I really want to finish blogging about my HCASB trip, but I'm still waiting for an uninterrupted hour or so where I can sit down and write another really long post, so I can actually go into detail about it. However, I feel the events of today merit a brief interruption to the regularly scheduled HCASB-recap programming:
I lost my wallet about . . . three weeks ago, I think. I searched valiantly for it for a few days. My friend Kristine turned her apartment upside down, since there was a possibility that I might have left it there. But no luck. So, after swearing profusely for awhile, I froze my debit and credit cards, ordered a new driver's license, and generally set about getting stuff replaced. I was set for a long pain in the ass process; there was so much stuff in that wallet! My health insurance card, my Husky card, my library card, my Seattle Art Museum membership card . . . you name it, it was probably in there. Then this morning, Kristine texts me to tell me that she was cleaning her apartment this weekend and found my wallet behind her bookshelf, wedged between some books and the wall! How it got there, I have no idea. But I am thrilled that I won't have to get all that crap replaced now. I went to work thanking God for little miracles like that and thinking that it was going to be a fabulous day.
. . . Apparently the universe or God or whatever decided I did not deserve a stand-alone small miracle and took it upon Itself to even things out for me. As some of you probably know, my aunt lives in California and lets me stay in her house and drive her car rent-free. Well, she emailed me today saying she had gotten a letter today from the Seattle Photo Enforcement Program. Apparently, I got caught on candid camera running a red light on March 12th at 10:48pm, and because the car is registered to my aunt, they issued the ticket to her. If it was my car, my ticket, etc., I would have been irritated, but just taken care of it. But this is her car, and she's being generous enough to let me borrow it, and I put her driving record and her insurance premiums in jeopardy. So in addition to being irritated, I feel guilty and embarrassed. Fortunately, it won't be a part of her driving record and will be processed as a parking infraction. She's sending it to me so I can pay it. I sent her a profusely apologetic email.
I'm pretty sure I remember when this happened, oddly enough. I don't remember the date, but I know that one night a few weeks ago, I was driving home from Kristine's and came to the big intersection of 45th Street and 35th Ave (right near the Tully's and the Safeway by U-Village) just as the light was turning yellow. It was late, there was no one around, so I just gunned through it. The light was definitely red by the time I made it to the other side . . . I had underestimated how long it would take me to actually get across the intersection. The weird part was that as I was crossing, I saw/heard something flash. I thought "I hope that isn't a traffic camera, because technically I just ran that light." I guess it was a traffic camera.
I am really irritated, though. It was late at night, there was no one around, I put nobody in danger (not even myself). I didn't even flat-out run the light (I never do that). I just cut it too close on a yellow light. If it had been a real live cop instead of a camera, I probably wouldn't have gotten a ticket.
Oh, as a side note, would you like to guess how much I now owe the city of Seattle?
$124. One hundred and twenty-four American dollars. For running a light at 11:00 at night when no one was around.
FUCK.
Monday, March 30, 2009
Monday, March 23, 2009
HCASB
Greetings from Yakima! I wasn't sure if I was going to have the internet here, but it would appear that I do, which is pretty cool.
I'm here for Health Care Alternative Spring Break (HCASB), which is a student-run program at the UW to get pre-health students interested in rural healthcare. They send teams of students out to rural/underserved communities in eastern Washington where they stay with local families or at churches, shadow doctors/dentists/health professionals in their chosen fields, and learn about what it's like to practice medicine in a rural/underserved area.
My team is four people, all girls. Our team leader is Erin, a fifth-year senior who's graduating this year and has already gotten into med school. Then there's Catherine, who's a pre-med sophomore, like me, and Stephanie, who's a pre-pharmacy freshman from Taiwan. Oh, and there's me :).
We left the UW campus on Sunday afternoon in a rental car provided by HCASB. It only took a couple of hours to get to Yakima. The drive in itself was kind of an experience for me, since I've never been to eastern Washington before. I'm a straight-shot DC-to-Seattle transplant, so really, aside from Seattle and Olympia, I don't know Washington that well. I was amazed at how much the scenery changed after we went over the pass. Basically, it's like the primary color of the landscape changes from green to brown. On one side of the mountains you've got these seemingly never-ending forests of pine trees, and then you cross the mountains and you're practically in the freaking desert! Any longtime Washingtonian who's reading this will probably laugh at my ignorance, but it still kind of boggles my mind.
Anyway, we made it to Yakima in a couple of hours, drove around for a bit and got the lay of the land, met up with the other Yakima team and got some dinner, then went to our homestays (Catherine and I are staying in one house, Erin and Stephanie are staying in another). My host family, the Jennings, are so nice. The husband, Ron, is a pharmacist at the clinic where we're all shadowing (Steph is actually spending almost all of her time shadowing him, since she's pre-pharm), and the wife, Jeri, is a registered dietician who works mostly with patients on dialysis. They have really cute pets: Jammer the black lab, Boomer the pug-like mutt of indeterminate ancestry, and Duncan the gray-and-white kitty.
We're all shadowing at Yakima Neighborhood Health Services. When I got my assignment, I was a little bummed that I didn't get to go to some teeny-tiny, middle-of-nowhere town, just because that's something I've never experienced before and I'm all about trying new things. But I now realize that the upside of going to a slightly larger town like Yakima is that I get to shadow at a place like YNHS, which is a pretty big clinic, so I get to see a variety of different things. They have internists, pediatricians, family practicioners, an OB clinic, a pharmacy, a dental clinic, a WIC program (which provides information on breastfeeding, etc. to new mothers), a walk-in clinic, and a clinic for the homeless. I'm going to get to shadow at least once in most of those areas during my stay here. I'm pretty psyched.
Our schedules are divided up so that we're all separated and each of us is paired with one professional in the morning, and one in the afternoon. This morning, I shadowed Kelli, a nurse practicioner who works in the homeless clinic. I think the most striking part about that was seeing how important it was to most of those patients just to have someone to talk to, even for fifteen minutes (the allotted time for appointments there) about what's going on in their lives right now. I suppose this is true for a lot of people who go to the doctor, but many of the people I saw today don't have a circle of family, friends, etc. They don't often get asked "What's going on with you today?" or the equivalent, especially by someone who really wants to know the answer. Oh, the OTHER most striking part of the homeless clinic was the somewhat mentally-off-kilter guy who heard that I was from the University of Washington and decided instantly that I must be a doctor (he decided this despite Kelli clearly stating that I was a student). Of course, this guy also said that his job was "tracking various patterns around the state for the betterment of all of us" so I suppose deciding that I'm a doctor is not the least rational of his thoughts. Anyway, he started telling me all about how he wanted me to "pull strings" with my "connections" to get him in to see a doctor at the UW Medical Center (psshhh, I would be hard put to get myself in to see a doctor at UWMC). At the end of the appointment, Kelli told him she was going to leave and would be right back with his prescriptions, and he said "Leave me with her. I have a lot more that I need to tell her!" Fortunately for me, Kelli said "Sorry, she needs to stay with me today," and we left. I guess the poor guy thinks I'm the worst doctor ever.
In the afternoon, I shadowed Dr. Prier, a pediatrician, which basically just re-affirmed my belief that I want to be a pediatrician. I saw a lot of physicals, a few cold/flu/sick stomach/sore throat visits, and one obesity consult with a little girl who was seriously overweight. The doc said that obesity in kids is one of the main problems she encounters in her average day, and that thus far neither she nor any of her colleagues have been too successful in reversing the trend among their patients. One interesting thing about working with her was that all the patients she saw today were Spanish-speaking (at least the parents were. Most of the kids spoke English pretty well). I never took Spanish, and could not carry on a conversation in it to save my life, but I was pretty surprised at how much I can understand, just from context and cognates. I really want to learn Spanish now, though, it seems like it's really important. I mean, the clinic has translators, but it seemed like the fact that Dr. Prier knew Spanish and was able to go without a translator just added this whole new level of trust between her and her patients. My favorite visit of the day was a mom with two little girls, ages four and two, who were both there for their physicals. When the two-year-old was getting her physical, the four-year-old was being kind of disruptive, trying to get mom's attention while Dr. Prier was trying to explain something, climbing on things, etc, so I gave her my notepad to draw on (it helped that I happened to have a purple pen today). She talked to me in a mixture of English and Spanish, and I talked to her a little bit in English, but mostly just nodding, smiling, and hand gestures. She said something to me in Spanish that mom overheard, and mom said to her (I understood the Spanish but I won't try to write it here cause I'd butcher it), "She doesn't speak Spanish, you know." The little girl looked very indignant and said "Yes, she does!" We all burst out laughing, because I hadn't said a single word in Spanish since we'd walked into the room, and had been talking to the little girl only in English, but she was so positive I could speak Spanish. Lol kids are awesome.
We finished clinic at 5:30ish and went home, where Jeri fixed us delicious soft tacos. We've just been chilling out, and I'll probably be in bed before 10:30. I could so get used to this whole early-bedtime, eight-hours-of-sleep, normal-workday-hours type deal, but I guess I'd better not if I want to be a doctor. Anyway, I shadow in the OB clinic tomorrow. I've never done that before, so that should be exciting.
I'm here for Health Care Alternative Spring Break (HCASB), which is a student-run program at the UW to get pre-health students interested in rural healthcare. They send teams of students out to rural/underserved communities in eastern Washington where they stay with local families or at churches, shadow doctors/dentists/health professionals in their chosen fields, and learn about what it's like to practice medicine in a rural/underserved area.
My team is four people, all girls. Our team leader is Erin, a fifth-year senior who's graduating this year and has already gotten into med school. Then there's Catherine, who's a pre-med sophomore, like me, and Stephanie, who's a pre-pharmacy freshman from Taiwan. Oh, and there's me :).
We left the UW campus on Sunday afternoon in a rental car provided by HCASB. It only took a couple of hours to get to Yakima. The drive in itself was kind of an experience for me, since I've never been to eastern Washington before. I'm a straight-shot DC-to-Seattle transplant, so really, aside from Seattle and Olympia, I don't know Washington that well. I was amazed at how much the scenery changed after we went over the pass. Basically, it's like the primary color of the landscape changes from green to brown. On one side of the mountains you've got these seemingly never-ending forests of pine trees, and then you cross the mountains and you're practically in the freaking desert! Any longtime Washingtonian who's reading this will probably laugh at my ignorance, but it still kind of boggles my mind.
Anyway, we made it to Yakima in a couple of hours, drove around for a bit and got the lay of the land, met up with the other Yakima team and got some dinner, then went to our homestays (Catherine and I are staying in one house, Erin and Stephanie are staying in another). My host family, the Jennings, are so nice. The husband, Ron, is a pharmacist at the clinic where we're all shadowing (Steph is actually spending almost all of her time shadowing him, since she's pre-pharm), and the wife, Jeri, is a registered dietician who works mostly with patients on dialysis. They have really cute pets: Jammer the black lab, Boomer the pug-like mutt of indeterminate ancestry, and Duncan the gray-and-white kitty.
We're all shadowing at Yakima Neighborhood Health Services. When I got my assignment, I was a little bummed that I didn't get to go to some teeny-tiny, middle-of-nowhere town, just because that's something I've never experienced before and I'm all about trying new things. But I now realize that the upside of going to a slightly larger town like Yakima is that I get to shadow at a place like YNHS, which is a pretty big clinic, so I get to see a variety of different things. They have internists, pediatricians, family practicioners, an OB clinic, a pharmacy, a dental clinic, a WIC program (which provides information on breastfeeding, etc. to new mothers), a walk-in clinic, and a clinic for the homeless. I'm going to get to shadow at least once in most of those areas during my stay here. I'm pretty psyched.
Our schedules are divided up so that we're all separated and each of us is paired with one professional in the morning, and one in the afternoon. This morning, I shadowed Kelli, a nurse practicioner who works in the homeless clinic. I think the most striking part about that was seeing how important it was to most of those patients just to have someone to talk to, even for fifteen minutes (the allotted time for appointments there) about what's going on in their lives right now. I suppose this is true for a lot of people who go to the doctor, but many of the people I saw today don't have a circle of family, friends, etc. They don't often get asked "What's going on with you today?" or the equivalent, especially by someone who really wants to know the answer. Oh, the OTHER most striking part of the homeless clinic was the somewhat mentally-off-kilter guy who heard that I was from the University of Washington and decided instantly that I must be a doctor (he decided this despite Kelli clearly stating that I was a student). Of course, this guy also said that his job was "tracking various patterns around the state for the betterment of all of us" so I suppose deciding that I'm a doctor is not the least rational of his thoughts. Anyway, he started telling me all about how he wanted me to "pull strings" with my "connections" to get him in to see a doctor at the UW Medical Center (psshhh, I would be hard put to get myself in to see a doctor at UWMC). At the end of the appointment, Kelli told him she was going to leave and would be right back with his prescriptions, and he said "Leave me with her. I have a lot more that I need to tell her!" Fortunately for me, Kelli said "Sorry, she needs to stay with me today," and we left. I guess the poor guy thinks I'm the worst doctor ever.
In the afternoon, I shadowed Dr. Prier, a pediatrician, which basically just re-affirmed my belief that I want to be a pediatrician. I saw a lot of physicals, a few cold/flu/sick stomach/sore throat visits, and one obesity consult with a little girl who was seriously overweight. The doc said that obesity in kids is one of the main problems she encounters in her average day, and that thus far neither she nor any of her colleagues have been too successful in reversing the trend among their patients. One interesting thing about working with her was that all the patients she saw today were Spanish-speaking (at least the parents were. Most of the kids spoke English pretty well). I never took Spanish, and could not carry on a conversation in it to save my life, but I was pretty surprised at how much I can understand, just from context and cognates. I really want to learn Spanish now, though, it seems like it's really important. I mean, the clinic has translators, but it seemed like the fact that Dr. Prier knew Spanish and was able to go without a translator just added this whole new level of trust between her and her patients. My favorite visit of the day was a mom with two little girls, ages four and two, who were both there for their physicals. When the two-year-old was getting her physical, the four-year-old was being kind of disruptive, trying to get mom's attention while Dr. Prier was trying to explain something, climbing on things, etc, so I gave her my notepad to draw on (it helped that I happened to have a purple pen today). She talked to me in a mixture of English and Spanish, and I talked to her a little bit in English, but mostly just nodding, smiling, and hand gestures. She said something to me in Spanish that mom overheard, and mom said to her (I understood the Spanish but I won't try to write it here cause I'd butcher it), "She doesn't speak Spanish, you know." The little girl looked very indignant and said "Yes, she does!" We all burst out laughing, because I hadn't said a single word in Spanish since we'd walked into the room, and had been talking to the little girl only in English, but she was so positive I could speak Spanish. Lol kids are awesome.
We finished clinic at 5:30ish and went home, where Jeri fixed us delicious soft tacos. We've just been chilling out, and I'll probably be in bed before 10:30. I could so get used to this whole early-bedtime, eight-hours-of-sleep, normal-workday-hours type deal, but I guess I'd better not if I want to be a doctor. Anyway, I shadow in the OB clinic tomorrow. I've never done that before, so that should be exciting.
Thursday, March 5, 2009
Wisdom Teeth
I had my wisdom teeth out yesterday. Despite the fact that anything involving large sharp objects in your mouth is kind of a bummer, and having four wisdom teeth, three of which are impacted, removed, is anything but fun, I was kind of intrigued going into surgery yesterday. It was the first time I've ever had any remotely significant medical procedure done, because I've been very lucky my whole life, and the wanna-be-doctor part of me was curious. But perhaps more interesting than the surgery was what happened in the waiting room before I went in . . .
My grandmother drove me to the oral surgeon's office. Now, just as a disclaimer, I love my grandmother dearly; she's a sweet lady, and has done a lot for me my whole life, including taking great care of me the past couple of days. But sometimes, her grasp on reality is not as tight as might be ideal. This isn't an age thing either, just her personality. But anyway, we were chilling in the waiting room and this young woman walked in with an adorable little baby and sat down near us. Grandmother and I both love babies, so we started making small talk, and then the baby was hungry and the mom went to the corner of the room to nurse her, so Grandmother started telling me about her "spiritual experience" of the other day (she has these at a somewhat alarming frequency). Apparently, she was sleeping on the couch in her living room and woke up suddenly, and saw a "light-black man" in a business suit standing right in front of her, and then he disappeared. For anyone who doesn't know my grandmother, this might seem a little disturbing, but it's actually one of the tamer stories she's told me in recent years. I just said something along the lines of "Oh, really, well, um . . . mmhmm" or something equally brilliant.
By now our waiting room friend was done nursing her baby and popped into the conversation with, "Wow! It was your guardian angel."
Just what my grandmother needed, I thought, someone to egg her on.
"I think it was Barack Obama!" my grandmother said (she's a big Obama fan). "I think he's watching out for me."
Yes, grandmother, I thought. Barack Obama is chilling in your living room while you're sleeping. Also, please, God, when I can I go back to the surgery room and get away from this meeting of the insane minds?
"Well," said the woman to my grandmother, "you believe in the Bible, don't you?"
"Not literally," said my grandmother, "but I think it's a very wise book."
"Well, in Revalations, they say that angels are sent to those who are vessels of salvation."
Whoever comes to take me out of this room will be my vessel of salvation, I thought.
My grandmother looked absolutely fascinated, "Oh, wow!" she said.
"At least you're not seeing the shadows," said the woman. "Those are the ones you have to rebuke."
"Oh, yes," said my grandmother, like this made all the sense in the world.
What? What?! What?!?! I had never been so eager for general anesthesia in my life.
Fortunately, pretty soon after that they called me back to the room, where they had me rinse my mouth out and then got me all set up to go under. The tech put oxygen on my nose, an EKG on my chest/stomach, and an O2 sat moniter on my finger. Then the doctor came in and started an IV in my arm. The last thing I remember is his asking me "Are you starting to feel the medicine yet?" and my saying "I think so, a little bit." After that I was out. I woke up alone in the room, feeling like I'd had the best nap ever. I soon discovered I was still totally numb; my talking, smiling, etc. was far from up to par. Throughout the day I gradually got the feeling back in my upper lip and tongue, but my bottom lip/chin/jaw were still completely numb. The first time I had any pain was when I woke up this morning. It's not so bad, but the Ibu-profin hasn't helped, so I may take one of my painkillers, soon, because, frankly, I'm a little curious to see what they feel like ;).
Overall, this wasn't bad though, compared to the horror stories I've heard from some people. I'll be back at work tomorrow, for sure.
My grandmother drove me to the oral surgeon's office. Now, just as a disclaimer, I love my grandmother dearly; she's a sweet lady, and has done a lot for me my whole life, including taking great care of me the past couple of days. But sometimes, her grasp on reality is not as tight as might be ideal. This isn't an age thing either, just her personality. But anyway, we were chilling in the waiting room and this young woman walked in with an adorable little baby and sat down near us. Grandmother and I both love babies, so we started making small talk, and then the baby was hungry and the mom went to the corner of the room to nurse her, so Grandmother started telling me about her "spiritual experience" of the other day (she has these at a somewhat alarming frequency). Apparently, she was sleeping on the couch in her living room and woke up suddenly, and saw a "light-black man" in a business suit standing right in front of her, and then he disappeared. For anyone who doesn't know my grandmother, this might seem a little disturbing, but it's actually one of the tamer stories she's told me in recent years. I just said something along the lines of "Oh, really, well, um . . . mmhmm" or something equally brilliant.
By now our waiting room friend was done nursing her baby and popped into the conversation with, "Wow! It was your guardian angel."
Just what my grandmother needed, I thought, someone to egg her on.
"I think it was Barack Obama!" my grandmother said (she's a big Obama fan). "I think he's watching out for me."
Yes, grandmother, I thought. Barack Obama is chilling in your living room while you're sleeping. Also, please, God, when I can I go back to the surgery room and get away from this meeting of the insane minds?
"Well," said the woman to my grandmother, "you believe in the Bible, don't you?"
"Not literally," said my grandmother, "but I think it's a very wise book."
"Well, in Revalations, they say that angels are sent to those who are vessels of salvation."
Whoever comes to take me out of this room will be my vessel of salvation, I thought.
My grandmother looked absolutely fascinated, "Oh, wow!" she said.
"At least you're not seeing the shadows," said the woman. "Those are the ones you have to rebuke."
"Oh, yes," said my grandmother, like this made all the sense in the world.
What? What?! What?!?! I had never been so eager for general anesthesia in my life.
Fortunately, pretty soon after that they called me back to the room, where they had me rinse my mouth out and then got me all set up to go under. The tech put oxygen on my nose, an EKG on my chest/stomach, and an O2 sat moniter on my finger. Then the doctor came in and started an IV in my arm. The last thing I remember is his asking me "Are you starting to feel the medicine yet?" and my saying "I think so, a little bit." After that I was out. I woke up alone in the room, feeling like I'd had the best nap ever. I soon discovered I was still totally numb; my talking, smiling, etc. was far from up to par. Throughout the day I gradually got the feeling back in my upper lip and tongue, but my bottom lip/chin/jaw were still completely numb. The first time I had any pain was when I woke up this morning. It's not so bad, but the Ibu-profin hasn't helped, so I may take one of my painkillers, soon, because, frankly, I'm a little curious to see what they feel like ;).
Overall, this wasn't bad though, compared to the horror stories I've heard from some people. I'll be back at work tomorrow, for sure.
Sunday, March 1, 2009
My New Job
This week, I started doing clinical training for my new job (in addition to Bright Horizons) as a medical scribe at an ER near Seattle. The word "scribe" makes it sound like my job should involve a large and fancy quill pen, but alas, it does not (how sweet would that be, seriously?). What a scribe does is follow a doctor around over the course of one of their shifts and do most of their charting for them. The goal of this is to minimize the amount of time the docs have to spend on paperwork and maximize the amount of face-to-face time they can have with their patients (e.g., a doctor who has a scribe can actually sit and listen to a patient's explanation of what's wrong, when their symptoms started, etc., rather than clacking away at the computer the whole time so they don't forget any information that might be important later. I get to clack away at the computer instead).
It's going pretty well, so far. Before I started I was warned that it could be a very fast-paced, hectic job, but clearly the people who warned me about that have never taught preschool. I'm still kind of intimidated by the doctors, not gonna lie. During one of my training shifts, this one doctor called me "Bernice" the entire time, and I couldn't even bring myself to correct him, which was highly amusing to the girl who was training me. I just figured as long as I was making a good impression he could call me whatever he wanted. It's really cool to see the different doctors with their patients, though. In particular, the doctor who calls me Bernice has an amazing bedside manner with kids. He can literally get a screaming, justifiably pissed-off two-year-old with an ear infection to stop crying and sit calmly while he looks in their ears. He does all the regular tricks, like shining the light in his own ears first, so they can see it doesn't hurt, but I've seen other doctors do that without the same effect. It's mostly just something in his personality, or tone of voice, or something else; I don't know what. Talk about a useful skill for a would-be pediatrician . . . if I learn one thing doing this job, I want it to be how he does that.
I like writing HPIs (history of present illness); it's kind of fun jotting down all the random things that a patient says and then trying to form it all into a succinct but informative, professional-sounding summary of why this person is in the ER. And sometimes the reasons are pretty hilarious, which sounds really insensitive, but if you are going to do something like punch a tree and then come to the hospital because the hand you punched the tree with hurts, then I am sorry, but my sensitivity for you is going to be in short supply. That was the funniest thing I've seen in my three shifts at the ER; this dude hurt his hand punching a tree (he was okay, it wasn't broken or anything, I'd feel slightly bad making fun of a guy with a broken hand). I was standing in the room listening to the doctor interviewing the patient and trying not to laugh. I greatly enjoyed writing the sentence "Insert Name Here is an x-year old male who presents with contusion-abrasions and pain in the left hand following a physical altercation with a tree."
It's going pretty well, so far. Before I started I was warned that it could be a very fast-paced, hectic job, but clearly the people who warned me about that have never taught preschool. I'm still kind of intimidated by the doctors, not gonna lie. During one of my training shifts, this one doctor called me "Bernice" the entire time, and I couldn't even bring myself to correct him, which was highly amusing to the girl who was training me. I just figured as long as I was making a good impression he could call me whatever he wanted. It's really cool to see the different doctors with their patients, though. In particular, the doctor who calls me Bernice has an amazing bedside manner with kids. He can literally get a screaming, justifiably pissed-off two-year-old with an ear infection to stop crying and sit calmly while he looks in their ears. He does all the regular tricks, like shining the light in his own ears first, so they can see it doesn't hurt, but I've seen other doctors do that without the same effect. It's mostly just something in his personality, or tone of voice, or something else; I don't know what. Talk about a useful skill for a would-be pediatrician . . . if I learn one thing doing this job, I want it to be how he does that.
I like writing HPIs (history of present illness); it's kind of fun jotting down all the random things that a patient says and then trying to form it all into a succinct but informative, professional-sounding summary of why this person is in the ER. And sometimes the reasons are pretty hilarious, which sounds really insensitive, but if you are going to do something like punch a tree and then come to the hospital because the hand you punched the tree with hurts, then I am sorry, but my sensitivity for you is going to be in short supply. That was the funniest thing I've seen in my three shifts at the ER; this dude hurt his hand punching a tree (he was okay, it wasn't broken or anything, I'd feel slightly bad making fun of a guy with a broken hand). I was standing in the room listening to the doctor interviewing the patient and trying not to laugh. I greatly enjoyed writing the sentence "Insert Name Here is an x-year old male who presents with contusion-abrasions and pain in the left hand following a physical altercation with a tree."
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