Three Days and Counting...

Three days left. Including call tomorrow. It's kind of the home stretch now. I've hit that point where it does not matter how tired I am because the end is in sight, and no matter how bad call could be tomorrow, come Friday afternoon, I am a free man! I kind of dreaded seeing my attending today. I knew that after the way things ended on Friday, I was not going to have warm fuzzy feelings for her. But again, the end is in sight. And I didn't have warm fuzzy feelings for her. It kind of sucks, because I think she's a good doctor, and I know she wants us to become a doctors, but her constant criticisms have just left me a bit annoyed with the entire month.

Miserable fucking day, Part 2

So, I have this bad habit of logging in to the hospital computer from home to check up on my patients. Before I left this afternoon, my attending was grilling me on why I ordered a CT angiogram on a patient of mine this morning. I defended my actions to her, but could tell that she wasn't too impressed that I had ordered a test which will probably cost the hospital a few thousand dollars. At 7 a.m., when I ordered the test, I knew I would have to defend my actions. This patient, has been complaining of a pain, and we haven't found and the source. The pain is not due to kidney stones, nor due to a kidney infection, so based on the fact that she uses injection drugs, I was worried about disease in the lung. I figured she had a lung infection which hadn't shown up on a normal chest x-ray. So I ordered the CT angiogram, cognizant of the fact that this patient doesn't have insurance.

And guess what, it shows that she has multiple tiny infections in the lung. The best part, is that they called my attending with the results. I wish I could have been there to seen her face when she found out that the test, which she criticized, had proven exactly what I was looking for.

Intern =1, Attending =0

And like that, all of a sudden, my confidence is right back to where it was before this downward spiral began.

A miserable fucking day

It's just been one of those days. Where the work is good, but the overall experience has just fucking sucked. Actually, this all began yesterday. Yesterday, my co-intern said "this could be the day I quit residency." I thought he was being a bit dramatic. Today, I said "this could be the day I quit residency or rather this residency." I know I was being dramatic. But is it funny, how when you're just stressed out, quitting seems like a good option. Let me explain...

At five o'clock last night, I met with my attending doctor. It had already been a trying day. First off, by five o'clock I should have already signed out and been at home. At 5 p.m., my attending gave me about another hour's worth of tasks that she felt needed to be done. So of course, I did them. Even though they could have waited till today. At six o'clock, I signed out to my co-intern (who thankfully hadn't quit). I then spent two hours with a patient and his family trying to figure out why he wasn't getting better. I left at eight. Four hours past when I should have left.

This morning I started at 6 a.m. By 8 a.m., Molly (our medical student), and I were telling a patient that he has esophageal cancer. A few minutes later, I ran into my attending doctor, and that is when the day began to turn sour. She hasn't been happy lately, and made it clear that today wasn't going to be an exception. To make matters worse, she informed me we would meet this afternoon. To make matters even more worse, she wasn't pleased to hear that my senior resident was getting me out early this afternoon. And so, knowing that in the afternoon we would have a confrontation, I spent most of the morning trying to figure out what the fuck her problem is. Our team has been working well over the number of hours we should be working, discharging patients quicker than other teams, and still she constantly has issues for me and my co-intern. Which is why, I had a miserable fucking day thinking about where I'd rather be than where I was.

How did my day end? Instead of leaving at one, I left at three. Surprise. Surprise. Surprise. And, that was after being berated for 20 minutes about things that happened yesterday, and things that hadn't been done today. Being a resident can just fucking suck.

Thank God, only one more week of medicine wards

More thoughts on the liberty

Today is my day off. I've decided to use these days off this month (all four of them) to have some fun in life. So today I was going to go hiking. Unfortunately, it's been passing rain for days now. Rain brings mud, a chance for dirtying up the liberty. So instead of going hiking, I went four-wheeling. My goal was to get mud on the top of the liberty. I was successful. Unfortunately, the liberty now has a wee bit of a scratch. Well, not a scratch really. Actually, after the bump I took I'm pretty happy that it's just a scratch. Some of the moulding is a little bit looser, that was earlier in the day. I'm pretty sure it's something that can be fixed fairly easily. I'm proud of the liberty, she handled like a charm...

anyways, it's probably time to go ahead and get busy on the things I really need to get done on my one day off this week. Grocery shopping laundry, etc. etc. etc.

hope you had a nice weekend!

Cheers,

Brian

New toys...

So, it's pretty amazing what you can do to justify buying a things. Let me explain. The thing I really dislike most about my job, it's all the damn paperwork. So, in my quest to reduce the amount of paperwork that have to do on a regular basis, or at least to make it more fun and interesting, I've decided to buy new toys. For example, tonight instead of using the boring keyboard to put this in I'm using my voice recognition software. How did I justify this purchase? Let me tell you..

Whenever someone leaves the hospital, we do this painful process of documenting their entire stay of the hospital with the premise that someone actually reads the pages long of babble that write. So, since I've been spending in oh at least an hour every night working on these summaries, and while I'm not the slowest type or the world, nor the fastest, I've justified buying some voice recognition software. And basically, you are my guinea pigs. Kidding!

So, tonight I'm working on my discharge summaries by dictating them at home. I'm hoping that, while it may not speed up the process, it will at least distract me from the pain associated with doing these damn discharge summaries. There's more though. Did you also know that they make SD cards, which are also jump drives? What this means, essentially, is that the discharge summaries that I start tonight, I will carry around in my palm pilot tomorrow, and update them periodically throughout the day. And as patients get discharged. I merely take the S D card of my palm pilot, plug it into a computer and boom I can get the patient discharged.

Tomorrow is my day to round. It should be a short day, theoretically. In at 8 a.m., and if all goes well, out the door by 2 p.m. That being said, realistically, I know will probably be 3 or 4 p.m.

Anyways, now it's time to put this new toy to work, and crank out some of those damn discharge summaries.

Cheers, Brian

A Million Thoughts...

Are running through my mind. It's monday night, 9:15 and I'm basically sitting here paralyzed. I want to go to the gym. I want to go grocery shopping. I want to read about my patient's conditions. I need to start writing the discharge summaries for my patients. I want to get caught up on email. I want to get caught up on talking to family. I really want to get caught up on sleep!

I hoped that a cup of coffee would start a nuclear reaction of energy and that somehow, I'd find the energy to do something from the above list. And nada..

Work is busy. Busy, blah blah blah. But it's good. I find I set myself up for this dilemma every day. We're suppose to work 7am to 4pm. "suppose to." Today was 6:30 am. I was hoping to make it out of there by 4pm today (so I could get some of the above errands done). Realistically I knew it would be 6pm. But shit, again there was a patient to be discharge at the last minute. And then I wanted to go check up on 2 patients before I left for then night. I left late.

It's not really a big deal, except that I had expectations to get some stuff done this evening. Which is why it is now 9:30, and I can't even figure out where to start.

Today was a pretty good reality check. Just when things seem to be clicking along great, feeling pretty confident that I've learned a lot so far, wham-O! Very complicated patient. A fantastic patient who I totally adore, who is a bit sick. I admitted her last night. At first it seemed kind of straight forward when the call came from the ED. Pneumonia. Simple stuff. But then when I met the patient and got the story and looked at her preliminary labs, the simplicity quickly faded. My current reference frame for seeing patients is "in 3 years and 2 months (yikes), I may very well be working out in the boonies and what would I do in this situation." Usually that forces me to think things through and things start falling into place. Last night, though, ll I could come up with was: Better get the hematologist to tell me what the hell is going on! And as I headed home last night, I was determined to put on my detective hat look up some of the abnormalities, and figure out what was going on... But I was just too tired to muster the strength to open my "Harrison's Principles of Internal Medicine." I'm not going to read tonight either...

B

March of the Jeep Liberty

Have you seen March of the Penguins? There's this part where the penguins essentially call out for their mates and kids. Last night in the parking lot, when I could not for the life of me remember where I parked, I had to walk around pushing my automatic lock button waiting to hear the Liberty beckon me to her!

Back on med wards.. I think I had forgotten how busy med wards is.. But, that's not necessarily a bad thing. I no longer get that "oh God, now what" feeling when my pager goes off. It doesn't freak me out that I have patients to discharge and at the same time others waiting to be admitted. I think this is going to be a great month to learn and improve my skills.

So the earliest we can sign out on non-call days is 4pm. I think I'm just going to resign myself to planning on leaving at 6pm every night (which actually means It'll be more like 7pm). I had a discussion with a co-intern in my program today. We both have a reputation for being there late. And we discussed how it seems to be that other interns leave at 4pm. Granted, it is quite possible that we're both just slow. Rather, we concluded that enjoying the best part of our job (actually talking with patients and families), means that we're in the hospital later. I'm pretty sure I could have dodged out of there at 6pm (instead of 7:30), but that would have meant not going around to peek in on everybody this evening, and leaving a few loose ends for the on-call intern to deal with.. As we were getting ready to leave, there were 2 senior residents who, likewise, were not on call, and who were leaving damn late. They are in our program. What do I like best about the residents in our program? We care for our patients. This brings me back to the Time article (see previous post). Personally, their fucking slant against residents pisses me off, and quite frankly, they can fuck off. (Although I did sign out for a subscription to fight my cultural ignorance). So, it's almost 10 pm, I had a quick bite after popping in to the gym briefly, and now I'm going to spend at least an hour on the computer working on discharge summaries for patients who are hopefully going to go home tomorrow. (Again, fuck off Time).

I suspect I'll be Marching for the Jeep Liberty again soon.

Cheers,
B