is when you realize that you slept through your alarm or it never went off, and you now have exactly 7 minutes before you need to leave the house to get to work on time.
That happened to me this morning, and it left me in a bad mood all day. I didn't feel human again until I got home and was able to take the shower that I had meant to wake up in time for. ugh! I am such a morning shower-er, no matter how early that means I wake up. I even woke up and showered before rounds on surgery. Looking back, that was just madness.
Anyway, it stinks when you have to use your only free hours all weekend to study, grocery shop, do laundry, spend money to take an expensive medical licensing exam, and send in reimbursement receipts. I guess these are the sort of things I usually do in free time, but today I had to get it all done after already going in to work. Errands spread out over a few days are tolerable, but all at once? Not my style.
They still haven't given out any of the important Oscars yet. I wish I lived in a more reasonable time zone; this is killing me. I've gotta sleep! Get this over with already!
I'm hoping for a better mood when I wake up tomorrow. Only 4 days of medicine left!
PS Will write about CDC/ATL at some later date, when I am no longer tired of talking about it!
Sunday, February 27, 2011
Wednesday, February 23, 2011
molly =(
Molly, our lovable happy and happily fat dog, died suddenly early this morning after being really sick for a few days. I can't believe she won't be there the next time I come home to get super excited and roll around on the floor in her happy dance. Or to eat my scraps off the kitchen floor at dinner. She was just the cutest dog. I am going to miss her like crazy. It won't feel right to have 1 dog and 2 cats, and I bet Loki feels outnumbered and sad right now. Poor Loki! But poor Molly most of all. I hope she is eating everyone's food in dog heaven.
This is how skinny Molly was when we got her: so tiny!! Haha I look like a lightweight too. I bet there was a squirrel up that tree that she wanted to eat, though.
All of the pictures I have are from a book that Becky made me when I went to college, so they are older and that's why she looks so young!
Look at Loki! He looks sad like Molly said something mean. But she would never do that. He is just a goofball.
This is how I remember Molly though: fattened up from all our love! Haha and this was still years and years ago. Back when I wore denim jackets. Haha.
Look how big Loki got! Awww.
Anyway. I love my family's animals. I always come home so excited to see them. It won't be the same without Molly dog. We love you Molly! Be happy.
This is how skinny Molly was when we got her: so tiny!! Haha I look like a lightweight too. I bet there was a squirrel up that tree that she wanted to eat, though.
All of the pictures I have are from a book that Becky made me when I went to college, so they are older and that's why she looks so young!
Look at Loki! He looks sad like Molly said something mean. But she would never do that. He is just a goofball.
This is how I remember Molly though: fattened up from all our love! Haha and this was still years and years ago. Back when I wore denim jackets. Haha.
Look how big Loki got! Awww.Anyway. I love my family's animals. I always come home so excited to see them. It won't be the same without Molly dog. We love you Molly! Be happy.
Tuesday, February 22, 2011
the cheech
Let me introduce you the concept known as "cheeching." (I guess that's how you'd spell it?) It is essentially the shortened colloquial form of "to work something up by ordering a lot of tests/imaging." So, your patient has galactorrhea. You better cheech up that pituitary.
Cheeching can be a verb as in "to cheech" or a noun "the pituitary cheech."
Perhaps the best use of the term came today in the office when during signout, the intern said something like "so the patient is getting the pituitary cheech and the adrenal cheech, which is essentally the endocrine cheech." This may win the award for most times "cheech" has ever been used in a medical context in the same sentence. But no - I trust that our firm can outdo itself.
Later, a debate on whether all this stuff is really worth cheeching up! Is it really good for a patient to come in for a pulmonary complaint and leave with 3 different, newly cheeched-out diagnoses? Is it good for the healthcare system? Do we have enough resources for all this cheeching? Is it weird that a residency program so formal that the interns change out of their scrubs after night call into formal clothes for morning rounds uses a term like "cheech"? Do any other Osler firms even use this word???
That last question might be the only easy one to answer!
Cheeching can be a verb as in "to cheech" or a noun "the pituitary cheech."
Perhaps the best use of the term came today in the office when during signout, the intern said something like "so the patient is getting the pituitary cheech and the adrenal cheech, which is essentally the endocrine cheech." This may win the award for most times "cheech" has ever been used in a medical context in the same sentence. But no - I trust that our firm can outdo itself.
Later, a debate on whether all this stuff is really worth cheeching up! Is it really good for a patient to come in for a pulmonary complaint and leave with 3 different, newly cheeched-out diagnoses? Is it good for the healthcare system? Do we have enough resources for all this cheeching? Is it weird that a residency program so formal that the interns change out of their scrubs after night call into formal clothes for morning rounds uses a term like "cheech"? Do any other Osler firms even use this word???
That last question might be the only easy one to answer!
Monday, February 21, 2011
lolz
Today was a funny day in the office. I wrote out all the funny quotes and then deleted them all, realizing that some of them didn't make sense out of context, and some of them just might come back to haunt me. So I say nothing!! You can't catch me now, sneaky blog readers that are deciding my future residency/job options based on my now very bland blog!
Anyway, my SARs switch tomorrow and then the interns on Thursday. And our ACS is gone for the week, so that makes for one very sad week. No me gusta. I hate hate hate it when the team changes in the middle of a rotation; you have to walk on eggshells all over again until you readjust to the new personalities. UGH
Also our ACS being gone means that we have a rando attending. ALSO UGH
Alright, I realize this blog has been very work-heavy. Sorry, that's all I do these days. More interesting things as they occur. Less than a month till Spring Break and a cruise and a trip to htown!!
Anyway, my SARs switch tomorrow and then the interns on Thursday. And our ACS is gone for the week, so that makes for one very sad week. No me gusta. I hate hate hate it when the team changes in the middle of a rotation; you have to walk on eggshells all over again until you readjust to the new personalities. UGH
Also our ACS being gone means that we have a rando attending. ALSO UGH
Alright, I realize this blog has been very work-heavy. Sorry, that's all I do these days. More interesting things as they occur. Less than a month till Spring Break and a cruise and a trip to htown!!
Friday, February 18, 2011
oops
I already failed my new experiment in posting once a day. In my defense, I was on call. Anyway Brandon is coming in today!! Hooray!! It sucks, though, that I have to work on Sunday. I basically go to work just to do their scut work. I don't think it would be so bad if it wasn't such a waste of my time. At this point I'm actually looking forward to having some responsibility for my patients when I'm a sub intern.
My schedule is only going to get worse from here. I feel super bad sometimes. I guess on the plus side duty hours are lighter than they've ever been before; on the down side, the cap is still 80 hr/week and I'll be exhausted for 3 straight years after I graduate. 4 if I go meds/peds. Boohiss!
My schedule is only going to get worse from here. I feel super bad sometimes. I guess on the plus side duty hours are lighter than they've ever been before; on the down side, the cap is still 80 hr/week and I'll be exhausted for 3 straight years after I graduate. 4 if I go meds/peds. Boohiss!
Wednesday, February 16, 2011
WHAT UP, BLOG
I am back!! New goal: Write at least a tiny sentence every day. Like, "I am so tired that I fell asleep while just trying to think," or "Today a patient sneered "I thought Johns Hopkins was where the good doctors are" at me. That way you will learn at least a little bit about my life. Plus, I have been feeling rather reflective lately, as it comes time to make big decisions about what I will do with the rest of my life. On the days where I do not fall asleep after approx 1 sentence, I may become reflective. Wear sunglasses to protect your eyes if necessary. LOLZ
Here is a day in my life.
7am - Arrive at work. Have already looked at lab values of my patients at home. Look at other electronic records of my patients. Go check them out. Gather as much information as possible. Try to find the interns, who hold all of the actual information about the patient, as med students are a generally useless figurehead-type position.
8am- Cardflip. My team is trying out a new schedule to comply with the new ACGME resident duty hours that will take effect in the fall. They call it Night Rider because it is a night float system. (lolz) This has no effect on me, EXCEPT: I get to sit in the office while we cardflip on the "olds" (old patients) instead of walking around from room to room for an hour plus each morning. This is definitely a bonus for me, as I can barely take all the standing required for rounding on the "news." Sometimes I catch other med students on other teams already on work rounds when I am still pre-rounding on my patients. This makes me really love Night Rider, because after I do my pre-rounding I get to sit on a couch and eat graham crackers.
9am- My ACS strolls in and is like "good morning x10". We re-do cardflip, but this time it is called social work rounds because people from social work are there. Hint: Social work makes the medicine service go round. No one would ever leave the hospital if not for social work. Bless their souls. Social work rounds are much shorter than cardflip and will be done by 9:25.
9:25-9:30: If you drank a cup of coffee this morning, you better pee now, cuz there won't be another chance until noon.
9:30: We start rounding on the "news." The intern who admitted the patient presents them; I try to pay attention to every single word, but I still miss out on important bits because I start thinking about food, or coffee, or what I'm going to do that night. Or if I'm going to be called on to answer a question.
Then we (the med students) are put on the spot and told to read the EKGs and chest xrays on each patient. This is terrifying for the first 2 times, then becomes a part of life. I actually like reading the x-rays. I did not enjoy doing the EKGs at first, but it turns out I am actually learning by being put on the spot. This, really, turns out to be the main way you learn on the Osler service (the O).
THEN the intern presents their assessment and plan. SARs and ACS discuss. Then SAR turns to the med students, brings up some point from the presentation, and lightly "pimps" us. I find this to be an utterly horrifying experience; the questions you know the answers to are inevitably asked of the other students; then you get something out of left field that you just don't know. It's horrible. But shame, it turns out, is a pretty effective way of learning. Then the ACS gets super impressive and drops a few knowledge bombs. If he is feeling like it (and if we have time), more pimping occurs.
THEN we go to the next patient. Repeat x# of admissions last night. Then the medical student on call from the night before presents. Same process, just more nervousness. FUN TIMES.
12noon: Rounding on the news makes time pass incredibly quickly. I learn basically at least 10 new things each day. Then we go to lecture at noon. The quality of the lectures so far has been A to A+, which is incredibly high praise from somebody who can barely stay awake after sitting still for 40 minutes. Also lunch is FREEEEEEE which is my favorite thing.
1pm: Finally free to go say "hey what up" to your patients.
2pm-whenever: Often more teaching occurs.
Whenever-closing time (6-7 pm): More seeing patients, checking up on labs and studies, helping out your intern. If it's a Monday or a Thursday, EKG class from 5-6pm.
If you're on call, you stay on, pick up a patient, work them up, write them up, and present them the next day.
-------------
I am greatly enjoying my time on the O. I'm learning a ton and actually having fun doing it. This is not how everyone feels about the O by a long shot; seems I got lucky. The day goes by so fast and then I go home, study for an hour or so, talk to Brandon and then pass out.
Things that have struck me on medicine so far:
*(This struck me on peds too) How little, in inpatient medicine, you actually see the patient. You see them so rarely! Even when you try, with all the teaching, it's hard. And if you're a resident, you're busy with other things. You see the patient on rounds, and then you have to work really hard just to get back with them 2 more times throughout the day. It's just not what I thought doctoring would be like, probably because I just hadn't had that much exposure to inpatient medicine.
*Old sick people make me sad. They're so vulnerable! And I hate when they come from nursing homes and we send them back to nursing homes. Old age can be so cruel.
*I have just become too tired to go on. MORE TO COME
Here is a day in my life.
7am - Arrive at work. Have already looked at lab values of my patients at home. Look at other electronic records of my patients. Go check them out. Gather as much information as possible. Try to find the interns, who hold all of the actual information about the patient, as med students are a generally useless figurehead-type position.
8am- Cardflip. My team is trying out a new schedule to comply with the new ACGME resident duty hours that will take effect in the fall. They call it Night Rider because it is a night float system. (lolz) This has no effect on me, EXCEPT: I get to sit in the office while we cardflip on the "olds" (old patients) instead of walking around from room to room for an hour plus each morning. This is definitely a bonus for me, as I can barely take all the standing required for rounding on the "news." Sometimes I catch other med students on other teams already on work rounds when I am still pre-rounding on my patients. This makes me really love Night Rider, because after I do my pre-rounding I get to sit on a couch and eat graham crackers.
9am- My ACS strolls in and is like "good morning x10". We re-do cardflip, but this time it is called social work rounds because people from social work are there. Hint: Social work makes the medicine service go round. No one would ever leave the hospital if not for social work. Bless their souls. Social work rounds are much shorter than cardflip and will be done by 9:25.
9:25-9:30: If you drank a cup of coffee this morning, you better pee now, cuz there won't be another chance until noon.
9:30: We start rounding on the "news." The intern who admitted the patient presents them; I try to pay attention to every single word, but I still miss out on important bits because I start thinking about food, or coffee, or what I'm going to do that night. Or if I'm going to be called on to answer a question.
Then we (the med students) are put on the spot and told to read the EKGs and chest xrays on each patient. This is terrifying for the first 2 times, then becomes a part of life. I actually like reading the x-rays. I did not enjoy doing the EKGs at first, but it turns out I am actually learning by being put on the spot. This, really, turns out to be the main way you learn on the Osler service (the O).
THEN the intern presents their assessment and plan. SARs and ACS discuss. Then SAR turns to the med students, brings up some point from the presentation, and lightly "pimps" us. I find this to be an utterly horrifying experience; the questions you know the answers to are inevitably asked of the other students; then you get something out of left field that you just don't know. It's horrible. But shame, it turns out, is a pretty effective way of learning. Then the ACS gets super impressive and drops a few knowledge bombs. If he is feeling like it (and if we have time), more pimping occurs.
THEN we go to the next patient. Repeat x# of admissions last night. Then the medical student on call from the night before presents. Same process, just more nervousness. FUN TIMES.
12noon: Rounding on the news makes time pass incredibly quickly. I learn basically at least 10 new things each day. Then we go to lecture at noon. The quality of the lectures so far has been A to A+, which is incredibly high praise from somebody who can barely stay awake after sitting still for 40 minutes. Also lunch is FREEEEEEE which is my favorite thing.
1pm: Finally free to go say "hey what up" to your patients.
2pm-whenever: Often more teaching occurs.
Whenever-closing time (6-7 pm): More seeing patients, checking up on labs and studies, helping out your intern. If it's a Monday or a Thursday, EKG class from 5-6pm.
If you're on call, you stay on, pick up a patient, work them up, write them up, and present them the next day.
-------------
I am greatly enjoying my time on the O. I'm learning a ton and actually having fun doing it. This is not how everyone feels about the O by a long shot; seems I got lucky. The day goes by so fast and then I go home, study for an hour or so, talk to Brandon and then pass out.
Things that have struck me on medicine so far:
*(This struck me on peds too) How little, in inpatient medicine, you actually see the patient. You see them so rarely! Even when you try, with all the teaching, it's hard. And if you're a resident, you're busy with other things. You see the patient on rounds, and then you have to work really hard just to get back with them 2 more times throughout the day. It's just not what I thought doctoring would be like, probably because I just hadn't had that much exposure to inpatient medicine.
*Old sick people make me sad. They're so vulnerable! And I hate when they come from nursing homes and we send them back to nursing homes. Old age can be so cruel.
*I have just become too tired to go on. MORE TO COME
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