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starting med school...and a diary.

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11 years 7 months ago #68559 by Drey
Today DH wanted me to watch a video that at some point involved a discovery-channel style fight to the death between a lion and a buffalo. It really upset me actually. :guilty: I'm not sure why it affected me like that. I know that animals eat each other. In fact, I eat animals. I think they're tasty. I've also seen PEOPLE die, so I'm not sure why I was so bothered by the death of an animal that happened in the past on a continent in the other hemisphere.

I can stand in a corner of the room, and watch a person code, and the thoughts running through my mind are {what rhythm do they have?} or {why don't we have any epinephrine or atropine yet?} or {okay, let's see if I can mentally name all the H's and T's for PEA} or even more selfishly: {do you think they'll let ME do a central line??}. I guess I've been trained to think about a person dying as problem to solve, and yet I feel helpless at the death of an animal, even one on TV.

I just finished a month in the ICU. There are two types of people in the ICU: people whose lives have truly been saved by competent nurses and doctors, and people who can't die (but probably should) because modern medicine won't let them. You tend to not remember as well the people who spend a day or two on the ventillator and were happily transferred to the floor doing much better. What you remember is the person with metastatic cancer who now has gram negative sepsis post-chemo, is on 3 pressors, and the family is discussing whether she should get a tracheostomy and a PEG tube (surgical feeding tube). I told my husband that if I'm that sick I don't EVER want to be trached and PEGed. EVER. If I'm mentally awake enough to choose, fine, but if you're making that choice for me, you're making the wrong one. We finally withdrew care on that lady and she died in two minutes. TWO MINUTES. I think I was unaware up until that point just to what extent modern medicine can keep a body alive whose person for all intents and purposes has already left.

Sory for the morbid post tonight, but it's what's on my mind. On the life update side, DD is crawling (yikes!), we're trying to locate child care in Pittsburgh, and planning a house-buying trip.

I have three weeks of medical school left. :crossfingers:

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11 years 6 months ago #68560 by Drey
Wow, so much has changed in the past several weeks. I'm done with my rotations now after a leisurely month at the rehab hospital (DONE! WOOHOO!). :cool: We bought a house. :cloud9:

It's amazing how different our situation is now than 4 years ago. When I started med school, it was just the two of us relocating to a new city and it took DH over a year to find an acceptable job. Now, we're relocating again, but we are moving into our first house, we both have jobs waiting for us, and we're bringing our infant daughter and pest of a dog with us. :D I am soooooooooo excited. :D

Our house is in an area of town that our realtor told us was "not the best neighborhood" but then we asked our friend (who lives there) about it, and she said "What he means is that it's a predominately black neighborhood." Sigh. Thanks for the reminder that racism is a alive and well buddy. We looked up the crime statistics for the neighborhoods, and it's not any different from anywhere else in the city. We bought the house.

I got my schedule for next year. I'm starting out on toxicology, and then I get to be trauma surgery's scutmonkey for a month. I know residency will be a lot of work, but I'm looking forward to it. I talked to one of the attendings and he said the one thing he missed most was the opportunity to do something new every month. I figure I can do anything one month at a time.

Babygirl is crawling and pulling up on everything. She's also having a separation anxiety phase where you are not permitted to set her down and then walk into another room. :weeping: :weeping: :weeping: <---Her response. Oh well. At least she's cute.

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11 years 4 months ago #68561 by Drey
Residency. It's finally here. I've got an MD in hand and am trying hard to convince people (mostly myself) that I'm a real doctor. My first order was for a nicotine patch. Real exciting. I'm on toxicology right now, which is great, because I don't take call and I don't do weekends. Patients are incredibly ungrateful, since most of them were trying to kill themselves, some of them with pretty good attempts, and none of them are pleased to wake up in an ICU or hospital floor. They're even less thrilled to find out they're being involuntarily committed to psychiatry. Hours are good though, so I'm not complaining too much. I'm in for a rude awakening because in August I'm on trauma surgery, and I'm told that lying about your hours is expected and encouraged. :( My mantra: I can do anything for one month.

I got moved in to P-burgh, with my new house. It took me several weeks to find child care, so I ended up leaving baby girl with my mom in Ohio for two weeks :wave:

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11 years 2 months ago #68562 by Drey
Residency is upon me. August was terrible. I violated every work hour restriction out there, sometimes all on the same day. Trauma surgery sucks, and that's all I'm saying because I either get angry or cry every time I think about it. I did learn however, that if you have exercise induced asthma, you should not run from the police K-9 unit. It ends badly.

I had a day off today and I got my hair cut. My husband came home and said "you look good, it must be that you got some sleep last night." :rolleyes: To be fair, he went days without seeing me last month, since I left before he woke up and came home after he went to bed. This means I didn't see baby girl either.

I'm working a lot and learning a lot. I feel so dumb, but I've talked to some people this week, and it sounds like everyone else does too. I think the worst part about residency is the isolation, and feeling as if you're the only hopeless one, the only one who can't do anything right. It doesn't help that each attending and specialty likes things done differently.

Baby girl turned 1 year old yesterday. We had cake and presents, and she was thrilled with the paper and boxes. :) She walks, she climbs stairs, and she refuses to eat anything that she can't feed to herself.

We have a class weekend off coming up in 2 weeks and we're renting a house in Deep Creek Maryland that has a hot tub and an indoor pool. I am very much looking forward to some venting and bonding time.

I don't want my readers to feel like I'm unhappy every day, but residency IS a lot of work, and it's frustrating to know you have a baby and a husband at home eating Ravioli-O's, or whatever it is my husband cooks when he's on his own. I know that every working woman has this conflict, and I am equally sure that I would make the world's worst housewife or SAHM, but some days.......

This month and next month I'm back in the ED, so I'll be a little more :cool:

If anyone has any ideas for a research project, send them my way.

Drey

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11 years 20 hours ago #68563 by Drey
You may have thought I fell off the face of the earth. No no, it's just that I'm an intern. I'm currently on q3 call in the CCU, which is pretty much just as bad as it sounds. Not only do I get to be on call on Thanskgiving, but I also get to be on call that weekend as well. :rolleyes: I'm going to have a post-call pity party on that Friday. I just hope someone saves me some turkey skin.

My attendings and older residents keep talking about these mysterious things called "reading" and "research projects." I'm not quite sure what they mean, as I pretty much only have time to sleep or be at the hospital.

On the other hand, my husband makes a GREAT single parent. I would like to interrupt this blog to brag about how fantastic my husband is. He does the dishes every night. He gets my daughter to and from daycare every day, does the laundry, walks the dog, and cleans the house too sometimes. Then, when I do come home, he asks me if he can do anything for me. :banghead: and :weeping: but I find myself overall fairly happy. During the bad rotations, I just remind myself that it's career choice confirmation, and that I will be back in the ER shortly. And any bad day in the ER is better than a good overnight call on CCU or gen surg.

Mental picture from the ER for the day: Intubating an HIV (+) man with massive hematemesis.

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10 years 9 months ago #68564 by Drey
And so it goes.

7 months down in intern year.

Had a meeting with my program director last week. He seemed disappointed that I hadn't done a lot of the required paperwork and such (followups, procedure logs, online quizzes). He seemed perplexed that I had practically none of that done, but was getting good reviews from my attendings. Here's the short answer--the farther along in my training I get, and the older I get, the less I care about rules other people have made for me. Maybe it's the kid, or maybe it's just my point in life, but the sinking feeling of dread I used to get when I was in trouble with the teacher is no longer there.

It's interesting to see my dreams diverge from what other people expect of me. My whole life has been an exercise in doing things that other people would be proud of me for. Get A's, join clubs, do projects, etc. Go to college, go to med school, etc. Now I find that you never really arrive at a plateau in terms of other people's expectations. Now that I'm in residency, the next tier that you're expected to want is an academic job, a fellowship, and renowned publications.

For the first time, I don't want what other people want for me. If I thought about it honestly, I want to practice ER medicine in a genial group for decent pay and generous vacation time. That's it. If my name never makes the top of a NEJM article, I don't think I give a rat's ass. I think I am supposed to be ashamed about this.

I recently wrote a prescription for amoxicillin for a friend last week. She had been babysitting for some kids with proven Strep throat and was getting a pharyngitis herself. So I treated her. I felt like I was doing something illegal. She thought so too. :) She was worried that the prescription wouldn't work or that she'd get "questioned" about how she got it. We both giggled about it. It's amazing how much I still feel like I'm just pretending to be a doctor.

In other news, DH loves his job, and little girl is learning new words every day. Gas bill was $600 last month, so I'm learning to live with the thermostat at 58 degrees. :boggled:

Gen med floors this month :rolleyes: . At least February is a short month.

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