:

Internist, to my student: [Student], have you considered that wearing those dangly earrings to work might be hazardous to your health?"

Alacrity: "Although that is true, Dr. [Internist], have you considered that commenting on a woman's wardrobe at work might be hazardous to your health?"

ahhh, university life:

You guys, I'm currently working at a university, and that means:

1) About 85-90% of my work conversations include some permutation of the phrase: "But did you read the paper/study that showed (whatever)?"

Usually this is followed by, "No," which is then followed by "I'll send it to you/print it for you."

2) Everyone is very, very impressed if you can quote the authors when you're quoting a study to prove a point. At this point, I'm just excited if I can remember the study.

3) Stuuuuuuudents! Vet students are awesome. But seriously, you guys:

- Someone may care if you appear to be fire-stormingly fascinated with (whatever rotation you're on), but that person is not me. I know that those of you who are gonna be cow vets are probably about as interested in the intimate details of the canine cutaneous mast cell tumor prognostic panel as I am in the intimate details of synching herd ovulation: not much. You don't have to fake it.

- Don't let anyone make you feel small if you don't know the answer to a question. There is so much to know that you cannot possibly know it all. BUT it totally behooves you to look that shit up and recon with the person who was quizzing you when you DO know the answer.

- Sleep is really, really important. Take advantage of all opportunities to sleep. Sleeping is magical.

4) Ultrasounds take at least 45 minutes, sometimes over an hour. Also, everyone looks at you like it's your fault when the sedation wears off or the patient loses patience.

5) Appointments regularly take 6+ hours. I am not even kidding. If you're bringing your pet to a university for a consult, plan for it to be a day's event.

6) The anesthesia department is absolutely not fucking around. Neither is the ICU staff.

7) Some sort of conference, thesis defense, or guest lecture is always happening. I get e-mails about all of them. Sometimes there is food involved.

8) There are six or seven different on-call schedules for various situations that may happen in the night or over a weekend. They are all posted in different places and are varying degrees of accurate.

9) A parade of work-study students and residents wander by the oncology department at regular intervals. They ask for blood and/or urine samples from particular patients who have diseases that are relevant to their research.

10) There is so much hand sanitizer.