One of the toughest things about third year is balancing your need to learn about EVERYTHING (aka accepting the fact that you remember nothing from the first two years of school) and the complete and total awesomeness that is clinical medicine.
I was on call yesterday; as per our course director, the third year picks up the first admission of the day. I did my admission, a really sweet lady with hepatic encephalopathy. Nice bread-and-butter case. Then, as I was finishing up the admission note for her, my resident called me over and was like,
“Hey, we just got this new lady with monoarticular arthritis and what sounds like a cool story. How about you take her as well?”
Technically this is against the rules, but I have trouble saying no, especially when there is a chance of a medical mystery. And medical mystery it was! After the H&P, the resident, intern and I brainstormed a crazy differential, including all kinds of zebras (tuberculosis of the hip?)
The downside, however, is that I was in the hospital until nearly 11 PM last night. I dragged myself home and fell straight into bed without even bothering to change out of my scrubs. And then I woke up so late this morning that I had to rush off to pre-round IN THE SAME SCRUBS AS YESTERDAY. Gross, I know.
My resident is very awesome and let me leave after attending rounds today so I could go study for the shelf. I wish we didn’t have to take this stupid exam, because I’m sitting here reading about random things without real clinical context — it’s like second year, part deux — when I would really rather be on the floors, taking care of Ms. Monoarticular Arthritis and Mr. Inexplicable Recurrent Hypotension.