11.17.09
My new attending this morning looked at me, shook my hand, and taught me about chronic versus acute pancreatitis. And the intern sat down and took me through our patient’s EKG. People were interested in me and my education!
I didn’t realize just how bad the last rotation was until I got to this one and my preceptor said, “I do have other clinical responsibilities, but for these five weeks, my primary responsibility is you.”
It’s gonna be a great rotation.
11.11.09
Overheard in clinic
PATIENT
Are doctors and nurses not allowed to wear makeup?
BLEARY-EYED RESIDENT
Huh?
PATIENT
All you gynecologists are women, but I never see anyone wearing makeup.
RESIDENT
I had to be at work at 4 this morning. If I had to wake up earlier to put on makeup, I’d kill myself.
PATIENT
Oh, honey! Here’s a dollar. Buy yourself a coffee.
11.08.09
How a Bill Becomes a Law
Obama Calls Health Care Bill’s Passage ‘Courageous’ – NYTimes.com.
It would be nice if the vote had been less partisan, but baby steps.
11.06.09
Dolor
Just to balance out all the negativity I’ve been feeling for the past few weeks: I really do like my gyn residents. They are supportive of each other and of the medical students, and although it’s busy busy busy, they do try to teach when they can. Today I was in the OR most of the day with the R3, who is straight-up hilarious. He can do spot-on imitations of the weirder attendings, and whenever you greet him, he makes Munch’s “The Scream” face and says, “So much paperwork! I have dolor from the paperwork!”
Me, I have dolor from studying for the shelf. This time, we have an oral component in addition to the written. Muchisimo dolor!
11.01.09
Team player
Nothing makes you feel like part of the team like having a resident say to your intern, “I don’t want med students here when I’m discussing this case.” And then your intern says (very nicely), “Sorry, guys, can you just wait over to the side?”
Well, it’s only ten more days, of which two are didactics and one is the shelf. Manageable. And I’m really looking forward the next rotation. Like, really.
10.31.09
Burnout
Third year is really starting to get to me. I’m tired all the time. I am irritable and snappish. My diet consists of the following: bagels with cream cheese, coffee, and red velvet cake. My first week, I worked 98 hours in 7 days (I don’t get a single weekend off this month), excluding studying and reading up at home; stopped counting after that. I don’t mind the long hours in themselves — I probably worked almost as much on neurology — but on this rotation, the patients don’t want students, the attendings don’t want students, the residents tolerate students only as scutmonkeys.
Mid-point feedback was a couple of days ago, but I heeded the advice of upperclassmen who told me that the course director wants ego-stroking, not feedback. So I put on my biggest, fakest smile and said “Oh, yes, Dr. R., I’m having a great time on this rotation. It’s challenging but everyone’s so interested in teaching and I’ve learned a lot, especially in clinic.”
I felt dirty but showered afterwards and ate more red velvet cake.
10.22.09
Babies everywhere!
C. and I were hanging out in OB Triage the other day. It was slow. We were bored. There was just one patient, who was sent up from the ER with a chief complaint of constipation (seriously?), and we had to wait to see her until the nurse was done taking her vitals.
Then the nurse poked her head out the door.
“Um, we need a delivery kit in here, because … I can see the head.”
10.11.09
Vacay
One of the great things about the way our third year is set up is that we get two vacation weeks. So I just came back from what was, essentially, Fall Break.
It was lovely to just sit around at home and sleep and watch television and go out with friends, like a normal human being.
Next up: OB/Gyn!
09.28.09
Washing hands
Doctor and Patient – Why Don’t Doctors Wash Their Hands More? – NYTimes.com.
Surgeons are, with good reason, the most hand-washing-happy crowd I know. Today I was with a surgeon in his office hours, and he did a minor procedure on a patient but was nevertheless as careful as he is in the OR. Autoclaved the instruments. Placed everything just so on a blue sheet. Even got the special surgery gloves, which come individually wrapped (like gift chocolates, but made of latex!) instead of the standard ones on the wall. He also prescribed the patient Levaquin afterwards, saying to me after she’d left the room, “I didn’t see any breach of sterile technique, but you can never be too careful.”
(Ok, overuse of antibiotics might be an issue.)
Bottom line is well summed up here:
Hand hygiene and sterile technique are so successfully maintained in operating rooms not because of the reminders that hang over scrub sinks, but because it is part of the culture and identity of those who work there.
For the rest of us, those Purell sanitizers are key.
