In the Life of a Fickle Intern

February 2, 2013

Anticipatory Stress

Filed under: Personal Ramble — dailymedicine @ 23:39

I have a problem with anticipation, whether it’s good anticipation or bad anticipation. It goes hand in hand with my mild-obsession with my calendar (and partial Type A personality). I check and update my calendar a lot. These next two months are going to be busy, not necessarily bad busy, but just busy. I have my yearly in-service, national Emergency Medicine board, my junior case presentation, Step 3 (last of 3 national boards!), and I am running my first half-marathon, all while rotating through the Burn ICU (hello 80 hour weeks!). In the midst of all of this, I am going to Las Vegas for AAEM . Just typing everything is sort of stressing me out. Though I often tell my friends who are stressing out that they should take one day at a time, it’s much harder to follow my own advice, especially now that I’ve started to study for these silly tests that I keep having to take. I don’t know how I used to study so much (10-12 hrs a day for 30 days straight for Step 1)! Now, it’s hard even to motivate myself to study after working all day. However, despite it all, as ironic as it may seem, I think I do much better when I’m busy and stressed. Due to my time limitation, I am much more productive and I procrastinate a lot less, or so I tell myself. With that being said, I may have to go old-school and make a study schedule. I have a lot of practice questions to get through and not so much time. I don’t know how this schedule got to be so hectic, but for now, I just need to keep reminding myself to take deep breaths. Just have to get through the next two months. Sigh.

January 24, 2013

Antibiotics

Filed under: Daily Lowdown — dailymedicine @ 21:10

Three weeks and some days later, I’m giving in and taking a short course of antibiotics. Since New Year’s Eve, I’ve had this lingering cough and sinusitis that will not go away. Though I feel physically much better (no more congestion or headache!), I still sound like I’ve been smoking 2 packs of cigarettes a day for the last 10 years. (I’ve never even tried a cigarette!) Though I don’t get sick very often, when I do, it lasts for quite a while. I’ve had multiple colleagues offer to call in some antibiotics for me and I finally gave in last night at dinner as I was having trouble finishing my sentences from my coughing fit. To be fair, I STILL think it’s a virus and I  STILL believe that I’m not contagious, but to appease those around me, I’ll take the dang medicine.

As for this month, I am on trauma anesthesia.Everyone wants to tell you that you don’t need strength to intubate (putting a person to sleep to put a tube in their trachea to breathe for them) and it’s all technique, but it TOTALLY requires a little bit of arm strength. I’m very much right arm dominant and all of a sudden, I’m only using my left arm. My petite size has been a limiting factor for the first time in my life! For my first few shifts, I would come home with my left arm completely and utterly sore from using muscles I didn’t even know I had. Though my techniques have improved some and I’ve learned some tricks of the trade to help with the procedure, I still have a lot to learn! It’s been busy but it’s been good. Now I am going to go do push ups to build up some muscles (sort of kidding…mostly kidding…sort of).

December 31, 2012

Happy New Year

Filed under: Personal Ramble — dailymedicine @ 19:16

I think this is the first time I’ve ever really wanted a year to end. Though compared to everything else that’s going on in the world, things in my life are pretty inconsequential. Nonetheless, I’ve had my ups and downs this year, more downs than I’m used to. Sadly, I think it’s just part of residency. This has been confirmed by many, many friends and acquaintances going through the same process. Though everything is fine and great now, this year has definitely been a tough one to get through with a lot of little hurtles to overcome. I’m just grateful to not be an intern anymore! My mom has dutifully pointed out that I may have a bald spot from all the hair I lost secondary to stress last year. Such a rewarding reminder of intern year. It’ll grow back, right?

Two thousand thirteen is going to be a big year, whether I want it to be or not. Last leg (1.5 years to be exact) of residency! By the fall of 2013, I will hopefully have a job, a real life, paying job with semi-normal people hours waiting for me when I graduate. Scary!

Though I don’t have resolutions, I do have some goals for the upcoming year: make more time for friends, master the control of my sleep cycle (somehow…), be more social (apparently being tired from work is a lame excuse not to go out according to some people), eat more vegetables, and be more empathetic to my patients (even if they just want some dilaudid). I think these are reasonable!

As for tonight, though I will drag myself from the warmth of my apartment to be semi-social, I think I ultimately will have some alone time with my new-found friend, Sudafed. I have this terrible cold that keeps me nice and congested, waking me up several times a night to say hi. Work is even more brutal when you can’t breathe!

Again, happy new year! Please have a safe and wonderful night! Don’t drink and drive! And the best wishes for the year to come!

December 25, 2012

Merry Christmas!

Filed under: Personal Ramble — dailymedicine @ 19:58

Residency is tough, but it’s the hardest during the holiday season because unlike most jobs, every day is the same for us. We don’t get holidays (or weekends or nights…). Last year, I missed my first family Thanksgiving; this year, Thanksgiving and Christmas. Though I have a great family away from home and I did get to see my own family a few weeks ago, it still kind of sucks. I’m actually on a very light rotation, working on average of 3-4 hours a day just learning, mostly. However, despite having all my weekends off, I’m on sick call, meaning that I am expected to be available 24/7 to cover anyone who gets sick. We all have to do it, but I am still going to pout about it. I can’t travel. I can’t drink. I am just available.

To make the best of this situation (spending Christmas away from home), I have situated myself on the couch surrounded by girl scout cookies, chocolate and hot cocoa. I am hosting my own ABC Family and Disney movie marathon, which is intermittently interrupted with phone calls and text messages from my family and friends. It’s actually kind of nice, in a weird kind of way. Though spending Christmas away from home is not ideal, spending Christmas day doing nothing is kind of amazing.  It’s a free pass to indulge in a guilt-free, chocolate-eating, tv-watching laziness.

I hope you’re having a wonderful holiday season with lots of friends, family, food and laughter! Happy holidays!

December 10, 2012

Insomnia

Filed under: Daily Lowdown — dailymedicine @ 08:42

If I were in Baltimore, waking up at 6:30 am is almost perfect. I am very much a morning person. So much more productive. Since I’m out west this week, 3:30 am is a tad early to get the day started. Considering I’ve been off nights now for 4 days, my sleep cycle is still off. I think that after an hour of perusing the internet, I’ve caught up on my daily news, stalked a sufficient amount of people, and managed to be semi-productive for work. Maybe I should start waking up at 3:30 more often.

I had an elective medical procedure done on Friday (very elective, nothing to do with my health, and definitely no new plastic parts anywhere!) It was kind of strange being on the other side of the doctor/patient relationship. I had to deal with a lot of different healthcare providers from techs to nurses to midlevel providers to the actual doctor. Everyone was super pleasant except for the midlevel provider! I was thrown off a little by her cold bedside manner. It made me wonder about my own bedside manners. Apart from the extremes, having patients tell me that I’m amazing to drunks cussing me out, I wonder what a normal person would think of me as their doctor…I’m a relatively nice person, I think.

The funny thing about me is that I’m very anti-medicine when it comes to my own personal health. I strongly believe in letting my body take care of itself by taking care of it. I rarely take any medications other than an ibuprofen or tylenol every so often. I was a bit nervous about this procedure. I knew a little too much about what was going to happen. The staff offered me a Xanax (anxiolytic) to calm my nerves and reluctantly, I took it.

Despite only taking 1 mg, I don’t remember much about the night once I got home. My mom told me that I headed straight to bed. She checked on me hourly (probably more often, knowing her) and apparently we had some short, but interesting conversations about colors and butterflies. I don’t remember any of this. Hopefully this will be my only experience with an anxiolytic. It’s really unnerving and kind of funny that I give out these types of medications (narcotics, sedatives, anxiolytics) to my patients all the time! Most of them request the meds by name…

December 3, 2012

Nocturnal Life, Part 2

Filed under: Daily Lowdown — dailymedicine @ 15:58

Though having weekends off is kind of amazing, I am pretty much over working nights. My whole life is on a standstill right now because my schedule is so messed up. Even though I’ve thoroughly enjoyed my weekends, I am chronically tired. I sleep weird hours (I woke up at 4 am last night and I just took a 5 hr nap this morning…) and I don’t have any productive hours outside of work during the weekdays. During this last weekend trip, I would wake up at ungodly hours in the morning and just lay there. In return, I literally napped every time we got in the car, whether it was to go to dinner or to the beach or wherever. I felt like an old woman. It was a bit ridiculous.

Despite the crazy sleep schedule, I am having a great month. I really like the new system where as a second year resident, I get to micromanage both an intern and a medical student. For those who know me, I can be a bit bossy and micromanaging is one of my favorite things, at least when it comes to work. I have had some really sick patients which is amazing for my learning, but it kind of sucks for them. This month is making me appreciate my health and the health of my friends and family that much more. I have had a few people coming in on the brink of death, ages ranging from the early 20s to the late 70s. Unfortunately, a few of them did not made it. It’s amazing how fleeting life can be. I forget that sometimes, but I am gently and sometimes not so gently reminded of our fragility almost everyday.

Three more nights and then I am off to California for a much needed break.  I am so deconditioned physically in every way. It’s kind of sad. I am looking forward to returning to a normal person schedule soon.

November 18, 2012

Noctural Life: Part I

Filed under: Daily Lowdown — dailymedicine @ 02:14

I am surviving the nocturnal life better than expected. I did invest in some melatonin to help adjust my sleep cycle but I feel so medically wrong for taking a sleep aid. I know that people do it all the time, but I dislike taking medicine if I can avoid it. It’s helping me get more hours of sleep during the day though. Being on nights really messes up my schedule. I haven’t done anything but work and sleep this last week. After being at the hospital for 14 hrs a day, there is not much time to do anything else. It’s weird because I work the same hours during the day, but my energy level is much higher and I actually hang out with people. It’s like being jet-lagged and trying to trick your body from reacting to natural day/night stimuli.

I was doing ok until yesterday. After five nights in a row, I woke up a little queasy after my nap. Nonetheless, I decided to l keep my dinner plans. I made the mistake of having some wine before my food arrived and it was all down hill from there. Despite having only half a glass of wine, I felt like I had taken 4 shots in a row. I was nauseous, lightheaded, and ready to pass out. My friend had to drive me home. It was a bit ridiculous. After sleeping 14 hours (!!!), I felt much better. Apparently lack of sleep and alcohol on an empty stomach are not good together. I don’t think I’ve ever slept that much in my life!

I actually like working nights, but I don’t know if the effects it has on my body is worth it. Many women physicians choose to work nights because it works well with their family schedule. You’re at work when your husband and kids are asleep. You get home in time to send your kids to school. Then you sleep while your family is gone, and wake up when they get home. It’s good in theory but I’m sure it doesn’t work out that well in reality.

Of note, my building, which has never been broken into, had a break in last week. Someone had accidentally left the back door open. It wasn’t my apartment and the robber was arrested, but seriously! Is it me? Do I attract robberies? Maybe it was just a coincidence. Maybe.  I will continue to lock my bedroom door when I sleep for now. Mild-PTSD.

 

November 2, 2012

November

Filed under: Personal Ramble — dailymedicine @ 18:26

Fall is my favorite season. I love the food, the warm drinks (hot chocolate!), the colors, everything! This year, I have even more to look forward to, especially in November and December. Starting this week, I have become nocturnal. For the next 5 weeks, I will only work night shifts. In return, I have every single weekend off starting with this upcoming weekend until 2013. I haven’t had this many weekends off since the start of medical school!

Though I am super excited about my free weekends, I am a little worried my body is not going to handle the nocturnal change for such an extensive amount of time very well. I am terrible, horrible day time sleeper. I am definitely a morning person and more importantly, I need my 7-8 hours of sleep or else I am just not very fun to be around. When I work nights, I end up averaging about 4-5 hours of sleep and by the end of a string of shifts, I am a zombie. It’s like  being constantly jet-lagged for 5 weeks straight! I am going to have to do some research about how to get more sleep during the day.

As for my weekends, I am going to start the month out with some post-birthday celebration with some friends. Luck has it so this year, I am working on every holiday, including my own birthday. You name it and I’m probably working: Halloween, Thanksgiving, Christmas Eve, Christmas Day. Such is the life of a resident. However, to make full use of my time off, I already have a few weekend trips planned so far. I may go utterly broke from my weekend getaways, but I sure do love this weekend concept! I cannot wait to reconnect with some of my long lost friends!

 

 

October 30, 2012

Hurricane Sandy

Filed under: Daily Lowdown — dailymedicine @ 21:38

As people prepared for Hurricane Sandy by gathering food and water and generators, I prepared by taking a prophylactic nap just in case I was called in overnight. With the roads closed and streets flooded, if you lived within a short distance from the hospital, there was a chance that you may be called in to work for those who lived further. Yesterday was actually my day off, one in between two sets of 4 shifts. We got an email earlier in the day asking who all was working and who all would be available if staff was needed. One of my friends who was scheduled to work last night and tonight was stranded in North Carolina and his shifts needed coverage. I actually offered to come in and cover, but because of scheduling, I would have gone over duty hours*. So luckily, I weathered the storm on the couch with my roommate.

It’s kind of weird because this is my first storm as a real health care provider. Instead of getting days off work, I anticipate working more. Instead of being safe and sound at home, there is a chance I actually have to drive to the hospital. It’s so strange to think that from now on, I could be an active participant during any emergency situation. Totally weird.

Now that things are settled and the worst of the storm has passed, I am heading off to work my string of nights shifts. I’m predicting that it’s either going to be a mad house in the ED with people affected by the storm or it’s going to be completely quiet. I’m not sure what I hope it’ll be. Wish me luck!

I hope everyone stayed safe and dry and that your electricity comes back on soon if it went out!

*As residents, we are technically not supposed to work more than 80 hours a week on average over the month.

October 8, 2012

Procedures

Filed under: Daily Lowdown — dailymedicine @ 17:15

We do a lot of procedures in the Emergency Room. From basic suturing (cuts and lacerations) to intubating (putting a tube down someone’s throat to breathe for them) to even delivering babies, we have exposure to a little of everything. As a resident, I love procedures! They make my shifts that much better because they’re interactive, fun, and just satifying. Though I am still learning and developing my own techniques, after 1.5 years in residency, I am pretty comfortable with our bread and butter procedures because we do them so often.

The other day I had two parents request that my attending do the lumbar puncture on their 5 week old child. Though they were nice about it, I was a little peeved. The only reason I picked up that chart was to get to do the procedure. In my head, I couldn’t help but roll my eyes and think, “Don’t come to a teaching hospital if you don’t want a resident!” but nonetheless, I was cordial. After my attending failed her attempt and another attending failed his attempt, though I felt bad for the baby, I couldn’t help but gloat internally for a moment at the parents. Chances are, I probably have done a lumbar puncture more recently than either of them because in a teaching institution, residents do all procedures.

This got me to thinking, which I try not to do too often. I always joked that if I got sick, I would never go to a teaching hospital. I wouldn’t want a resident, big-eyed and bushy-tailed, pointing and prodding at me. But after some more thinking, it seems counter initiative. After residency, you probably know everything that you will know. Even if you are an avid reader and stay on top of all the literature, for the rest of the life, you will still be practicing based on everything you learned during these formative years. Additionally, in a teaching facility, there is a wide safety network so chances are, medical errors will be caught. There are a lot of checks and balances in a teaching system.

So after all of this contemplation and googling to see where the majority of health errors occur, I have decided that I will just have to never get sick. That will prevent any problems in the future.

Though in all seriousness, I think teaching hospitals tend to be better for so many reasons. In addition to the ones that I’ve mentioned, teaching hospitals tend to be tertiary care centers with so many more resources, both people and technology wise. Other than delivering my baby, I think I am ok with having a resident be my primary doctor if I ever have to go to the hospital for anything. *Knock on wood.*

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