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!!

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!

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

lauren's wedding: photobooth style

growing up

Last weekend at the Jersey Shore (insert lolz) Brandon turned to me and asked me if I considered myself to be an adult. Without really thinking about it, I said yes. And he said that he didn't really feel that way at all. So I thought about it some more.

In the PRO-adult category, we have the following:

I do basically everything by myself. I live miles away from family, I pay bills, I buy and make food, I clean my clothes and room and house, I have a boyfriend that I carefully arrange my schedule around (ha!), I make doctors' appointments for myself, and I am attending (and successfully completing, thus far) medical school (I mean I haven't flunked out yet or anything). Functionally, I am a fully independent human being.

However, and there is a HUGE however, I am not financially independent. I am pretty much entirely dependent, actually. Unlike many of my classmates, I am lucky enough to have some financial support from my parents. I will not become financially independent until I start making some money.

So in the CON-adult, we have:

Financial dependence. No responsibility for any person other than myself. Oh also I litter my speech with internet terminology and waste a lot of my free time instead of being productive.

Those are really the only concrete "cons" I can come up with. But I also worry a lot. And I never, ever used to worry. I have always had very concrete plans for my life. Actually, I had one plan: medical school. I used to think that after that everything would just fall into place. I didn't realize I'd have to make more plans. And now that I'm here, planning for the future seems pretty much impossible. I feel more anxiety and uncertainty about what's to come than possibly ever before.

Then I read this article about the new "developmental phase" of life called emerging adulthood.

There are two quotes from this article that particularly resonate with me:

1)“It’s somewhat terrifying,” writes a 25-year-old named Jennifer, “to think about all the things I’m supposed to be doing in order to ‘get somewhere’ successful: ‘Follow your passions, live your dreams, take risks, network with the right people, find mentors, be financially responsible, volunteer, work, think about or go to grad school, fall in love and maintain personal well-being, mental health and nutrition.’ When is there time to just be and enjoy?”

I don't find it terrifying so much as exhausting. It makes me want to sit on the couch and do none of the above. Despite the fact that this should be one of the most inspired periods of my life - my time at a great medical school, doing things I've always wanted to do - I sometimes feel less motivated than I did at UT.

2) THE 20S ARE LIKE the stem cell of human development, the pluripotent moment when any of several outcomes is possible. Decisions and actions during this time have lasting ramifications. (emphasis mine)

Yes, I know! Oh gosh! Freak out about what career I want/when I'm going to get married/where I want to do residency and how that will affect my career/ etc etc.

The funniest part is that I don't even think I really fit this "developmental phase" of "emerging adulthood" because I'm not trying to decide what career I want/changing jobs/moving back home. But I do feel like it fits me.

After all, I've hit only 2 of the 5 criteria for "transitioning to adulthood":

1) Completing school (I think they mean earlier phases of school): CHECK

2) Leaving home: CHECK

3) Becoming financially independent...not so much

4) Marrying...nope

5) Having a child...thankfully, not yet.

At this rate I will probably never be an adult. HOORAY

backdated!

I posted 2 old entries from the time of surg. Dated April/May.

Thursday's the big day - I am so ready. I need a break. On Sunday we took one:

Yes, that is a kiddie pool in my backyard. It's the biggest kiddie pool I've ever seen though. It comfortably fits 3 full-sized humans, maybe 4 if you're all friendly.

The sad part is that you can't see my flashcards, which are on the ground on the right beside me. I mean, the sad part is that there are flashcards on the ground right beside me. Maybe Kamna and I will get bonus "cool points" on the exam for "creative studying venues."

oh PS I added two blogs on the right - smitten kitchen, which I've been reading for ages, and hyperbole & a half, which is really how i wish my blog read, because it is laugh out loud hilarious. Lolz all over the place.

hello everyone!

So I've been getting some sass for not updating this thang. Here are my excuses:

1) When I was on surgery, I was working or sleeping. And if I wasn't doing that, I should have been reading about surgery. Or maybe eating. Anyway, it's a shame I didn't post more during that time, because there were lots of good stories, and that's supposed to be the point of this blog. Which leads to my 2nd excuse, which is that:

2) I'm just really bad at blogging; I start posts, I don't finish them. I will try to be better. Again.

3) THIRD EXCUSE: Since surgery I have been studying for the boards, and there is nothing, and I mean nothing, that will turn you into a boring person faster. Everytime mom calls she's like "hey what are you doing" and I'm like "studying." And it's actually true, which is the worst part.

SO to show you how boring my life is, here is a list of the things I googled 2 days ago:

holoprosencephaly - your brain does not develop properly into 2 hemispheres
sirenomelia - mermaid babies!! (actually not a good thing)
patent ductus arteriosus - your ductus arteriosus stays open when you are born, leading to a classic "machinery like" murmur. oh and the whole point of it is to bypass the lungs in the fetus and send blood straight from the pulmonary arteries to the aorta. but if it stays open once you're born, you need to close it.
syringomyelia - enlargement of central canal of the spinal cord. crossing fibers of the spinothalamic tract are typically damaged first, so you get bilateral loss of pain and temperature sensation in the upper extremities with preservation of touch sensation.

Okay I'll spare you the rest. Get the idea? I took a four hour practice test today and that's half the length of the actual exam. BLARGH. I am so tired, and my brain feels so full. There was actually a study done that showed my brain gets bigger while I study for this exam, compared to students who take the summer off. GO MY BRAIN!!!

PS I do have one post from when I was on surgery that I just never completed - I'll backdate that one and post it sometime, so look out for that.