A Few Things

Surgery has been a positive experience (so far) in so many ways:

1) I know what I want to be when I grow up! (No, for real this time!) Barring some life-altering event in the next year, I will be applying for a residency in Ob/Gyn. I've learned from my rotation that I love the OR. It's my favorite place in the hospital; well, favorite next to labor and delivery. I also have learned that I really don't mind heading to the hospital at 4am on a Sunday when it's to do something I enjoy. Knowing that makes the idea of a tough residency (as if any are easy) much more palatable. I've learned that I am tougher than I thought I was and that I can take what's given and smile knowing that in the end, I win! I get to do what I have wanted to do for so long.

2) I gots myself tough. Getting told you're dumb all day everyday will make it run right off ya.

3) I've learned how to be a more effective team member and, someday, a better senior resident, etc. How did I learn this? By watching what my chief does and knowing that I can do so much better. I've had some great teachers, and the people coming behind me deserve the same.

4) One handed knot tying is sexy.

5) Having a beer after 3 nights of call is the best beer you'll ever have!

Keepin on.

Wow.

That was a long night.

24 hour shifts are for the birds.

Trauma surgery is for a tougher person than I.

And getting hit by a car looks like almost the worst experience a person could have.

I'll write more later when I have more wits about me.

Terrified.

Tomorrow night I will take a night of trauma call at the infamously busy Denver Health Medical Center. I'm freaked out. More than that, really. But this too will pass.....

Why did I want to do that?

So I am on my anesthesia week, and clearly when I decided a long time ago I wanted to be an anesthesiologist, I was not thinking. I don't like it. It's not a bad week, the days are short, the people are (mostly) nice, but...the patients are asleep. Universally (almost!). I also have started to believe the addage of anesthesia - 90% boredom, 10% panic. They are amazing critical care docs. They can stick a breathing tube in faster than anyone in the hospital. They can get access to pretty much any vein, or artery, for a line when it's needed. If you are really sick, you want an anesthesiologist around, even if you never have to actually know they are there. But do I want to be one? No. I got to intubate today, and I really didn't like it. Something about shoving a giant tube down someone's throat just rubs me the wrong way. It's good, I suppose, to knock a few choices off the list, and start to narrow down what it is I want to do, but something about watching my attending get to work at 7 and leave at 1:30 in the afternoon makes me wish I could find a redeeming quality. I just don't think I can.

On Surgery

For everyone who I have been neglecting...I'm so sorry. Surgery lives up to its rough hours even when you're at the "good" place. I'm on call this weekend, so yesterday I was there from 4am to 4pm. Today I was in at 4, but I was able to leave after rounding was over at 10. That was a nice surprise. There is a case going later today, but we'll see if I get called in since it's just a laparoscopy and probably quicker for the surgeon to not wait for me to come in. Plus he asked me if I was getting enough rest today, so maybe I looked like hell and he wants me to sleep. Either way, I'm feeling lots better after my little nap. Refreshed, at least a little, and almost ready for the week ahead. And there's no excuse for complaining since after today, I only have 2 weekend calls left, and I don't mean the whole weekend, 2 weekend days.

On the whole, once I'm out of bed I am really digging surgery. I think the OR is a really fun place, after you're comfortable with how to stay sterile or stay out of the way of the sterile people. Even though I can do less during them, I love the laparoscopic procedures. I think it's amazing the stuff you can do through such a tiny incision. And I'm hoping that with the exception of C-sections, most of the procedures I'll do in the future will be laparoscopic too. If the rest of this rotation goes well, I think I will be able to safely say I can handle Ob/Gyn. It might not always be pretty, and the hours, especially during residency, can be really long, but if I love it and love the OR it's the right place for me to be.

Study break

So, the good news is I only have 3 more shifts in the ED. This is great because, as it turns out, I don't really like emergency medicine. I like continuity of care. ED is the opposite of that. The other good news is, working in the ED gives the greatest stories ever. My new personal favorite: A teenager came in to the ED stating "there's a piece of chicken stuck in my throat!" This kiddo had no respiratory distress so for a while we all stood around looking at him like "so, should we do the heimleck?" We figured we shouldn't, though, because he clearly could breath so it wasn't stuck in his trachea or airway. There was almost certainly something stuck in his esophagus though, since he couldn't even swallow his spit and everything we tried to put down his throat promptly came back out. We told him he should vomit. He said he knew that. We said, put your finger down your throat and make it happen. He said - "don't you have something a bit more medically advanced than that!?" We grabbed a tongue depressor. He actually managed to throw up gastric contents, but not dislodge the piece of chicken! After that he continued to vom Dr. Pepper, but no chicken. We were starting to think maybe his hot chicken sammie burned his esophagus and it was actually so inflamed it was closing. The Dr. Pepper coming out was so dark we couldn't tell if it was bloody or not, so the doc asked him to throw up in the emesis basin rather than the trash can just in case we needed to test it. At that he promptly barfed up the piece of chicken and asked "so can I finish my chicken sandwich now?"

We have a large, tough, written exam on Friday, so that's a bummer. But as always, I love test days. It's great to have a weekend where nothing is due, there's nothing to study, and you can really, truly relax. That'll be me come Friday afternoon. Then I start surgery.

I'm actually pretty excited about surgery. Do I want to be a general surgeon? NO. But do I think my future career will entail some surgical procedures? Yes. So, it'll be a great learning experience. And let's not forget, it's at Rose!

On the down side, since I've been working nights, I've had hardly any time to do all the fun fall stuff I love. There have been no recent visits to the Farmer's market, no pumpin patch, no homemade apple cider. Three more shifts. I really hate nights. And rest assured, there will at least be apple cider this weekend!

From the Wards

So, I've seen the good, and some of the bad. Here's a couple of the not so great things I've seen in the last few months:

-A patient was denied pain medicine after hitting a wall (quite literally), the provider claiming a possible drug interaction. After the patient was in their room, the provider makes the comment that the pain in their hand was just cause and effect, and the provider likes cause and effect.

-A mother abandoned her baby in the nursery after delivery. Yes, there are many silver linings here, but the gut reaction is disgust.

-A group of providers laughing at a patient with dementia secondary to a progressive, and inoperable, brain tumor. Worst of all, the patient knew they weren't making any sense, and was incredibly frustrated by the situation.

-A nurse rolling their eyes and making fun of the provider every time the provider turned their back.

Man. Medicine can be a catty, crappy world sometimes. But then there are the good times, like my preceptor talking to a little girl, the daughter of a patient, who he delivered and being so excited telling her how he was the first person in the world to see her. His excitement made me realize that there is a reason to do this. And it's a pretty great reason.