In the Life of a Fickle Intern

June 23, 2012

Intern Year

Filed under: Daily Lowdown — dailymedicine @ 19:00

I wrapped up my last day as an intern today, spending a beautiful Saturday in front of a computer typing up interim summaries of all my patients and their hospital course so far to pass on to the brand new interns who start tomorrow. All I can say is that I am so very grateful not to be that bushy-tailed, bright-eyed, scared witless intern anywhere. I already had that experience and I think I lost half of my head of hair during those first three months! Now I’m a semi-experienced, chronically tired, mildly-jaded, slightly-aged second year. I accomplished all of that in one year. 🙂

This year went by really fast! I think that it probably didn’t feel so fast on a day to day basis, but overall, the year flew by. I’ve learned so much this year, but the more I learn, the more I realize that I have so much more to learn. Medicine is a very humbling field and there is just so much to try to absorb.

Overall, the year went really well. I had some bad moments here and there, but I have no complaints. Even  my month on Ob/Gyn was not as terrible as I dramatized it out to be. So the final count: I cried at work 3 times, one of which was not work related, twice because I was yelled at by someone. I hid in the bathroom/supply closet a handful of times mostly to close my eyes for just ten minutes during the wean hours of the mornings, but every so often because I felt really sick but wouldn’t tell anyone. I had seven patients die while I was taking care of them and I saw more arrests (when people stop breathing or their heart stop beating) and gun shot wounds and car wrecks than I can remember to count. I probably wrote enough narcotic prescriptions for the whole city of Baltimore (it sure felt that way!) I had a few mishaps with my living situation and a few parking tickets here and there (8 to be exact!) and some other small adventures that I hope not to experience again. You get the point. It was a crazy year but I wouldn’t change a thing. Maybe a few things. Nonetheless, it’s done and over with.

Unfortunately, unlike my internal medicine colleagues who get a whole week off to recuperate, I start my 2nd year tomorrow. The only difference is that I’ve gained a whole new number to my title – PGY II (post-graduate year II). One down, two to go, not that anyone is counting.

June 11, 2012

Conflict of Interest

Filed under: Daily Lowdown — dailymedicine @ 21:38

As an ED physician, my job is to do everything I can to resuscitate and to stabilize sick patients. And it’s an amazing job! In addition to the actual saving lives part, the whole code situation is such an intense, terrifying, emotional, adrenaline driven process that brings so many people together for one common goal. I love sick people, as morbid as that may sound. However, in the ED, after we resuscitate a patient, we package them up with their lines and tubes and ship them off to one of the many ICUs (intensive care units) in the hospital and move on to the next patient.

This month I am rotating in the medical ICU. Though the hours are a little longer and the rounding a little slower, I am having a great time learning so much medicine and physiology. I am on the other end of the spectrum, receiving those near-death resuscitated patients  from the ED to manage for the long haul. This is where my conflict of interest comes in. Though many people make it out of the ICU, the patients who come in on the brink of death (or sometimes even dead) who were aggressively resuscitated in the ED usually do not have a good prognosis. Though they are “alive” by technical definitions, their quality of life is gone. Many of them will be dependent on machines for the rest of their live for normal bodily functions like breathing and feeding. Many of these people will never wake up, yet we continue to treat them aggressively at their end of life. Should we have left things alone and let people died in peace in the ED? Is that morally and ethically acceptable? It is an amazing feat to bring someone back to life, but when they’re not really living anymore, are we doing these people a favor? Why are we invading their bodies with lines and tubes and breaking their ribs during CPR just to keep them on these machines? Where do we draw the line? Can we draw the line? Who makes these decisions?

These are the types of questions that keep on popping into my head as we go from one family meeting to another trying to establish how aggressive we should manage dying patients. Would they have been better off if they didn’t come to the ED in the first place? The worst part is when the patient has no family and we have to go through the court system to determine guardianship. This can take up to weeks and the patient is again maintained at a status quo in the ICU until then.

I know these questions probable sound terrible, but I’m just having this internal debate every time another patient dies. These are the sickest of the sick, and sometimes, many times, they don’t leave our unit.

June 3, 2012

Storage

Filed under: Daily Lowdown — dailymedicine @ 00:14

ImageI moved all my stuff into storage today. It turned into a bigger ordeal than I had hoped. With friends who have crazy schedules like myself, I opted out and hired movers. Unsure of how to approach this process, I ended up googling local moving companies. Mistake number one. I made an appointment with company # 1 for 2 pm today. Two o’clock came and passed and still no movers. At three, I called them. They were running a little late and now the estimated time was between 4 and 5. Whatever. Four came, then five, and then five thirty. I called back and they were still running late with the next available time slot being 7 pm. I was not a happy camper. Considering that today is my only day off this week and that my lease officially ends tomorrow, I was fuming. I cancelled my first appointment and did the only thing I knew to do. I googled more moving companies. Mistake number two. An hour later, two 6’5” big, black men showed up on my doorstep. I’m not going to lie. As a tiny, little Asian girl, I was kind of intimated. It didn’t help that their unmarked white moving truck had no roof. Minor details, right? However, they seemed nice enough and I really, really needed to move my stuff out.

I initially texted a friend who lived nearby to see if he had gotten off work so that he could come keep me company, mostly just for a sense of security. When he called back, I actually turned down his offer to come over because the guys were fine. They were just moving. However, I doubted my decision when we pulled into a dark, vacant storage facility. I couldn’t help it, but the image of my mangled body found locked in my rented storage unit crossed my mind. After our first trip through the dark mazes of metal doors, I called my friend again begging him to come to the storage unit so I wouldn’t be left alone with these two men. Nice as they were, they were still complete strangers who had all my possession readily available right there. Fortunately, my friend showed up 10 minutes later. It felt so much better!

When it was done and said, we had a little issue with the payment. I had paid online with a credit card but they were asking me to pay them in cash. I think it was just a misunderstanding and they did not argue much when I explained the situation, but it was definitely a little iffy.

I don’t know how I get myself into these situations. But nonetheless, I am so grateful to be done with this part of the moving process. Maybe my hair will stop falling out now! (Note: People deal with stress in different ways. My hair sheds like crazy when I’m stressed out. I didn’t discover this pro-balding effect until medical school. Go figure.)

Through I’m exhausted from my adventures, I’m trying to switch my circadian rhythm because I start a week of nights on the MICU (medical intensive care unit) tomorrow night.

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