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starting med school...and a diary.

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10 years 3 months ago #68565 by Drey
6 months since my last post....This is what intern year does for you. I was near the breaking point at the end of the year, sick of being treated like an idiot, sick of working constantly, sick of never being told I'm doing a good job. It's no wonder depression rates are so high for residents.

But the silver lining is, I'm NOT AN INTERN ANYMORE. This makes a huge difference. It's amazing how differently people treat you when they know you're a resident, not an intern. It's not like my medical competency is much different now than two weeks ago, but somehow people think it is. Sigh.

I'm at the tail end of a series of hellish months. MICU at hospital A, MICU at hospital B, and now on Trauma Surgery in the Trauma/Burn ICU back at hospital A. So I've been busy, but I can see the light at the end of the tunnel.

DH and I finally got to go on vacation at the end of intern year. We went diving in cancun, and it was really fantastic. This is the first vacation we've been on together that wasn't just visiting family, and we left dear daughter with my mom. It's our honeymoon, 4 1/2 years later. I think that vacation is a big part of why I'm handling trauma surgery this year with a more philosophical perspective.

Had a crazy night on call last night for trauma surgery. One trauma bay thoracotomy, one 95 year old man in a house fire, one young guy, unknown age, who decided to try suicide by jumping in front of a train. Several drunk car accidents. One assault. One fall down stairs. Welcome to trauma in July.

Little girl is talking like crazy! Knows her animals and noises, knows her colors, knows her body parts. Soo cute! I signed up for a baby, and suddenly I nearly have a preschooler. I'm trying to potty train without much success.

And....DH and I are TTC again. :crossfingers: Shhh! Don't tell, it's a secret.

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10 years 2 months ago #68566 by Drey
Multiple choice question:

How would you prefer to find out you have cancer?

a) No thanks, I'll pass
b) From my longtime family physician, in her office, with my spouse at my side
c) From an ER resident, sitting on a gurney between two other patients separated only by curtains, when your wife is at work, and you "don't want to bother her."

I found myself telling the nicest gentleman I had met all day that he most likely had metastatic lung cancer in the environment least conducive to understanding, empathy, and communication. I should have known he had something bad, because nice people always do. The unfortunate man then had the grace to thank me sincerely for my bedside manner. I'm pretty sure that if I had been told I had cancer in that situation, I could not have mustered up a "thank you."

And then you have to walk away from that man, because you have that diabetic with the blood sugar of 768 in bed 14 who claims she takes "pretty good care of herself." And the guy in bed 7 who starts yelling when you walk in because he doesn't understand why the triage nurse couldn't just refill his albuterol for him instead of bringing him back to be seen. The guy with the birdshot wound to the back must be ok, because I can hear him arguing with the nurse, and the nursing home transfer's labs are starting to come back. The OB/GYn Resident is on hold on line 3 for me, and the paramedics just rolled in with someone puking blood.

But none of that last paragraph bothers me. It's the sweet old man with cancer. Came in with routine chest pain, older man, easy admission, send some troponins, get an x-ray, call the hospitalist. Uh-oh, X-ray has a large pleural effusion, looks funny. Get a CT. CT with hilar mass, pleural nodularity, lymphadenopathy, suspicious for malignancy. Big words that all spell bad news for my nice gentleman. "Well sir, the heart looks okay, but..."

Sigh. Such is the life of an ER doc. Little vingettes of people's lives, maybe you help, maybe you don't, and sometimes you're there for people's worst moments. No one is ever having a good day if they're a patient in the ED, but some don't know how bad their day is about to be. Usually I try to make people's days a little better. Today I made his worse, and he still thanked me.

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10 years 1 month ago #68567 by Drey
Well I just finished my first overnight on our jeep. For those of you not in the know, the jeep is actually a Ford Explorer now, but is still called the jeep from 'back in the day.' It is a physician (er, resident) driven emergency response vehicle that drives around the city and responds to medic requests for help. I had multiple radio consults on everything as mundane as needing a verbal order for Zofran (an anti-nausea drug) to a young man who recently had neurosurgery and was probably septic (infected and in shock) based on the vital signs they gave me.

I was asked to discontinue resuscitation efforts on a relatively young person via the radio, which made me feel sad, but I did, because the situation was pretty hopeless.

The jeep makes me feel excited and terrified all at once. :boggled: I can't send her to daycare like this, poor baby :no: , and I can't ask DH to stay home when it's perfectly obvious that I am already at home for the day.

Did I mention I didn't sleep yesterday during the day either, though not for lack of trying? Oh, and I'm on again tonight overnight as well. I guess I'll sleep when I retire.

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10 years 1 day ago #71686 by Drey
So, some of you know this, but I'm about 10 weeks pregnant right now. Had my first OB visit and heard the heartbeat, so I guess there's no denying it now.

Little girl is 2 years old, and is getting a baby sibling in May. Everything I've heard about going from kid one to two kids scares me, but we've always wanted several, so here we go.

I finally told my program director (via email, because I'm a coward) and got an obligatory "congratulations" back, but haven't worked out any details. I'm currently worrying because a girl in my program last year was pregnant and was also not well liked, so I'm hoping that the negative energy doesn't transfer to me. A couple of people have told me that it was a personality thing they resented, not a pregnancy thing, but still I worry. I don't kid myself that there's not resentment and prejudice that still is around when it comes to pregnant ladies in the workplace.

So that's my news for the moment. I'm currently working at Children's hospital, which has been so painful. The pain is mostly coming from the fact that all of the schools sent home sheets basically telling kids to come to the ER if they so much as have the sniffles. We have H1N1 running rampant, but it's been pretty benign, and we're just sending kids home. However, the parents are beyond pissed because they got told to come, waited for 5 hours, then got told they were fine and should have stayed home. Totally beyond my control, but I've been frustrated at the amount of anger directed at me over the situation. No, it's not an emergency, no I'm not giving you Tamiflu, and no, I'm not even bothering to test people for it anymore because the labs are overwhelmed, and I'm not going to treat it anyways. I should just have a sign that says that, it would save me some breath.

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