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Looking at this nonsense fallout from the capitol riot, I can’t help but be reminded of how angry I was following the 2016 election results.

Y’know what I did?

I started volunteering at a local homeless shelter.

I know this reactionary nonsense has been steadily built over 4 years. But seeing it come to a head still leaves me feeling disappointed in this country.

#politics #capitol riot #white supremacy

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I’m kind of blown away with how good looking I am in recent pictures. I’ve kind of looked like some weird quasi person for the past couple of months. The fact that I look... cute? It’s still sinking in.

Most every trans woman has this innate fear at the beginning of her transition that she’ll just turn herself into a “man in a dress”. Seeing that apparently isn’t in the cards for me is a strange revelation. My inner pessimist doesn’t know what to make of this.

#FFS #transition

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Just posted a picture to facebook - I was only updating my profile pic to be more recent. Got a lot of reactions and comments. One of them was a dude telling me that my doctor does good work. He was literally an old Navy friend, haven’t actually been in the same state as him in years.

I’m actually really flattered.

#FFS #transition

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#FFS #Transition

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I really like the new team. Great bunch of folks. The chief resident and the R3 both really like their jobs and enjoy taking time to teach. Evening rounds took an extra ~45 minutes because they could not shut up about surgery. And I loved it.

Still don’t think I want to go into surgery.

Most veterans, myself included, have this really weird love hat relationship with the military. We fucking hated it, but there was a certain je nais se quois about it that makes us wistful. Not a rose colored glasses phenomenon here, there was something about military culture that just clicked. Can’t tell if it was the people, or the weird liminal feeling to every task, or the overriding structure.

Surgery has that same je nais se quois. Like, exactly the same.

In the OR, time kind of stops, and you are doing what you are doing. Nothing else matters but the task at hand. Everyone there is on the same page, and that sort of draws you together as a group. Some of the formality goes out the window, and the bullshitting ensues in a way you don’t usually see in medicine (until something complex comes up and everybody shushes for a couple minutes). That’s kind of nice.

But I was throwing stitches to close at the end of the case and I kept fucking up and some old thoughts came crawling through my head. “Unfuck that” “shit no” “looks like a bag of smashed donkey cock”. Looks like garden variety swearing, but those are the protypical swears used in the Navy. Just slipped right back into it.

Surgery makes me stop being Arin on some level, and turns me back into Petty Officer [deadname].

He was a dick.

Seriously, more of a dick than the worst surgeons I’ve had to interact with.

I’m so uncomfortable on this rotation because I’m working kind of hard to keep him from popping back out.

If I became a surgeon, I know I wouldn’t be able to do that forever.

#Medical School #Medical Student #Surgery #Surgery rotation #Veteran #I simultaneously hate it and I don't

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Switching teams in my rotation. On thoracic surgery now. The new chief resident took an entire half hour on the phone to talk to me about team roles and expectations. Seems like a really chill guy, and actually cares about what I can do for the team.

I think the second half of this rotation is going to go well.

#Medical student #Medical Scool #Surgery rotation

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Important update: I can whistle again.

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Just got misgendered at the store (I said hello and my voice Does Not Pass.)

The guy was distracted fiddling with an uncooperative computer so all he had to go off of was my voice so he asked someone else to “please help this gentleman.”

And I just gave him the absolutely most withering death stare - difficult to do when you still can’t emote very well due to plastic surgery.

I really dislike being “that tran” and I immediately felt bad. Dunno how much of that is internalized transphobia on my part.

#transition #misgendering #internalized transphobia

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Just got home and I am crashing hard. So glad I get weekends. I hope the OB/GYN is less intense than this one. Split me up between the OR and clinic.

Because it’s pretty nice that I enjoy the OR so much that I really don’t have it in me to turn it down if it’s an option. But it is really tiring. Just so incredibly tiring.

And the fact of the matter is that I hate everything else about surgery. Post operative care is so fucking boring.

-Are you pooping or farting?

-Are you nauseous or vomiting?

-How’s your appetite?

-Are you in any pain?

-Have you walked at all?

-Let me look at your incision.

-[look in record for vital signs]

I swear - it’s just some combination of those every. Damn. Time. And this is literally 100% of my patient interaction.

Part of what drew me to medicine was having a personal connection with the people I’m helping. And I understand that surgeons can have that, but that isn’t something coming through in this rotation - and likely wouldn’t until I was roughly half a decade into a surgical career.

This is to say nothing of the abysmal work life balance.

 I miss my fiance.

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The surgery side of the surgical rotation is going really well.

The administrative side is a fucking nightmare. I had easier times during my discharge from the military getting people’s attention on my exit paperwork (that also really sucked, but it ultimately had no impact on my life so I was able to just shrug it off).

I didn’t get any scheduling info until the first weekend, after I reached out to another med student (who I could only connect with because I bumped into him in the hallway on Friday). Until this point I’d been emailing the office folks since ~1 week before the rotation began to get this information. Still haven’t gotten anything form them aside from a short platitude, mind you. I ask them for my schedule including conferences, clinic duty, OR, and call obligation. They tell me “you’re with colorectal for 2 weeks (1 week when they actually got off their ass to email me), then thoracic 2 weeks”

No elucidation on ANY OF THOSE OTHER POINTS.

Shit hits the fan for me when one of these obligations, inevitably, falls through the cracks.

So I push it further up the chain. The paperwork I got from the other med student turns out to also be inaccurate, and I email the old director. Dude takes some time out of his day to extend his “sincerest apologies” for the mix up then proceed to victim blame me for the situation. Says I should have advocated for myself more (I did) and that I should remember that clinical staff view education as a “mid tier priority”. Finishes by saying he’s my biggest advocate.

He’s my biggest advocate, but I’m only a mid priority and really should not be bugging him about this - but also advocating for myself more than I already have.

Fuck’s sake - I’m glad he isn’t actually the director anymore.

(Also he had some *really* creepy words about “showing my shining face” during rounds. I need to shower with a brillo pad after having read that line - sounds like something you’d hear in an anti sexual harassment course.)

New director caught wind and put together a welcome meeting for the medical students. Now 2 weeks into the rotation. In a rotation with 4 clinical weeks (covid shortened it).

I don’t have enough four letter words in my vocabulary to adequately express how frustrated I am.

The OR is cool. I really like the OR.

But if this is any indication of how the profession is managed, you can bet your ass I’m giving the field a wide berth.

#Medical School #Medical student #Surgery rotation

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Today I impressed everyone on the surgical team in the OR. Did I point out an unlikely diagnosis? Remember an esoteric treatment? Catch a safety issue before it harmed a patient?

Nope. I moved to the other side of a resident in order to have a better angle to cut a suture while closing, without anybody having to point out to me that would be a good idea.

I feel I should be mildly insulted the bar is so low.

#Med school #Surgery clerkship #I still totally felt proud of myself

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I’m working on multiple projects for publication at the moment. Purely manuscript writing at this point.

The first one is an opinion piece written to take contemporary medical education to task for it’s lack of adequate focus on trans and intersex populations. I’m a bit worried that there will be a black mark put on me for attaching my name to it - it’s the sort of thing I could see getting me labeled as a trouble maker. But the way I see it, this is an incredibly important topic and change needs to come to the medical profession from within. If the trans people who are part of this profession don’t speak out, who will?

The second one is a research paper tracking mental health outcomes associated with gender affirming medical care given to trans pediatric populations. While we have the data showing that it is efficacious in reducing the highly disproportionate burden of mental health problems on trans pediatric populations, there has not been any work done to address how long it takes for tangible differences to be seen. Inside of a year, moderate-severe depression and suicidal thoughts are reduced by more than half. I just started writing the discussion section up, but I’m afraid they’re nothing more than the caffeine induced ramblings of a medical student who found some down time during call right now. I’ll have to work to get them cleaned up and shot off to the team writing the paper.

I really feel that this is why I went into medicine on some cosmic scale. I’m in the perfect position to be an advocate for the trans community. I have to embrace it in order to see that the change that the world so desperately needs in order to accept us comes about. Transphobia is built on rigid gender stereotypes and recycled homophobia that hurt so much more than the minority of folks who are trans.

#Med school #Medical school #Med student #Medical student #Advocacy #Trans advocacy #Transgender advocacy #Trans Rights are Human Rights #Research #Science

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I got hit with a bout of absolutely crippling voice dysphoria today. Literally came home and couldn’t talk because of it. I think that as I get closer to being cis passing, the last parts I’ve been putting off just hit me so much harder.

On the one hand that’s nice. I’m getting closer to being “done” with transition than not. (there isn’t really some discrete end point to transition you can actually point to)

Dysphoria never used to come out of left field like this, though. I literally crawled onto the bed with my fiancé and cried for 10 minutes straight as soon as I was home.

#trans #transition #gender dysphoria #voice dysphoria

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My surgeon put my hairline together in such a way that hair will grow back in front of my scar. The hairs have slowly been coming in over the past couple of weeks. I think I’ve noticed a bunch more in the past couple of days, so I’m hopeful I’ll see a bunch more come out soon. The scar is pretty thin, but I’d still like to be able to cover it up.

#FFS #transition

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Looking at myself, I can’t really see a dude anymore. Just a swollen lady.

Neato.

Now stop swelling already.

#FFS #transition

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Huh. Just did my injection and there was literally zero pain. I wonder if spending time in the OR is breaking through some mental barrier about breaking skin.

#I have literally stapled a person shut

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I remember at one point during a lecture, a trans person stated that cis people will never be able to understand trans people on an intrinsic level. And little “cis” me was just SO DAMN OFFENDED. EXCUSE ME, I HAPPEN TO TOTALLY UNDERSTAND WHAT BEING TRANS IS LIKE and yes I am quite happy with my assigned gender, why do you ask?

Oh, Arin. Oh sweet, stupid Arin.

#guess what idiot #what I wouldn't give for a time machine #if this offends you you may have some soul searching to do