In the Life of a Fickle Intern

October 19, 2011

Medical Students

Filed under: Daily Lowdown — dailymedicine @ 20:26

I love medical students, or at least I love the idea of them. I had such a great time being one that I really do want to provide that experience for others. In the ED, as interns, we don’t work directly with the students at all. There is enough on our plate without having to try to teach. Now that I am on Shock Trauma, there are three medical students on the team. I made it a personal goal to try to include them as much as possible in the care of the patients. I remember how it felt to be useful!

I had a patient with a nice, simple laceration on the back of her head that needed a few stitches. As a medical student, I was all over these minor procedures. It was fun, easy, and you felt like you achieved something. It was my first call night so I was working out logistics of how everything operated and I was hoping that once I got the med student started in the process, I could get some work done, but little did I know, my plan backfired! Apparently the med students here don’t get as much clinical exposure as I did at my institution so she had NEVER stitched up a living person before. They practice on mannequins and cadavers, which is great but it’s still not the same. My selfish intentions of pawning off a minor procedure to get work done turned into twice the work! I ended up having to supervise and walk her through the whole process from cleaning to numbing to putting in stitches. She was really good, but the whole time, I couldn’t help thinking how much faster it would have been if I just did it myself.

As I was sharing this experience with some of my  friends from medical school, we all had the same mentality. Medical students can really slow you down! I think I am a little more positive about it than they were because I do want to stay in the academic setting, but it was just so interesting to see how our perspectives have changed so much in just a few months. To think, I thought I was super helpful! Looking back, I am very grateful for having such good residents. I will continue to try to be that good resident for the students though I will be a little more judicious on when to include them.

October 10, 2011

My First Life

Filed under: Daily Lowdown — dailymedicine @ 21:56

We got a call from the paramedics that they were bringing in a gentleman with some difficulty breathing. He was awake and alert but his blood pressure was very low and he appeared dehydrated. I was caught up so I figured I should pick up this guy. An hour later, after we initiated his work up, as I was talking to him and his fiance, she casually mentioned, “oh by the way, sometimes he seizes” just as my patient started seizing. I’ve seen enough seizures by now that they don’t fluster me as much as the first time, but still, they will always be kind of scary. As I was giving instructions to the nurses to get medicine, my patient went pulseless and stopped breathing. Completely flatlined on the monitor. The next few hours were a whirlwind of activities trying to stabilize this person. Tubes, lines, fluids, you name it, we probably did it. We paralyzed him and sedated him and initiated the hypothermic protocol, literally cooling his core body temperature to preserve organ function. It was crazy. We had no idea what caused all this! Everyone was sure he was actively trying to die as his blood pressure kept on dropping back down to the 70s/40s (normal is around 120s/80s with variation). Somehow, we managed to keep him alive long enough for him to go upstairs to the intensive care unit.

The next day, I learned that not only did he wake up and was responsive; he was extubated and was breathing on his own. The team upstairs did not figure out the cause either, and from what I know, was waiting for the patient to wake up to ask him if he had taken anything.

Though we see these patients more often than not in the ED, as interns, we are usually not assigned these patients. They are medically complicated and require a lot of time and knowledge, which interns have neither. However, somehow, he became my patient and I was 100% involved in his care with my senior resident. It was a crazy adrenaline rush and when it was all over, this wave of exhaustion kicked in and I realized how tired I was. It was just like the movies and tv shows (for once.)

I’m totally counting this as my first life saving experience. These are the moments that remind me how much I love medicine. It’s simply amazing.

October 3, 2011

Family

Filed under: Personal Ramble — dailymedicine @ 11:37

You can never outgrow being the youngest child no matter how much you fight it or how old you get. I had my first week of vacation this past week. In order to maximize my time away from the hospital, I chose the furthest destination possible without having to travel anywhere, hence, I ended up on the west coast visiting my family out there.

When I was younger, aka two or three years ago, I would try to exhibit my independence from my family by resisting their attempts to take care of me. I was an adult. I was capable of taking care of myself.

Now that I have a paycheck (from which the government takes a nice chunk from every month) and real bills to pay, I have regressed more than usual to the role of the youngest child. I’ve never really abused this privilege, always resisting (though not always successful) help from my older brothers and sisters. However, on this trip, as my sister arranged for my naps and massages and pedicures, I just let it be. It was kind of amazing, just hanging out with my nieces and nephews. I didn’t have to do anything! It was so nice.

Apparently the pampering was necessary because I looked old and tired and skinny and a hot mess in general. I can’t help it. I’m an intern. And here I was thinking that I was adjusting well! Now that I’m well rested and well fed, I’m actually very much ready to get back to work. I have two more weeks of Emergency Medicine left before I go to Trauma and then Cardiac ICU. We’ll meet again in December! I’m mostly kidding but the next few months will be a little busier.

Nonetheless, I am grateful for family. I’m grateful for being the youngest. I’m grateful for not being so silly anymore, thinking that being independent meant that you couldn’t accept people’s kind gestures. You just have to remember to say “Thank you!”

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