In the Life of a Fickle Intern

July 28, 2010

Polar Opposite

Filed under: Daily Lowdown — dailymedicine @ 16:10

Without planning it, I probably chose the two most polar opposite programs to rotate at. Last month, in all my adult shifts together, I probably got to sit down for a total of 30 minutes. There were always multiple residents and attendings working, and there was always a constant flow of patients. Once I got to the hospital, it was nonstop until my shift ended, the majority of which would run over an hour or two. I was exhausted, but each shift flew by.

I had my first shift here last night. Not to be too dramatic, but those 10 hours were the longest 10 hours of my life. There was only one resident, one PA and one attending on call, and we still were not busy. Don’t get me wrong, everyone was ridiculously nice and I was impressed with their patient management and whatnot, but there just wasn’t that much going on. I got to see a few really interesting patients, but the majority of my time was spent trying not to fall asleep and watching the clock. It’s always a bad sign when you look at the clock more than once every hour; it’s even a worse sign when you look every 15 minutes!

Though I have no doubts that I will have great interactions with the people this month in a very relaxed atmosphere, I am a little worried that every shift will drag out as the one last night did. Staying positive! I’ll just bring a book next time, just in case.

July 26, 2010

Contact Lens

Filed under: Personal Ramble — dailymedicine @ 22:15

Being the complete space cadet that I am at times, I left all my contact lenses in Atlanta, in the cabinet underneath the sink. I had checked the closet, the bathroom, every nook and corner three times around before heading out, but apparently, my excitement to be done made me overlook the one spot that housed a very much needed commodity. Calling in a favor with a friend, I had him go pick up my stuff from my previous landlord. The bulk of the problem was solved. I’ll pick up my belongings when I head down to Atlanta in two weeks for my test.

The more pressing issue was how to get a pair of contact lens to use now. My current pair was not going to last for another two weeks. After one call to 1800-contacts, with whom I’ve ordered from in the past, the customer service representative took care of everything. He called my optometrist, got my prescription, faxed it over to a local dispenser, and had me set up to pick up two new boxes of contacts within an hour. That was the best customer service I’ve ever experienced! I’m not usually the type to make complaints or to praise people for customer service, but I made an exception and gushed my compliments to the supervisor. He totally made my life that much easier, if not but for a moment.

When I arrived at the local contact lens dispenser, the lady at the counter, after hearing my pathetic story about being so spastic, gave me a pair of contact lens to carry me through the next two weeks for free. I did not have to spend $50 on two new boxes. It was so nice of her!

It’s days like this that I am reminded of how great people are. It’s easy to overlook people’s kindness on an everyday basis, but in sticky situations like the one I got myself into, people’s generosity are much more noticeable. I really, really appreciate all the help these strangers provided me today, and I hope that I can help others in their moments of fluster and distress. It’s definitely the little things in life that make it so much better.

July 25, 2010

Pamper

Filed under: Personal Ramble — dailymedicine @ 21:45

The idea came to me last night as I lounged on an unfamiliar couch watching lifetime movies on a Saturday night, hours away from home. I needed to do something nice for myself. I deserve it. I’ve worked really hard. I considered buying myself something really nice, but that idea just did not excite me. After some brainstorming, I had it. Massage. Full body, deep tissue.

Being the frugal person that I am, I debated the issue back and forth. It was expensive, but I did have a long and stressful month. It was frivolous, but I do love massages. After internally debating through two movies, I finally gave in and decided to spurge. With some research, I found a really cute website for a place nearby. A few clicks later, I had an appointment.

I did not realize how tense and knotted my shoulders and back were until the masseuse started working on them. It was so painful, in a good way. The majority of the session was used to undo knots in my shoulders. It was amazing! Though I am completely and utterly sore right now, my shoulders feel ten times lighter than before! With all that pampering, I’m so ready to start up again tomorrow, sort of.

July 24, 2010

New City

Filed under: Daily Lowdown — dailymedicine @ 18:46

One month down. One to go.

Driving away today felt so amazingly great, as if I was shedding all the stress and pressure that I’ve been carrying around with me this last month. That may sound really dramatic, but I have been on pins and needles this whole last rotation. Coming from a lesser known public school (as I was told by the program director) to a more known private program, I had the mentality that I had to prove myself, to show them that I can do just as well, if not better than their own students. With this mindset and self-imposed competition, I worked my butt off this last month. However, it all paid off, I think. Overall, despite some minor nuances here and there, I had such a good experience at this program. I could see my own progression and improvement with every shift. It was kind of cool. Cool or not, I’m glad to be done!

This month will hopefully be a little less stressful since it’s my own program, but nonetheless, it’s still another unfamiliar city and an unfamiliar health care system. One more day of me-time and I should be good to start up again on Monday.

July 21, 2010

Hump Day

Filed under: Daily Lowdown — dailymedicine @ 20:02

Today I was told by my attending that if he was a patient having a bad day in the ER, he would probably be annoyed with my over-cheerfulness and high energy level. Though he assured me that this was not a bad thing and he hopes that I continue to be energetic in the future, I was a little unsure on how to react to this particular feedback. Normally, this would have made me ponder my own character a little more, but fortunately, throughout the day, I had made my own mental notes on the type of person he is. Let’s just say, he’s definitely not overly cheerful nor energetic. With that in mind, I’m going to take that comment with a spoonful of salt, maybe even as a compliment. I love what I do. What can I say?

In addition to today being my last shift for this rotation, I also got my Step 2 score back. I passed!  I had picked a random score to aim for, and I got that exact score on the dot so I’m definitely pleased. One more thing to check off of my massive list of “To-Dos” before I can graduate. One step closer…

Despite my hype on studying and finishing this month off strong, I definitely have not studied as much as I should of. The worst part is that I think I’m ok with going into these tests tomorrow only semi-prepared. Senioritis kicked in way too early! It couldn’t wait just for a few more days. Dang it. Oops.

July 18, 2010

Tests

Filed under: Daily Lowdown — dailymedicine @ 16:58

One of the perks of being a 4th year student is that we don’t have shelves – those awful, ulcer inducing, timed tests that we take after each of our rotation, or so I thought. Because I had convinced myself of this self-established lie, I was amazingly disappointed to find out that not only do I have a shelf-like test for this rotation, I have a graded OSCE as well. An OSCE is an objective structured clinical examination in which there are standardized patients with fake illnesses that have to be diagnosed and treated by fake doctors like myself. Somehow I had managed to turn off all test-studying motivation after I finished Step 2, and it has been amazingly difficult to motivate myself. After three weeks of avoiding the books, I finally sucked it up today and started reviewing. Because this is not a core rotation and the grade I get on it does not play a major role in my overall grade, I can easily disregard these tests. However, being the type A person that I am, I can’t bring myself to not care. Moreover, I can’t let my momentarily, hopefully transient, laziness affect my overall performance on the rotation. With that being said, I have designated Starbucks to be my home away from home this upcoming week when I’m not working. Might as well end the month with my best effort, right?

July 15, 2010

Fizzle # 2

Filed under: Daily Lowdown — dailymedicine @ 22:15

I think I might have worked with one of the worst attendings I’ve ever met today. Red flags should have gone up when I overheard her talking to another attending about having to do some online course because of complaints that were made against her to the hospital. I should have listened more carefully. When introducing myself to her, she did not make any eye contact and she never once introduced herself to me. Actually, the only thing she said to me directly was “hold on.” There was a resident working so I latched on to him for more direction. This was my first time at this particular hospital. He was about to go do a lumbar puncture on a 17 day old patient with a fever, and he offered me the procedure, which I gladly took. We had everything set up and I was about to start when she walked in. The conversation went something like this:

Her (to the resident): You’re letting her do it?
Resident: Yes, she’s going to do it. (At this point, I had prepped the patient and was about to insert the needle.)
Her: She’s just a med student. Can she do it? (To me) Have you even seen a LP (lumbar puncture)?
Me: Yes, ma’am. I’ve seen a few.
Resident: Yea, she can do it.
Her: Not on my shift. I want you to do it.
Resident (looking apologetically at me): Oh, ok. I’m sorry. (He took over from there.)

First of all, a lumbar puncture is NOT a difficult procedure, and YES, medical students do them all the time. Secondly, I was so offended by her tone, but I held my tongue and assisted the resident like a good student. It was fine. She wasn’t comfortable. Whatever.

The resident sent me in a room a little bit later to see a new patient. In the middle of my interview, she walked in and literally interrupted me and started her own history. I was flabbergasted. Seriously? I let it go and stood quietly and patiently as she did her history and physical. I presented the patient to my resident and told him what happened, watered down, of course. He thought it was weird too. He sent me to see another patient. Same thing happened again. REALLY!? I left the room this time. Later, attempting to make peace, I tried to present some information on a patient to her. Not only did she not acknowledge that I was there waiting, she turned around to the nurse and had a conversation completely unrelated to medicine. I was not a happy camper. I went up to my resident and told him that I was going to find someone else to work with. He agreed without hesitation.

It was the weirdest experience ever. She was a Pediatrician, for goodness sake. They’re known to be absurbly nice! I know that everything that happened this afternoon was not on account of me personally, but my feelings were hurt. For the rest of the shift, despite working with other, much nicer people, I could not help tearing up whenever the subject was brought up. I felt so mistreated. I know I can be emotional in my personal life, but I’m pretty tough at work. I’ve only teared up a handful of times in the past three years, but mostly only when I feel misjudged or treated. It would have been poor form to rehash the situation to other attendings so I held it all in. As soon as my shift was over and I was out the door, I burst into tears. After crying all the way home, I felt a lot better. She is a jerk. That is all there is to it. It still sucked, but she’s the exception, not the majority. Tomorrow is going to be better. I hope.

July 14, 2010

Fizzle

Filed under: Daily Lowdown — dailymedicine @ 21:27

Last night was my last overnight call for the month. I was feeling pretty good going in. I had a nice nap, did some reading, and enjoyed a late cup of coffee. When leaving for the shift, I decided to get another cup of coffee for the road, just in case. I was on top of it, or so I thought. The night started off really well. The doctor I was supposed to work with had a flight delay so I ended up working with the on-call doc, who wasn’t super thrilled to be there. Despite that, he was pleasant enough. Around 3 am, I started getting tired. I gurped about half of my 5 hr old coffee down before seeing the next patient. Within the next hour, I became really nauseous. I fought through it, continuing with my work. I was fine. Just a little sick in the stomach. Half an hour later, I could barely stand. I had to lean across the railing of the patient’s bed to stabilize myself to finish my history and exam. My gag reflex was fully activated. It was awful! The patient, fortunately, was completely intoxicated and did not notice. After telling my attending that I felt queasy, I hid in the bathroom for 10 minutes to regroup. The worse of it eventually passed around 5 am and I did get a 2nd wind to finish the shift, but it’s been a quite a while since I felt so physically sick. I was sooo glad when the shift ended. My evaluation from my attending at the end of the shift was “you did a good job, started really strong, but I noticed you fizzled as the night went by.” I’m not a fizzler, not normally, but I couldn’t tell him that. He knew that I got sick and even offered some Zofran (anti-nausea medicine) but excuses look bad so unless you were dying, you just suck it up. I still felt queasy after my “morning nap” but I feel a lot better now. Lesson learned. When tired and exhausted, do not chug unrefrigerated 5 hour old coffee that has milk products in it at 3 in the morning. Done. And no more “fizzling.” Fizzling is not my style.

July 12, 2010

Connections

Filed under: Daily Lowdown — dailymedicine @ 20:06

I’ve been busy trying to build up my EM connections. Coming from a school without an EM residency, I’m at a slight disadvantage because I don’t have the support network that other students have, mostly a mentor to advocate for me during the application process. Not surprisingly, medicine is yet another field in which who you know plays an important role in where you end up. Apparently, EM is no exception, or so we are told at this program. I’d like to think that I will match based on my own merit, but you can never be sure nowadays. In order to make some connections, I’ve worked these past few shifts with different program and clerkship directors. I have been going at 150% to make good impressions on these supposedly important people. It has been going well so far, but I think my body is not very happy with me. I woke up twice last night with shortness of breath, almost like anxiety attacks (though it wasn’t, I’m sure!). My schedule has been a little hectic and my eating has been even more sporadic, but I think I’m doing ok for now. This will be worth it in the end, hopefully.

July 9, 2010

Comfort

Filed under: Daily Lowdown — dailymedicine @ 19:12

With every rotation, there is about a week of adjustment, time needed to learn the computer system, to get to know the residents, and to get acquainted with the in’s and out’s of the service. As my third year progressed, my adjustment time decreased. In addition to establishing a comfort with all the hospitals and its medical systems, I had also developed a sense of confidence and security within my own program.

Being said, I’m two weeks into this away rotation and I have yet to establish the same sort of comfort. Apart from being at a completely new program in a new city, Emergency Medicine is not the most consistent medical field for students out there due to its sporadic shift work. I have yet to work with the same residents or attendings! Moreover, as a visiting student, I feel the pressure to constantly sell myself. Every word I say and every move I make can potentially be used for or against me in the long run. It just feels like every shift is a mini-interview. Though I know that this pressure is self-inflicted, I do have to get a letter of recommendation out of this rotation. Emergency Medicine residency application is all about these letters, unlike other specialties which focus on board scores and grades. With this mentality, these short eight hour shifts are amazingly draining, both physically and mentally, because you just don’t stop. I think I’ve sat down for a total of maybe 20 minutes in the last five shifts that I’ve done. Luckily, everyone has been really nice so far!

Alright. Off to work.

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