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.

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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