Hmm, I was certain I had posted since the March post. Did it disappear? Matter of fact, I remember writing it quite clearly. Bummer.

Well, no real new news to report. I'm q4 in the Level II nursery this week. I was in the NICU for a couple of weeks earlier this month. Absolutely loved it! It is without a doubt what I want to do for a career. :goodvibes: I even got my first umbilical lines in a tiny, tiny premie last week. First try! Few things feel as good as getting a line on your first try. Too bad I haven't been so fortunate with my taps (lumbar puncture)so far. I can only console myself with the fact that no one else was able to get the tap on those two patients either. (small consolation for me and the patient, of course!)

Life is good. I am (im)patiently waiting for my schedule for the next academic year. I want to make some plans for the summer, but nothing happens until I know what kind of schedule I'll be working.

Kids are good. Had to read the riot act about some grades on the last progress reports. We'll see if it worked. I basically told 2 of my kids if they didn't get their acts together they'd be in summer school instead of on the family vacation come June. Yes, that thought makes me queasy. They'd better not make me stick to my guns!!!

I'll have to write a "day in the life" entry about being on call in the Nurseries at the end of the month. Some funny stories!

Prepare yourselves. I'm going to muse on facing the last 2 months of my intern year.

Truly though, we just got our schedules for the next academic year and I cannot quite fathom that I am about to be a 2nd year resident. Finishing intern year has it's ups and downs. It certainly is nice to be doing something next year besides being buried on the wards for most of the year. It's also nice to step out of the low-man-on-the-totem-pole role. OTOH, now I'm supposed to know something! No longer able to hide behind the "lowly intern who doesn't know much yet" bit.

To be honest, I'm currently recovering from my last month in the Level II & III nurseries at our county hospital. It was a very good month, but I was pretty ramped up the whole time. Mostly a good thing, just being excited about being in the NICU. But also a little nervous, wanting my attendings to think well of me, wanting to do well, etc.

Frankly, it's nearing the end of intern year and everyone is tired. There aren't quite as many smiles going around these days. Nerves are a bit frazzled, reserves stretched thin.

And somehow one week off for all of us at the end of June needs to fix that... :rolleyes:

Actually not that bad. It's amazing how quickly you can recover once the pressure is off for a few days. I'm usually super cranky for a couple of days on an easier month, as if letting the pressure off lets me really feel how tired and worn out I am. Then a little extra sleep and no dreaming about patients allows me to get back to baseline once more.

Ah, swine flu. Preparations are ramped up. Everyone in patient care is getting fitted for protective face masks. *sigh* I predict much more will be made of this flu than is acually necessary.

Uh-oh, time to be taxi-mom!

*Ugh* Sorry, I'm going to vent about motherhood.

My son. My son has brought home uninspired B/C report cards all year. No amount of cajoling, pleading, grounding, etc. has changed that. A couple of weeks ago he brought home a progress report with an F in Math. I read him the riot act, told him he'd be in summer school and miss our vacation and generally laid it out for him. Then his dad went to a parent/teacher conference and they devised a system where he has to get his planner signed every day by each of his teachers. He's finishing 6th grade. I would have thought we'd be past that kind of hand-holding by now. Regardless, he brought home an improved report card last week. One C, a couple of B's and several A's. What a relief!

My highschool freshman daughter also brought home a poor progress report. We took away the cell phone. At the end of last week I asked her if the report card would be improved and if she had earned her cell phone back. She said "yes" and got the phone back over the weekend. Today I got her report card. It's the worst one ever! It's not like she was ever a straight A student, but this was atrocious. She flat out failed a 6 weeks of English. English??? My child who reads a book a day? Whose vocabulary beats most adults'? *arrggggh!*

I demanded the cellie, the ipod and sent her to her room in order to preserve her life. Okay, I exaggerate about the life-preserving. But still, I'm so furious! She's on the verge of having her first boyfriend. She asked me if she could wear a bikini this summer. She has a great social life. (finally, after several years of bullying and difficult friendships) And now this. It makes sense, of course. Her mind is on friends and fashion and boys, instead of school.

Why do I have 2 underachieving children and how on earth do I change them??? They are so very capable of the work and so very failing to turn it in. It's not that they can't do it. They just aren't doing the assignments or failing to study for the tests.

The thing is, I did this at their age too. I remember. And you know what? Nothing my parents did changed my behavior. That's what scares me. My SAT scores saved my butt and allowed me to get into some good universities. Once at college, I was able to see why I really cared about my grades.

But what if one or both of my underachieving kids actually manages to shoot themselves in the foot and misses out on important opportunities?

And before anyone thinks about this being an issue of a medical mom not having time for her kids, my mom was a SAHM. And like I said, I did the same thing. I could be home every afternoon when they walked in the door, but if they lie or withhold info about assignments I can't do anything about that. Okay, maybe I could call the teachers daily and follow them around school, but I don't think that's appropriate at this stage. (besides, they'd hate me and find other ways to rebel, wouldn't they?)

Dang. I'm just so frustrated. No idea what to do next. That's the thing about parenthood. Just when you get one part of parenthood figured out, they throw you into the next stage and you're completely clueless again!

*sigh*

-Tired Mom

I was so annoyed by this story today, http://www.slate.com/id/2217798/ , that I sent Oprah this email. (though I doubt it will get read)

Dear Oprah,
I watched your show daily for many, many years. I read your magazine and I support the fantastic work you have done for so many charities and organizations. I have to tell you, however, that I am deeply upset by your support and promotion of Jenny McCarthy and her anti-immunization campaign. I am the mother of 3 children and a pediatrician in training. You and I both know that there is no scientific proof that vaccines cause autism. There has been no decrease in the rate of autism since the removal of thimerosol from vaccines. There have been, however, increasing numbers of cases of children becoming very ill with vaccine preventable diseases. We've seen it at my hospital. We're seeing it all over the country. It deeply saddens me that you are lending your good name to the campaign against vaccines. Please reconsider, for the good of your viewership, your readership, and their children.

Maybe I shouldn't have been bragging about never getting sick... I'm home sick today. Nothing horrible, just upper respiratory junk, headaches and a bad case of the blahs. Just shy of a fever, too. And since my husband is also home sick, pretty sure it's contagious. :laughing:

I had dinner today with a friend who is finishing her Neonatology fellowship in about a month. Very happy for her! And jealous, too! I wish I were on the verge of being done instead of looking at 5 more years. But then, I know I'm no where near ready and I'm supposed to be enjoying the process. Living in the moment and all that. :laughing:

Anyone who knows me knows I'm not good at living in the moment. I'm always a day, week, month, year, decade ahead of myself. Great for planning, bad for managing anxiety.

Today was the kids' last day of school. Can't believe I have a Sophmore and 2 boys in Junior High now. I've met my daughter's boyfriend a few times now. He seems nice enough for a hormone-ridden adolescent boy. :laughing: One of my sons is very concerned about the fact that they kiss when no one's looking. I honestly don't know how to feel about it. I guess I know I wish she wouldn't kiss him, but I also know it's pretty normal for her age. Freaking out about it would just lead to her hiding things from me. So I've told her how I feel about things, and I've done my best to make sure the lines of communication stay open.

Wow, it's taking up a lot of my mental space lately, isn't it? I just one of those stages of parenthood I just wasn't ready for and here it is. Potty training seems so much easier now...

Yeah, so what am I doing at the hospital these days? General inpatient pediatrics at the county hospital. It's very strange to be at the end of intern year, still playing an intern role. I have an attending right now who tells me what to do and makes me carry charts from bedside to bedside and borrows our stethescopes because she doesn't carry her own. :rolleyes: I think she's younger than me. :p I want to say something to the effect of "Excuse me, I'm not a chart carrier. I'm a member of the medical team who happens to be the one who admits, writes the orders, and makes the discharges happen. Perhaps you could treat me that way?" Can't really say anything else about the floor or cases since I'm far from anonymous around here. I'll try to dream up some representative type cases to write about this month. I miss blogging regularly!

Can't wait for our family trip to Colorado in a few weeks! Cooler air, mountains, great coffee shops and great hiking/biking and other activities. Love it!

The training for my next half marathon is going well. It'll be interesting to see how it goes once I have to do day and night shifts in the ER in July and August. As always, my weight continues to plague me. If only I could stop eating! To be honest, I wish I could eat like my daughter. She eats like a bird, as they say. I remember when people used to accuse me of that, oh so many years ago.

Well, it finally happened. TR got sick. :p

I got sent home yesterday morning with cough and sore throat and spent the day on the couch. I felt so crummy I didn't even read email. I've had contact with several Flu A positive patients recently (as in H1N1 "swine" flu) and a fellow intern who has the flu. But fortunately no fever for me, thus no need for flu testing.

Today is my call day. And, I'm home again. Oh horrors! Really, though. Missing call is about the last thing on earth I actually want to have happen. While it sounds good in theory, I have this horrid sense of letting everyone down. I feel like I'm somehow weaker, not a top notch resident because not only did I succumb to illness, but I'm letting myself miss call for it.

OTOH, I have body aches, a constant cough and no energy. Which fellow nurse or resident would like to work with me tonight? Which patients or parents will be happy to have me coughing while examining them? From a reality standpoint, I know it's best to keep my germs at home.

Still, feel like a wimp.

The good news is, the way this rotation is arranged, there is a second intern on our team who is on call with me each time (an anesthesia rotator who is quite good) and an upper level who admits patients with us. So they probably won't need to call in any backup. The last few calls we've only admitted 2-3 patients a night. (yes, it's super slow at the county hospital in the summer as far as admits go!)

So here I am, at home, feeling like poo. :laughing:

Only 5 more intern days! *happy dance*

All in all, it's been a very good year. Would I do it again? Yes. Not, would I repeat the year (heaven forbid!), but would I do it knowing what I know now? Yes, knowing what I know now I would do this again. The world did not end. My family is as well-adjusted and happy as ever. My marriage is as healthy as ever. I'm a little worn out and exhausted at times, but I'm also still running and camping and going to the movies when I have a chance. Sure, things aren't perfect. But hey, they weren't perfect before I started residency either!

Did I mention the other day that I was really tired... Oh wait, I just realized that was the day before I realized I was sick. Well anyway, there are definitely days when I ask myself "why, why are you doing this very difficult thing?" But the answer is always, because it is what I want to do and it makes me very happy to be a doctor. My least favorite rotations this year (including the current one!) have been the ones where I was treated like a secretary and my thoughts and opinions and plans for patients were not heard or largely ignored. Even if I'm wrong, I prefer to have a voice.

The attendings I respect the most, by far, are the ones who allowed me to be the main doctor for my patients. They asked my plans, asked for my reasoning, and guided me to correct answers when my thoughts were wrong. I have learned the most from them. I may have been dead wrong a few times but I sure learned from voicing those wrong ideas and being guided to the right ones. I learn very little from attendings who just tell me what they want done. Medicine is a thought process, not direction following!

Ah man, I am utterly miserable. Since I posted yesterday my 99.8 temp decided to climb to 101. I got a rapid flu test, which was negative. I'm both relieved and frustrated. At least if I had flu I would have an excuse for missing so much work. My temp is 100.5 this morning, but I'm taking my advil and going to work. Guess I'll just have to wear a face mask while seeing patients and hope I can last 6 hours or so.

The headache and bodyaches are the worst. The constant cough is annoying, but the aches make me miserable. I'm a total wimp 'cus I haven't been sick like this in years. I had strep in 2nd year of med school, but got antibiotics within 24 hours and was fine in 48. Now I've been sick since late Tuesday and there's no end in sight. Oh yeah, the other good thing about if it had been flu was that I could have taken tamiflu.

Instead, I'm just suffering and trying to remember what I tell my patients to do when they have viral illnesses! :laughing: It's very unsatisfying to leave a doctors office with no medicine to "fix" things. My family doc did give me a script for a Zpack, just in case. I have no bacterial infections symptoms, though, so a zpack won't help.

Wah wah wah. It's 4am and I can't sleep. Been awake since 3am, more or less. I have to go to work today. Can't leave my team a man down for another day unless I'm in the hospital or flu positive. That's my rule, by the way. Not sure what my chief resident and upper level would say if I told them I still had fever. They'll have to see me and send me home, though. I'm too afraid everyone will be thinking I'm exaggerating or making this illness up just to avoid work.

What a crummy situation. And I have no days off this weekend because of our attempt to go see the shuttle launch last weekend. I used two days off last weekend and gave up the one for this weekend. No shuttle launch, too little rest, and now I'm sick and supposed to be working until Wed.

Tuesday is my last day as an intern.

(about the only positive thing a very grumpy TR can even think of now.)

Good news, I survived my "not flu," and my last week as an intern. Once I got over the fever, it still took the better part of a week to feel like my normal self. No one else at home got sick, luckily. I think it was the exhaustion and the travel in the middle of a call month that did me in. I was just so worn down.

But now I'm back. We just got back from a week in beautiful Breckenridge, CO. The temps there went from mid 40's to mid 70's. It was bliss! Meanwhile, we missed the 100+ degrees at home in TX. :p The family had a great time. We hiked, biked, shopped, joked around, ate in restaurants and basically spoiled ourselves. No video game consoles and no computers meant the kids spent a lot more time hanging out and talking with us. My 12 year old sons even held my hands a few times while we were strolling down the streets looking for interesting shops or hiking across snowy fields.

I tell you the truth, I did not want to come home!

I felt like a kid when you've had a great summer and suddenly school looms in the near future. I wanted to cry and refuse to get on the plane! :goodvibes: I'm so grateful that I'm not a clutz with procedures. They always intimidate the heck out of me, but I'm always so grateful when they go well. It's such a good feeling.

So maybe 2nd year isn't so bad, after all. Maybe I will survive another year. My schedule this month still stinks, though. I got the short end of the stick with only 7 days off all month and no 5 day break like the other interns get. "Someone has to get the short end of the stick." Fair enough, I've been pretty lucky with scheduling thus far. I also have a string of 8 nights in a row at the end of the month with only 1 day off in the middle of it. That's going to stink, big time. All our ER shifts are 12 hours, either 8am-8pm or 8pm-8am. Not much time for seeing family, sleeping, showering, and running. If something's gotta give, I guess I'll be one stinky resident this month! Hahahaha.

Did I mention my daughter has recently announced she wants to be a doctor? That just floored me! She's never said that before, and I figured with my kids old enough to see everything I'm going through in order to become a doctor that they'd just run in the other direction. Most doctor's kids don't become cognizant of what their parents do until they are practicing physicians, making money and not taking call every 4th night. Well, I think it's terribly cool and take it as a compliment.

I'll write about the joys of having adolescents home on their own in the summer on another day. This post is looking pretty long already.

Oh my word, I haven't had a mental break since my last post. I haven't watched a moment of tv. I haven't read a book, played a game, gone for a run, or done anything that resembles relaxing. I have worked 7 days straight and the last 4 days were 12 hour shifts in our big pediatric emergency center. I am mentally and emotionally exhausted.

At last, today I had a clinic this morning and nothing in the afternoon. Tomorrow is my first day off in a week. I came home and took my boys to see Ice Age. Not so much because I wanted to see the movie, it was okay, but because I wanted to be near my kids and be mentally "off."

The EC is interesting, but not for me. I dislike the rushed feeling and the lack of continuity. I keep wanting to know what happened to that patient I admitted, the kid in the accident, the one who went home on antibiotics... The pace is rushed, as well. Where I could easily wait hours for a consultant to come see a patient admitted in the hospital, in the EC I have to start harassing people if they haven't showed up in 15 minutes. I don't like it. And patients and families have this expectation that being seen in the EC should be fast and efficient. It might seem that way, but with 4 residents staffing 25 (!) EC beds, it's not fast. And if a trauma rolls in...

Also, EC's are so noisy! There are no quiet moments. There's no chance of a moment of privacy if you're frustrated or tired or want to eat your cold french fries in peace. Nurses have breaks and a dedicated lounge with a door. Attendings can just decide to walk across the street to Starbucks. We can't. Well, anyway.

The plus side is, I'm learning a ton. I'm seeing a ton of things that I didn't see on the floors. I'm getting better at quick evaluations of sick and not-so-sick patients. I was already pretty good with your standard ear infections and viral syndromes, but now I'm getting better at stomach bug vs surgical abdomen (needs an operation, like appendicitis). You'd be amazed at how much there is to learn.

And of course there's the ever-present pressure to know more and be more competent than I was as an intern. That's been weighing pretty heavily on me. I hope the feeling lightens up soon. It's a lot of additional mental pressure right now.

And then there's home...
The teenage daughter with the first boyfriend who came home with a hickey on her neck the other day. At the end of a 12 hour day, totally exhausted, I'm supposed to deal eloquently with that??? It's all going too fast. A few months ago I was counting myself lucky because she'd never even held a boy's hand and now it's kissing at the movies and a hickey. Where did the time go?

Lately, I've also been feeling the pressure to be a better mom/wife and envying women who stay home. Weird, huh? My husband has this former colleague from work, married many years, who now stays home. They don't have kids. She goes to museums and has started a creative writing group... I'm tired and grumpy again just writing about it.

I thought the end of intern year meant not being so exhausted so much. I'm disappointed and wondering how I can do 2 more years of this.

Hmm, maybe I should take a day off soon. :p