cardiology · MS-4

Off-label

I was with my fellow in the clinic today. One of the patients was a very pleasant middle-aged lady, here for labs/med follow-up.

FELLOW
Well, Mrs. Two-Thirty, your bloodwork is looking great.

PATIENT
Doctor, can you give me something for sleep?

FELLOW
You’re already on a pretty high dose of trazodone. How about if we switch you to Ambien?

PATIENT
No, doctor, that don’t work neither.

FELLOW
Ok, what about Benadryl?

PATIENT
Can you give me Percocet?

FELLOW
Percocet! That’s only for pain.

 PATIENT
It’s the only thing that works for me, doc. I tried it, and it made me feel good.

FELLOW
I bet it did. Here’s an Ambien sample, see you in three months.

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cardiology · MS-4

And here we go (again)

Tomorrow I start my first clinical rotation in nine months, cardiology consult. I’m excited, but also really really terrified. What is the heart? How does it fail? Digoxin, whazzat?  I’ve dusted off Dubin’s EKG book, and Lilly’s Heart Disease, and the ever-helpful Step Up to Medicine, but I’m too scared to read them. I feel like a fraud. It doesn’t help that I have spent much of the last month trying to get back my access to our electronic medical record, our residency advising website, my student printing and IT benefits, my financial aid. It’s like I never existed here, and ought not to exist now.

I’ve been having anxiety dreams for the last week, which is never fun. There was one, in particular, that woke me up with a start. I was on the subway platform, watching a group of people on the platform across from me waiting for the train. Finally a train arrived — one of those old-fashioned tram-like cars with open sides. It was going the wrong way, heading uptown on the downtown track. I watched as the group consulted hurriedly, then sent one person (who looked astonishingly like me) off to ask at the booth. But while she was gone, another train arrived, going in the right direction, and the group boarded that one. By the time the girl returned, her friends had been whisked away. And the girl just stood there in her black dress and light green cardigan, leaning over the tracks to watch the diminishing lights.

You don’t need to be Freud to figure that one out.

It’s much harder than I expected to take a year off. I knew there was going to be a learning curve both ways. But the hardest really is seeing my closest friends leave. I helped R move out the last few bags and boxes, and her apartment echoed. Med school is such a cohort mentality, and it’s really weird to see your cohort pack up and ship out without you. I’m not usually a sentimental person (I hated The Notebook, for what it’s worth) but this month has been bad for me.

cardiology · classes · MS-2

You know you’ve been studying too long when your first waking thought is “Elevated sed rate.”

Cardio’s been a generally good block.  Once you get the hang of it, the material is logical; rote memorization is limited to side effects of the gazillion drugs on the market.  But we’ve been doing NOTHING else for three weeks.  I suppose if you have a particular interest in cardiology, you’d like it, but I am ready for something completely different.