1 year later

One year ago today I was sitting anxiously in a room with all my medical school colleagues, awaiting to receive the envelope that held my future. In the past year so much has happened; I moved south, after living in Michigan for most my life (exceptions being college in Indiana and the year I spent teaching biology in Thailand), started residency, made some amazing new friends, and got a puppy!

Yesterday many of my friends embarked on the same epic journey... so congratulations to all my friends who matched yesterday into the programs of their choice (for more information on the match, check it out on my medical school blog)!

While sitting in my car post call, I waited anxiously half a country away to hear where my friends would be going. But it wasn't just exciting to hear that my friend were going to their top choice, it was exciting to see who the new interns in my program would be come July 1. Yes, new interns are on their way!!!! It's hard to imagine that my intern year is 3 months from being done, but it's true. And now there's a light at the end of the tunnel, the replacements have been identified, and will be coming in to take over.

However, with that means I'm stepping up to my PGY-2 (post graduate year -2), and that comes with a whole lot of changes. Firstly, the infinitely wise ACGME hour restrictions (hence my sarcasm, please see below), will allow me, for the first time since I was a medical student, to take in-house 24 hour call. It also means that I'll be running the CCA ("critical care assessment"), which is the trauma ER at our program.

My biggest fear (and one that I'm pretty sure is going to come true) is me being the desk doc in the CCA on July 1... when the amount of traumas are at the highest. Its a daunting task for any second year resident to be in the CCA during the beginning of the year. But now throw into the mix that it'll be the first time I'm taking real call. Needless to say, kind of freaking out about the whole thing.

Anyways... Residency has been going well since I last updated you all.

In January I was on Transplant Surgery. I really like the rotation and had a wonderful time! I got to operate a fair bit, and even got to do a vascular anastomosis (i.e. sew an artery to a vein for dialysis access). The transplant staff was awesome and I learned a lot! Honestly, I'm kind of excited to rotate through the service again as a third year (in, you know, 3-4 years).

In February I spent some time of the cardiovascular surgery service. The month wasn't too bad, and I had enough time to get a puppy!

Currently I'm back in the Surgical Intensive Care Unit, which I really like, again. The more I thought about it, the happier I am that I came to a program that is so intensive care heavy, I think it makes me think a lot more about why I do what I do... It's been an excellent month so far.

And may I now introduce you to Adson:

At PetSmart the day she came home

She loves hiding in bushes and tall grasses

Playing with toys at the apartment

At "The Barking Lot" downtown

Nothing like the pathetic "It's raining mommy" looks

Love her SO much!

Hour Restrictions Rant: I really don't understand how the ACGME thinks it's completely fine for PGY-2s to take 24h call, but not the interns. And I don't say that because I think the 16h rule is valid, but because I think it's incredibly stupid. Walking into my PGY-2 year, I'm incredibly behind where my second year colleagues were when they started their year. Not only that, but now, in addition to taking 24h call for the first time, the expectations of where I should be are incredibly higher. Oh, and because of the hour restrictions I've seen a whole lot less operative time that the interns in years past.
And then there's the whole "you can't take more than 6 night floats in a row"... How having us switch from days to nights constantly, instead of allowing us to take all our nights in a row is supposed to be better and make us less tired makes absolutely ZERO sense to me.
I just want to yell at the ACGME, "what the hell? have you all completely lost your minds?"
and, soap box done... for now.

8 Things to Know About Resident Physicians

My old roommate wrote this and posted it on her facebook, and it's too good not to share... So here you go, enjoy:

Yesterday, my friend sent me this blasphemously hilarious article called, “5 Things to know before dating a scientist.” http://www.thejayfk.com/?p=1709  Not to be outdone, I decided to write this 8-item blog because studying for Step 3 is boring and let’s face it, dating a resident physician is terrible.

1. Page us if you really want our attention.
It is frankly rude for us as residents (aka underlings) to pull out our cell phones 90% of the time we are at the hospital.  We are either presenting a patient on rounds, sitting in a lecture, or pretending to listen to a patient.  Please understand that we are in a service industry and a learning environment that takes no text breaks, snack breaks, pee breaks, or lunch breaks.  Very often, textswill not be checked or replied to in a timely fashion.   So if you must communicate a dire need / clarify a dinner plan to us… please page us.
It is much easier to read a page at the hospital because it appears to be work-related!  Many of us have mastered the “I am communicating important patient information to another colleague” look while we are paging other resident physicians emoticons and pages about where to get free food.  Most likely, our response time will be much better on the pager because while we are not a slave to you or our phones, the pager is our ball-and-chain.  However, if you get an automatic response, such as “Yes/OK, Thank you, or In 15 minutes,” then just know we are supremely busy and we apologize for the curtness.  So don’t take it personally.

The caveat is that some resident physicians do not like using their pagers for non-hospital communication.  So just ask yours if you should page / text / call them.

2. We love sleep.

We adore it, worship it, love it, and crave it.  All the time.  Since our second year of medical school, we have had a yearning for it.  It is precious to us.  When you’ve been up 34 hours straight and have half-slept on a hospital cot clutching a pager, you will understand our love for our beds.  I’ve heard of residents sleeping on the kitchen mat before their kitchen sinks while doing their dishes, residents sleeping through their friends’ weddings, and residents falling asleep talking to their significant others—you.   Sorry.

If we have the chance to be uninteractive for more than 10 minutes, then we will invariably close our eyes and drift into REM sleep.  What we want is uninterrupted, un-anxious, fulfilling, undeprived sleep.  Most of the sleep we accumulated in medical school was drunken hangover sleep and dreaming of test material, and most of the sleep we experience now is with a dysfunctional circadian rhythm.

So please do not wake us up early on days we can sleep in.   Most of us only get sick during residency because we do not sleep enough.   An early 6:00 am morning walk on the beach to see the sunrise is akin to a non-urgent page at 4:30am— tolerable, but annoying.

3. We love to ask questions.  Please ask us questions too!

Most of us resident physicians have been learners for 20+ years, heck, some of us even have PhDs and Masters degrees.  We have evolved to learn, memorize, analyze, and think critically extremely quickly.   If it is rude to you that we whip out our cell phones to wikipedia every building or foreign food or new drug being advertised, consider us sorry—but not really.  Our jobs require us to keep on learning, so it is only natural we apply the inquisitive approach to whatever seems interesting to us. 

Our brains were beaten to a pulp to learn each minute, relevant and irrelevant detail so that we could somehow catalogue those tidbits into a useful, accessible database.    As a consequence, if you say something remotely fascinating, please don’t be offended by our follow-up interrogating.  It is our way of interactive learning.  Blame Socrates.

So, broaden our horizons by teaching us something.   And ask us if you don’t understand an acronym or the jargon we’ve just spewed out.  We generally like teaching you too.
 

4. Don’t ever lie to us. 

Been anxious? Not sticking to your diet plan?  Didn’t really like the dress?  In pain?  Don’t really know the directions?  We can usually tell.   It’s a good thing though, because we would do anything to help ya.  But if you have an ulterior motive—don’t think I’m a naive nerd who made it this far by studying.

Our job as physicians is to find the truth in the patient’s history, symptoms, lab results, and imaging.  We love to believe you, but if what you says seems fishy, we will inadvertently turn to objective data to corroborate your story.

We see enough pathologic liars at work.  Believe me, you don’t want to be lumped in with the pain-med seeker who has 10/10 headaches and can still sleep soundly in the ED, yell at the triage nurses, and eat a full meal while sitting under bright fluorescent lights.
 

5. We are not medication or medical imaging vending machines.

Please tell us if you aren’t feeling well.  Feel free to refer your family/friends to us for an informal conversation re: their low back pain or new rash.  Let us know if you have been in an ER waiting room for hours.  We want to help you, but generally, we cannot give you stuff other than medical advice that is better than WebMD.  If we can help you, we will offer to.

In addition, it is unethical for us to prescribe your mother’s Xanax and impossible for us to give you a free MRI.  In addition, we as physicians are taught to never treat who we're dating and to never date who we're treating.  It is an ethical issue.
 

6. Color us cynical, but we still have feelings.

The things we hear, the diseases we see, the people we touch, the emotional burden we bear, the hours we work, and the medical responsibility we have—those are things you will never experience.  So please don’t say you understand how difficult my job is or how my patient feels.

The painful, ugly, humiliating, and private things that make you gasp on TV, we’ve probably seen ten of them in living color and had to touch them.

Most of us have healthily coped with the stresses and situations by becoming a bit cynical and numb.  If we cried for every cancer patient, if we felt sorry for every drug abuser and homeless man, if we were mad for every hour we worked “overtime,” we would be so emotionally spent that we could not function as a person.

But still, every resident still has feelings that the day to day coping mechanisms cannot compensate for.  For me, when I hit rock rock bottom, I just need to spend lots ofalone time with my dog on my bed. Find out your MD/ DO's means of escape from the hospital and make sure you R-E-S-P-E-C-T it.
Thank you.
 

7. Non- hospital food and coffee is ALWAYS superior to hospital food and coffee.
We would love some—homecooked, deli, leftovers from a restaurant.  Anything.  Anytime. Anywhere.  You can totally make our day with a Chipotle burrito or a morning donut/ coffee.  When we sip that Starbucks coffee cup at work, it is a pleasant reminder to us that we are still somewhat normal human beings in touch with the outside world.  Life becomes very lame when all of your fluid intake/output is at the hospital.  Remember, jellos and saltine crackers are not dinner.

8. VERY IMPORTANT: Don't ever complain about your work hours and your salary.  We have it worse.
But if we complain to much, please kindly remind us that it was way worse 30 years ago. 

(Thanks Eileen! This is awesome!)

The One Where I Confess I'm a Horrible Person...

*** sorry, it's long and I don't have time to proof read, please forgive the errors and just be surprised I managed to get something out into the blogosphere***

Despite weekly reminders popping up on my phone, and inconsistent (but nonetheless, copious) comments from my parents about my negligence in regard to this blog, I confess, I have been abhorrently horrible about updating my blog. Although I can rationalize my absence in the blogosphere as residency being too taxing and my false claim that my time too precious, we all know that I could have found a few moments to update you on the life of this general surgery resident. So, to the few and proud still lurking around, I beg for your utmost and (hopefully), expeditious forgiveness.

I believe the last time I was here was the end of August, at the end of my most favoritest rotation to date: pediatric surgery (yes, the verbose proclamation of love for pediatric surgery happens on an almost weekly basis, but I'll spare you, for now). That being said, I do believe I owe you all some recaps (for those of you not friends on Facebook or following me on twitter):

September: September found me on the endoscopy/ nutrition service. It was a lovely, and very low key, month. I didn't have to arrive to the hospital until about 6 or 7 on any given day and was usually done by around 3pm (this is unheard of for most surgery residents). I spent 2 mornings a week doing upper endoscopy (EGDs, or putting a camera down the throat and into the stomach and first part of the small intestines). 2 other days I would head over to the VA hospital and do colonoscopies in the afternoon (camera up the butt to look at the colon). The rest of my time was spent rounding on the nutrition support service and learning the intricacies of different tube feed formulas and how to give nutrition through IVs. On Saturdays you could find me covering the burn ICU, and having a plethora of free time to read. It was a thoroughly enjoyable month.


October: My October started with a week of vacation, which started off with the wedding of one of my best friends from college, who married his middle school crush. I then headed to my parent's house in Michigan and enjoyed the beautiful fall that happens in Michigan. I went to the apple orchard with my mom and had gloriously delicious apple cider and enjoyed the changing of the leaves (if you've not experience a northern fall, you are missing out... and, although I've very biased, I believe Michigan has one of, if not the best autumns). I returned to work the following week, were I started working on the general surgery service at a private hospital east of the city. My days started between 3:30 or 4, and the days were long... but I loved my time at the hospital (with the exception of the horrible EMR they have). I learned a lot, got to observe some really amazing and advanced surgeries, and even got to operate (almost daily). During this rotation the PGY-1 residents spend a lot of time with the program director doing breast surgery. Although the procedures may seem small to many, it was the first time I really got to do surgery on my own (the program director was there the whole time, but she just redirected and taught). Also, it's an amazing feeling to be able to tell a women you got rid of all the cancer we could find. I also, despite of the long hours, was able to get a lot of studying done during the month and spent a lot of time with my residency best friend studying at coffee shops and having weekly dinners.


November: Can I just say that I still REALLY like trauma and the intensive care unit?! I loved the complexity of patients that I took care of during November and really enjoyed the chance to be involved in the trauma resuscitations. I didn't get a lot of chances to operate, but I did get a few, and it was wonderful. But in spite of not operating, I had a wonderful time taking care of the ICU patients, having to think through all the problems, and really digging deep into the literature about different conditions and treatments. The month was also fabulous because one of my favorite coresidents was there with me; we had a system worked out so that I would bring her coffee in the mornings and she'd bring me tea at night when we were both covering the unit. We had so much fun complaining to each other about what was going on (venting is really good, especially when you have a friend right there with you... and we knew that a lot of it meant nothing). One of my other favorite coresidents was the floor doc during the same shifts I was in the unit, so we had time to hang out in between the crazy busy moments. Overall, it was a wonderful month!


December: I'm not going to lie, this past month was a rough one for me. I was on vascular surgery, which at it's roots is the exact opposite of pediatric surgery. The patients are generally old and have about a bazillion different medical problems. Also, I hate feet. Needless to say, I did not have a very good month at work and many times found myself questioning not only why I went into surgery, but also why I even became a doctor. At more than one time I postulated that it wasn't too late to drop out, until I remembered the massive amounts of debt I have from medical school. The month was hard because more than half of it was spent on night shift, covering about 5 services and never really feeling part of any team. Despite being the vascular intern, I only ever saw one of the attendings and spent most of the month by myself in the hospital at night (which aint fun). The week that I was on days wasn't horrible, however, and I found that I didn't mind the rotation nearly as much as I hated it while on night float.  The one great thing about the month was I managed to finagle about 11 days off between a week of vacation and a holiday schedule that got me 4 days off at Christmas (best idea ever!)

During my week off my mom came to visit me. We went to all the sites, saw part of a show (before we left, because, while the acting was great, the script itself was horribly unbearable), went to the zoo, went shopping, decorated my Christmas tree and made holiday cookies. It was wonderful, and exhausting. After my mom left I spent about 2 days on the couch recuperating from all the excitement.

At Christmas I actually managed to get home to Michigan. I got to see my entire family (almost, I didn't see 4/21 cousins) and spent quality time with my best friend and her family (whom I hadn't seen in almost 6 months). It was a wonderfully excellent Christmas.

Things to come: January: This month I'm on the transplant service, while I hear it's a busy service, I'm excited. I think transplant is fascinating and I'm looking forward to caring for pseudo-ICU type patients. The truly stressful aspect of this month is that this is ABSITE month. For you Grey's Anatomy fans out there, this is that big test that they have to take each year; or rather, the ABSITE is the year in-training exam all surgery residents must take. It's 250 questions and is a big predictor on what your options are for fellowship (kind of like the SAT for college, or MCAT for medical school, or USMLE for residency). Needless to say, most of my free time this month will be taken up by studying for the exam, which occurs on the last Saturday of the month.


Reflections: Despite of the intermittent horribleness that can be any residency (specialty or institution), I am glad that I chose to do surgery. The highs are great, even though the lows can be rather low and dark. Most of the time has been a great experience. I still love operating. I still love the diseases and complexity that occurs with surgery patients.

I'm glad I'm where I'm at for residency. No matter where you end up for residency, you'll be able to find issues or attending that you maybe aren't a huge fan of... but for the most part, I love my program. I think the attendings are rotations are great and I've learned a lot over the past 6 months.

I love my new city, even though I've not had a lot of time to explore it. I love my friend here, they're all awesome people.

That being said, residency is hard. Residency is exhausting. Residency sometimes wants to make you buried your head in your pillow and not wake up. I think this has been made harder by the fact that I'm at least 12 hours away from my family and all my friends, and the fact that communicating can be difficult with the limited hours of free time to get ahold of people. Someone told me to pick a residency close to home, I'm not sure I would do that even now, but I can understand why people told me that often.

Anyways, I'm half way done with my intern year, and that to me is a huge accomplishment. As far as I can tell I'm not floundering too badly and I'm having fun more days than not.


Resolutions (because, you know, it's a new year... Happy 2012!):
1. Be better about blogging (I promise I will try)
2. Be better about communicating with the most important people in my life
3. Be better about studying everyday, no matter how tired I am or how soon I have to be back to work
4. Make 1 new recipe every week
5. Work out (I don't know where I'm going to find the time... so I'm not going to designate a number of times per week... we'll just leave it as, work out at least weekly)
6. Read (or listen) to my Bible more consistently
7. Work on my bad character traits (impatience, getting frustrated easily, etc.).
8. Pay off my credit card debt
9. Buy a house??
10. See Newsies on Broadway with the best friend


On that note, I'm post night shift and still have beacoup d'etudiant.
Paix et benediction a vous tous pour la nouvelle annee (Peace and blessings for the new year to you all)

Pediatric Surgery Recap

It's hard to believe that my second month of residency is almost over!

This month was spent doing pediatric surgery, which is what I ultimately hope to do with my life. Needless to say, I've really enjoyed this month: from the patients to the procedures. Despite enjoying the rotation, it's been another crazy busy month.

The rotation usually has 3 fellows, 1 PGY-2, 2 PGY-1s, and an NP. At one point this month it was just the 3 fellows and me, as the PGY-2 was on vacation and the NP was speaking at a conference. I'm thankful for the extra help from the fellows, but it was a little overwhelming to be taking care of 20+ floor patients (fellows cover the NICU/ PICU). It's been so busy, that even though I'm leaving when I need to for duty hours, I've found myself having to finish up 2-3 hours of notes and dictations from home on multiple nights over the month (which, I've been told, isn't a violation, so I'm okay).

That being said, I have had the opportunity to operate this month. I've helped on a few really cool cases and I've gotten to be "surgeon junior" on a few lumps and bumps, for which I'm very grateful.

One of the fellows this month asked me why I wanted to do pediatric surgery, after my explanation, she said she loved it for the same reasons. So I thought I'd share here: Pediatric Surgeons are some of the last general surgeons (I'll throw trauma in there as well). Nowadays, most of surgery is really segmented, but outside of pediatric neurosurgery, orthopedics, cardiothoracic, and urology (all of which are separate specialities, minus CTS), the pediatric surgeon does everything else.

And while I know most pediatric surgeons see hernias and appendectomies all day, it's the congenital "stuff" that I love: gastroschisis, omphaloceles, duodenal atresias, tracheoesophageal fistulas, sacrococcygeal teratomas, Hirschsprung's disease, imperofrate anus, pyloric stenosis. I find the disease mechanisms so fascinating. Yes, I feel horrible for the kids that have these conditions, but I love that we can step in and change their lives.

So that is what I've been filling my last four weeks up with. I'm actually kind of sad the month is ending.

Other things happening in my life:
Hmm, let's see... My dad went back to the hospital with a complication during the first week of the month, and was in the hospital for about 2 weeks. But he's doing well now, and is home recuperating.

I've gotten yelled at in the middle of M&M for not studying at all, since I didn't know one thing. While I know I should have been better prepared, I think it's more than a little reactionary to assume I've not done anything in the past 2 months, when you don't actually know.

For the record: I've read 300+ pages of sabiston, read about my patient's conditions, and read for conference every week (usually prepping all the cases, not just the 3-4 interesting cases I'm expected to read). I'm not trying to toot my own horn here, but it's really frustrating to be told you aren't doing your job at all when 1) they only see you for 1 hour a week, 2) don't see your work ethic on the job, and 3) have no idea what your actually doing to prepare.

On to happier things: I received a pair of loupes from an awesome twitter friend. I finally became a Tennessee resident. I got my nails done (twice if you count later today). And have had dinner with a good friend twice, including time to vent our mutual frustrations about residency (you got to do it every once and awhile, no matter how much you enjoy your job).

On that note, it's time for me to hit up Sabiston again.

I wish you all a wonderful weekend and my prayers and luck to all you on the east coast; May Irene treat you more kindly than expected.

Also, next month's rotation is: Endoscopy/ Nutrition

P.S. Sorry for the lack of picture, I wrote this on pages on the iPad and then cut and pasted into blogger on the iPad (blogger, we need an app!)

The First Time is the Hardest

Image from http://www.elderlyjournal.com/

Once again the past two weeks have been a blur of activity, but what is coming into severe focus is that my first month of residency is 1 shift from being over. This month has been a huge learning curve, as I sure the rest of the year will be... but nonetheless, it has a great experience.

Besides being crazy busy, it has been a week of four firsts.

A Patient Lost
I've lost my first patient as a physician. The patient had been really sick for awhile; The family had changed the code status to DNR recently. However, when it actually happened, it happened quickly. Thankfully my attending was already in house and made the call to the family. Either way, it was so strange to watch the vitals fall, knowing we couldn't do anything at that point, knowing that within seconds, this patient, who I've gotten to know over weeks, was about to die.

When the family came in it was hard:. It was hard to see the family I've gotten to know hurting and it was hard to have a patient I've gotten to know pass. I can't say that I didn't have to step away for a moment to collect myself. To be honest, while I do hope that it gets a little easier to lose patients, I hope that I don't lose the emotions attached with it, whether I've know then for a day or a month.

A Patient Stabilized
The second first, I performed a bronchoscopy. Over the past month I gotten a little more comfortable with managing ventilated patients (almost everyone in the unit is on a ventilator), however, there are still times when I make that call to the attending. This was one of those times: The O2 saturation, ABG, and CXR were fine, but peak airway pressures were rising and we were unable to adequately suction the patient. The attending agreed that a bronchoscopy was probably needed and told me to get everything ready and started and that he would be there in 10 minutes. So I walked into the room and started the bronchoscopy, suctioning and removing all the junk in the trachea down to carina. The attending checked out the bronchi and we were done, everything went back to normal. And just like that I realized I somehow managed to do a bronchoscopy; I guess it really can be see one, do one, teach one (although, I think I want to do a few more before trying to teach someone).


A Patient on the Table
The third first: I finally made it to the OR! It took about three weeks, and I had to stay after sign out  and up to my 16 hour limit, but I got to scrub. The case was interesting and went well, and although I was scrubbed I wasn't able to do much (since there was an attending and 2 fellows in the room). But nonetheless, it was a little rewarding to hear the attending add my name as one of the surgeons* to the operative report.

*A note on that, my med student said to me (on one of the rougher days), that no matter what happens, I'm an motherf@#& surgeon. I laughed, and by no means claim that title at this point... I mean, I know I'm a surgery resident, but it's been all of a month. Nonetheless, I came to the realization, that it's probably what my patient's are seeing me as. Weird. I hope that at some point I feel a little more comfortable with that title, but even then, I don't think I'm be claiming to be a surgeon for a very very long time.


A Patient Saved
The fourth first: I experienced my first code as a physician (another title I'm still trying to grow into). Now, I've be "part of codes" as a medical student, but most of them consistent of me standing at the back and just watching it all go down; I think I only was actively involved in 1 during medical school, during which I was doing chest compressions.

This was a completely different situation. First, it was my patient, not one that happened to be on the same floor, or one that my team was cross-covering, it was a patient for which I had already been responsible for taking care. Secondly, I was the one standing there as she as she started to de-compensate, the one who called for stat anesthesia intubation, the one who hit the code blue button, and the one who started chest compressions. Thirdly, I was the only physician in the room... I had the CRNAs there for intubation, I had a lot of nurses with a ton of experience, but it was just me, making the call about what to give the patient. Thankfully, the charge nurse called the attending, who helped to calm the situation and guide the code over the telephone. And thankfully, the patient was resuscitated.

Nonetheless, I was shaken for the rest of the morning.

My attending pulled me aside later and said talked me through everything that happened, confirming the choices I had made and using it as a teaching point for later. It took me awhile to be okay, but I definitely walked away having learned, not only about how to run a code, but having learned how to gain confidence in that situation. Hopefully next time I'll feel a little better about it, and have someone else next to me.

After I left today, I had the chance to talk to a different charge nurse, who really made me feel better about it all. She mentioned, that although I've made some choices in care that they usually don't choose (some of which worked), that my confidence and demeanor was excellent and that she thought I'd do well.

However, if M&M this week were any indication of the year ahead, it's going to be a rough few years.

The Other Side of Residency: Real Life
I've been really blessed to have gotten to know one of my fellow interns over the past few weeks. And at least once per week for the last 4 weeks, we've managed to get dinner post-shift and decompress about everything that's been happening. It's been a great resource to have.

Last night, during one of the downtimes, I also got the chance to catch up with one of my best friend's from medical school. I had been meaning to text her earlier that day, when I received her text. I had a few moments, so I gave her a call. I can honestly say, that the friend's you make in medical school are the people who understand you... they've been with you through the thick of it and you've both made it through the war (that is medical school) *


*I'm pretty sure that friends from residency will be a similar type of experience.

Tonight I had the great pleasure of having dinner with the one and only @Potato_Chip. It was so great to have a few moments to catch up on what's going on with her life over a great meal and ice cream.

Despite all the great, anyone following me on twitter knows life has also thrown a ton of wrenches into my plans recently. My dad was in the hospital about a week and a half ago, but is now doing well and at home. The passenger-side mirror on my car decided to meet a concrete barrier. And then my entire car decided to take a vacation from working (thankfully, I live right near the trolley line, which, although a little unpredictable, has at least gotten me to and from work).

On that note, I should probably crack open the Sabiston or start reading the chapter from ACS for basic science lecture this week.

Hope that life is treating everyone else well.

God bless and godspeed.

2 Down, 260 Weeks to Go!

Image found on Photobucket

We're saving lives at the Elvis Presley Memorial Trauma Center!

I have somehow survived the first 2 weeks of residency, which I can only credit to amazing nurses, understanding attendings, and the big man upstairs... Oh, and some credit to Wayne, for really preparing me to jump in feet first and expect to start running.

To be honest, the first two weeks were somewhat of a blur, considering I worked 140 hours in the first week and a half. But, even though I was exhausted walking out of the hospital on Wednesday, I'm enjoyed every minute of it... even the bad ones.

In the first week I've changed LOTS and LOTS of lines (femoral central lines and arterial lines), and learn not only how to change a swan-ganz catheter, but how to float one and perform a wedge (which I've had to do too many times to count at this point). I've also seen, admitted and discharged patients with the attending relying on me for my judgement (there's no senior residents on my service, but there is a fellow who takes home call).

More than anything, I'm beginning to feel a little more comfortable in my new role (while still knowing that I have a long way to go).

That being said, I pretty much get home and crash, real hard.

For example, during my first week the fire alarm went off in my building, waking me up. However, my thought process was far from rational at this point. On waking up to a noise, I immediately thought it was my alarm, which I tried turning off. Seeing as hitting the screen on my phone was not accomplishing the task at hand I immediately came to the brilliant conclusion that the loud beeping was coming from my broken DSL modem (I know, brilliant)... Nevertheless, I walked over and unplugged it from the wall. When the high-pitched, deafening sound still ceased to desist, I finally thought, "Oh, fire alarm. Did I leave my oven on?" At which point I checked my oven. Finally I realized it was the building's fire alarm and seriously contemplated going back to bed. Thankfully my better judgement told me to thrown on some shoes and go outside. 45 minutes later, the alarm still going, we were cleared to go back inside... Please see, "alarm still going", the FD could not figure out how to turn it off. However, I walked back inside, threw 3 pillows over my head and managed to fall back asleep within a few moments.

Anyways, right now I'm actually back in Michigan. My family had a slight emergency. My attending upon hearing about it called my program director and they both said I needed to come home. Thankfully, I only missed Wednesday conferences and 1 shift. Everything seems to be fine, but prayers are still much appreciated.

I'm flying back to the mid-south at the butt-crack-of-dawn tomorrow (have to leave my house at about 4am, not that that's completely unusual, but it is for my mom, who has to drive me to Detroit for my flight).

I hope that the summer is treating you all wonderfully, and for all those other interns out there, God bless and Godspeed.

A Mad Case of Imposter Syndrome

Thank you NotDeadDinosaur of dinosaurmusings.wordpress.com for posting this wonderfully well point and poignant article.

I can promise everyone that all my co-interns have had the exact same conversation over the past few weeks.