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.

I had my own beer festival....

And didn't take any pictures! Last night we had some friends from college over to have our own version of the Great American Beer Festival. We've been to the GABF 3 times in the past, and for those who aren't familiar, it's a giant ruckus with breweries from all over the country pouring one oz. samples of their products. The Denver Convention Center gets so packed with people, they line up 12 across and the line goes all the way around the Convention Center for 2 days of beer drinking debauchery. It's a good time, but it's getting to be too big, too loud, and too crowded for our aging tastes. What can I say, we're getting old. So instead, this year we decided to have our own version. I went to a liquor store near us that lets you buy individual beers and mix and match your own six packs, so I found 24 different beers we'd never tried, or had tried and liked, and asked everyone to grab a six pack or a bomber of something they liked or wanted to try. Our friends S&B just got back from the real thing Oktoberfest in Germany so they brought their faves from there. Let's just say that this morning we have a LOT of leftover beer, so we'll obviously have to have some more fun next weekend.

For food we went German style and grilled up some brats in the afternoon, then let them cook in beer and sauerkraut for 6 hours. They were delicious (but my stomach is none too sure about them this morning). We also had some homemade beer cheese soup, that would have been helped greatly by some croutons, but hey, lesson learned. I did buy a bunch of those super pretzels, but we didn't make a single one and now the freezer is packed to capacity plus some. The food was really tasty though!

Overall, I think the party was a great idea, and next year, look for an evite early. I think this could catch on!

Well, crap.

This week I have spent every morning at the University Hospital Level I nursery. This is the happy nursery. The nursery where the healthy babies go. It is awesome! A very happy place in medicine, that's for sure. The thing about it, though, is that it has reignited my interest in ob/gyn. I just love that stuff. And I wish I didn't love that stuff. I want to have a life. I'm afraid of that residency. But, when it comes down to it, maybe I'm just afraid of residency. There is no easy residency. I just have to face that fact. I guess I'm right back to where I started.

So at least I get one more day with the cute babies, and one more day at the private practice peds office! All good things. I'm looking forward to a nice weekend, and hopefully getting organized again. Ever since this clerkship started I've just been kind of flying by the seat of my pants. Hope everyone is doing well, and hopefully I'll have some fun pictures to post after the weekend!

Rocky's Day Out

Today I took Rocky to the farmer's market with me. He was great! I love having (at least) one good dog that I can bring in public without worrying he might eat a kid or pull me into a vendor's tent.

I have to say I'm enjoying the fall. It's the best time of year for farmer's market produce, the weather is nice and cool but still warm enough to enjoy it, and for me it just seems to be the most optimistic time of year. This is only fueled by the best news I've gotten all year - I am going to do my surgery rotation at Rose Medical Center.

Why is this great news? Because at Rose your life doesn't suck. That's why. Students work one weekend a month instead of every weekend. Students get meal tickets! Students get free parking! Students (so far) don't get yelled at! I've been so dreading this rotation (which starts in the middle of October), and now I don't feel nearly as scared. So far third year has shaped up to be better than expected. I hope I don't jinx myself for saying that!

For now, I am just enjoying my time in private practice pediatrics. Everyone has been so nice, and I enjoy working with kids and families. Right now, life is good!