Happy 1 year anniversary
When I started this blog last year, I was writing with a broken heart and belief that I may not be worth anything. I was facing Step 1 and the wide unknown of Med 3 waiting over the horizon. There was lots of anger, lots of freaking out, and general questioning of if I should or shouldn't even keep going. My future seemed to stretch in front of me as a wide expanse of loneliness and unhappiness.
In the past year, I've gone 32 hours without sleep. I lost an election, got written up, and made a few enemies in the medical community. On the other hand, I've delivered a baby by myself. I was referred to as 'doctor' by patients who wanted my advice. I danced with the dance majors at the university and earned a brown belt in judo. I wrote the first third year emergency medicine elective at my school and won the state judo championship. I discovered some amazing people on my rotations and helped some of my friends through what could be the worst times of their lives.
One year later, I am no longer questioning what I am doing. I disagree with many things in medicine, but I do not doubt that I am doing the right thing by being here. I feel that I am stronger and more in control that I was during med 2. Recently, I started reading the blog of a melanoma patient
Sarah who is dying, and when she was well enough, she had written about the things she'd delayed or missed because she thought she'd have time for it later. She talked about how fear and the ease of putting things off makes all of us miss things we should be embracing.
That being said, I'm going to open up about something. For the past 5 months, I have been seeing someone, stating that it's nothing serious and that I don't want commitment. I've had this box around myself, insisting that I don't feel anything beyond the enjoyment of hanging out.
To steal portions of the
Izzy' Steven's speech:"I am an optimist. I am hopeful. I am not sure . . . [] I can't promise the future. I can't promise perfection because we're us and I'm me and who knows what will happen . . . "
What did that mean? It means that I am acknowledging my willingness to figure out if I have a future with this person. I'm not ready for 'forever' right now, and nowhere near saying the 'l word,' but I am saying that I'm not going to pretend anymore that I don't care. I see it as a very distinct possibility that things will come crashing down and I will be broken, but unless I open up to the pain, the possibility of falling for him and making things permanent does not exist.
You miss 100 percent of the swings you don't take.
Labels: failure, grey's anatomy, love, medical school, melanoma, relationships, sarah
Hiding from my patient
On my last day of my inpatient peds rotation, we got some imaging from one of my patients. This patient had been in my care for a long time. He was, technically, was an adult but was being treated in peds anyway. Which meant I had a pissed off adolescent teenager who was pretty unreasonable.
Yeah, I said it. Unreasonable. Being sick sucks. I got it. Grow up, life isn't fair. He had a diagnosis that had a long recovery ahead after surgery - scheduled a week away - that my service fought very hard to get approved. He lived in total denial of what was happening to him and had a freak out my last day over the size of scar he will have with screaming and crying that he wouldn't have the surgery. I so much wanted to reach out and shake him, 'if you don't have the surgery you will die and no one will care how nice of a corpse you look!' His ever-present parents were very aware of how bad his prognosis was without surgery.
Before you judge me too harshly, this is not his first freak out. This is like his 20th. I spent alot of time keeping his nurses spirits up, whom he treated pretty badly. His diagnosis wasn't cancer (since I was on a non-cancer service) so it's not like I'm talking about a kid that had been sick for years. This 'kid' can fight for his country, he can vote, he can drive, and he is allowed to make healthcare decisions for himself.
So moving past that part of the situation. We sent him down for some additional imaging. We saw something we didn't expect to see, and it was BAD news. My last rotation in surgery tells me that what we saw changed everything. It was very likely that we weren't talking about a surgery next week with a hopeful discharge for his graduation. We were probably talking about a surgery as soon as they could get the team assembled.
However, without the official word, we could tell the patient nothing. In fact, my house staff specifically told me not to re-enter the room for any reason. We did not have an official read of the results and we did not have a plan of action. The plan was up to the surgeons, and all we would do is upset the family and screw up the care of the patient by not having solid answers.
Thus I hid. It was my last day, but under no circumstances was I coming back to say good-bye to the family. I know myself. They would ask me about the test results, and I would have trouble saying 'no official read yet' without betraying our suspected BAD BAD news. It sucks to say this, but in medicine, until you have an official attending backing you up, you aren't allowed to say what you think.
I was sent home before the surgery team even found out the news. Yes, it is an unsatisfying climax to a story, but that is how medicine can be.
Labels: bad news, hiding, medicine, pediatrics, surgery
D@mn, it's good to be a doctor
First class deliverySo you are on a plane and a woman goes into labor. Normally that wouldn't be your problem, except that you are a doctor, which does make it your problem. Even if you are out of your specialty, you probably know more about OB than anyone else unless an OB nurse happens to be there.
Which is why a pediatric cardiologist (Dr. Robert Vincent) and an adult cardiologist (Dr. Dieter K. Gunkel) delivered a baby on a plane. The peds guy almost certainly had more experience with L and D than the adult guy did. Still, judging by their titles and photos of pediatrics guy, it had probably been a good 5-10 years since either of them had delivered a baby in a hospital - let alone a mile above the ground in the first class row.
Having done an OB rotation more recently than either of them, it must have been rough. Especially with the baby going all bradycardic (thank goodness they were cardiologists and were able to HEAR the baby's heartbeat slowing in whatever crappy stethoscope kept in the air emergency kit) Maybe they'd have had their own stethoscopes . . . wait, they were probably attendings and wouldn't carry that.
That being said, I bet Delta will be instituting a new pregnancy policy because its not that often you have docs on international flights. Good thing that there was that cardiology conference last week in Europe, I'd bet.
Maybe they'll start offering reduced prices for flights now if you flash that MD. I can only hope.
Labels: airplane, delivery, Delta, Dieter Gunkel, doctors, emergency, Robert Vincent
Surgery - I just don't get it
We all know I love the TV show Grey's Anatomy. I watch it religiously and will endlessly talk about it if given the opportunity. However, there is no way that I would
EVER become a surgeon after my past rotation and now being on peds. The surgery rotation is made to crush your spirit and is practically a waste of time on account of its overwhelming ineffieciency. Worse, the cracks in the foundation are extremely obvious and it's maddening that everyone has to pretend how wonderful it is. While I now respect the surgeons more, I think that anyone who tolerates this is insane.
So I wanted to make a comment on some of my pet peeves about the surgery rotation. (I am writing this 2 months after I finished it, and I still feel just as strongly)
1)Why am I here at 4:30am? Honestly, I don't really know because the nurses haven't even draw the labs. It doesn't make sense for me to get here this early because WITHOUT labs no notes are complete and pre rounding can't even be done. Most days the labs aren't up until 7am, and you can't finish notes or round without labs. And without rounding, no resident can scrub into the cases.
2)Why can't the attendings round by themselves? My service had six attendings last month. Yes, six. No one could go home until we had rounded as a team with all six attendings. It was even worse when one attending would be very late and decide he wanted to teach. Most fo these attendings rounded on their patients in the am and the pm. They get impatient and pissed off if the team isn't waiting for them to round - perhaps it is because we are rounding w/another attending. Heaven forbid you round by yourself in the am and then communicate to the chief what 3 new orders you put it. Did all of us need to be there to see you replaced Ms. K's potassium?
3)Why can't you use your manpower effectively - aka - why am I even here? The first two weeks on my service were horrible b/c the chief resident insisted on doing things in a 'his way' format that was inefficient and worthless. He was gone for a week and didn't realize we went to a moderately more efficient set up which involved the med students seeing a section of the hospital w/o the residents. When he came back he accused us of skipping out on work and refused to talk to us for a few hours before he asked us what we had done all morning. Heaven forbid we put some organization into our day.
4)What 80-hour work week? As with many other specialties, it is still a joke. The residents are lying about their hours. I don't need another talk about how the 80 hour work week is the worst thing that happened to medicine from someone who has been brainwashed into believing this is good. I can't believe how some absolutely brilliant people can buy into a rhetoric that denies them basic sleep deliberately. I think surgery was certainly the worst of the group with OB and medicine coming in close second and third.
You know, I could go on for a long time about what is wrong with surgery and how we train for it, but it is like yelling at the rain. You can't change the wet, but you can get an umbrella.
Labels: 80 hour work week, residency, rounds, surgery
That shoulder - she's separated
So I was having a good time in Peds. Babies are cute and, even when their mommas abandon them at the hospital, Auntie Allie is there to hold them - of course while auscultating with my stethoscope. I had enough time to see the sun sometimes, and even fight in a judo tournament. I did lose a match in overtime on account of being out of shape.
In an effort to push my training into higher gear, I went to judo more. There is a third degree black belt with a hurt shoulder. We were sparring in stand up, and one of the throws went bad. I heard this tearing sound from my shoulder, and that told me there was something very wrong.
Finally got it confirmed by an ER attending - that left shoulder - she's separated. And it will hurt like hell for a month. So it will be the spring of my left arm's discontent.
In other sad news, Veronica Mars was officially canceled. What will MDave and I watch during Med 4?
Labels: injury, judo, pediatrics, shoulder, veronica mars
Hardly partying
So here from the land of pediatrics, I'm having a less stressful time than on surgery. Well, the patients are cuter and they aren't as annoying since many of them aren't able to talk yet. It is also less hours than surgery, which means I could go out! And when I say 'go out,' I mean 'drink very lightly.'
Friday night: Birthday Blackout
Drink count: 3
In the ongoing celebration of
Stacey's and
Aaron's birthday, I attended yet again this year. I left judo early b/c I wasn't feeling so hot, but I perked up a little bit after eating dinner. At the party, I missed
Sanjida, ran into Donny,
MDave, and
Ene, and was easily recognized at the '
video well-wisher' from last year. I've yet to see this year's pictures. However, based on past years, it will be quite exciting. This year I even climbed out the window onto the roof, which I have avoided doing in past years. My window exit had nothing to do with my drinking because I stayed long enough to metabolize my cup of vodka-sprite and Mikes Lemonade.
Saturday night: Cinco de Mayo
Drink count: 1
I was on my way to bed when the text message came through inviting me out with some of his friends. After determining the where/when, I coerced Anna into accompanying me to said event. She performed beautifully, successfully meeting him for the first time and charming his friends. I like to think I performed appropriately well too. There was dancing, dart throwing, and pool playing - except me who readily admits to sucking at pool. We didn't stick around to close down the bar, but that 6am wakeup for the hospital the next morning seemed pretty darn early.
Labels: birthday, cinco de mayo, drinking, party, pediatrics
