One down...

One rotation down, 11 to go in my intern year. Well as you can probably tell from my disappearance from everything, it has been a crazy first month. I think the biggest transition has been spending so much time away from Jordan. I really miss her.

My first month of intern year was on a general hospital medicine service that took care of the patient's that don't have Kaiser (mostly uninsured or Medicaid patients). We took care of patients on general medicine floors and in the ICU. I only had a few patients that were in the ICU so it doesn't make me any less nervous to be starting my official ICU month now. Oh well, it is going to happen either way tomorrow.

I have enjoyed my time so far (I think). I mean the interactions with the patients has been great almost universally, I really like the staff, and I love the residents and attendings at Joes. I just miss the heck out of Jordan. When I am there, busy, and not thinking constantly about being home, it has totally rocked. When things are slow, or we would have a late admission that was gonna keep me from home, I got grumpy. My days off almost universally have ended with some sort of sad feeling ranging from just feeling down, to straight up losing it. It's weird, I want to be rested and recharged but it's almost like I am reminded of what I am missing. I am hoping that feeling will pass some but I am not holding my breath.

I am trying to think of some good stories that would be far less boring than just reading my complaining. I have seen a variety of things from IV drug users with infections in their arms, to major heart attacks,  to newly diagnosed advanced cancer. I have had some wonderful interactions with patients and I have had a schizophrenic patient threaten me if I didn't leave his room. I had another bipolar patient tell me he is the antichrist, nonchalant of course. I treated a patient that has been in the hospital since April and will continue to be there for a while. I saw a patient gain 30 lbs in water weight from his heart failure. I treated pancreatitis in a guy my age that was from drinking alcohol and was so severe it has made him abstinent. I treated a recovering alcoholic mother who developed postpartum depression and fell off the rocker, only to end up in withdrawal, in the hospital, holding her toddler. In all the hurt and and sadness in that mom, I also saw the miracle of having a husband stand by her, be there to pick her up, and love her enough to carry her through recovery- again. I treated an older lady from New Mexico that was hard of hearing (sound familiar?). She had a heart attack with a strange presentation. She reminded me so much of my grandma that we ended up chatting about making tortillas, her son's restaurant, and even what cities in New Mexico we have family in. I guess when I think about all this and how it has all happened in just my first month as a physician, I am able to somewhat grasp the reality of this all. I am able to grasp how blessed I am to be doing this.

ICU tomorrow. I guess I should stop writing and go to sleep. I am SO nervous for my first overnight covering the unit. Thoughts and prayers are certainly appreciated! As I said a month ago...Well, here goes nothing!

~vaya con dios

I know the pieces fit

Pay no attention to the title, I am listening to music in bed and am kinda amped up from a crazy busy day. My plan was to share a few pearls from what I've done/learned in residency so far, but I don't really know what to say! Oh well, here goes nothing, random thoughts from 3 weeks of residency:

1. Being a new doctor is hard!
2. Sleep is a commodity
3. Patients think it's funny to see a doctor that looks young (seriously, I mean they literally laugh)- it's a great compliment!
4. I have a lot to learn. Every day I am learning SO much and being taught so much. It really makes me wonder what I did in med school. I had to have learned something, right?
5. I literally had to write an order that stated, "ok to give patient a pickle."
6. I had a nurse tell me today, "I've only been doing this for 10 years, but what do I know." when I wouldn't let a patient eat while on a special breathing machine. Honestly though, I was right on this one and I wasn't even trying to argue the point!
7. I have a lot to learn
8. Being sick is scary. I admitted a patient in her 30's for a heart attack today. I can't imagine how that must feel for her and her husband. It's really sad. Her whole life is different now.
9. I will probably be uncomfortable for the next 6 months, maybe even 2 years. That is the nature of changing what you are doing every month. Every time I fell comfortable even a little, it will be time to switch.
10. I have a lot to learn.

Ok, like I said sleep is a commodity, and well, I have less than 8 hours before I have to be up to do it again!

~vaya con dios

Bad Feeling

Today sucked. Today was that day that I knew would happen, it just felt worse than I expected. Today was my resident's day off so I had more responsibility than usual. Now, I have already done this 3 other times (just the way the schedule worked out) and it actually went well those other times. What was different? Well our team had a higher number of sicker patients today. We actually only had half of the maximum number we can have (My team can have 14 patients and I can follow 10), but I was still 3 away from my maximum. What was hard was how ill the patients were. One in particular got so ill at the end of the day, I had to transfer him to the ICU. By this time of the day, my attending was gone and I was all alone. I had other residents I can ask for help, but the truth is they are busy and focused on their own things. If something went really south they'd be there, but boy it sure did feel scary. I am exhausted, I have no desire to do this again tomorrow, and frankly I am just defeated.  I will try to get on to blog some good experiences soon, but I felt like whining and figured blogging it to the internet abyss sounded most therapeutic. All is well, I will feel better after some sleep. Hope to give some good stories soon!

~vaya con dios