Heal thy self

Words I have a feeling I may need to remember frequently in the next 3 years. I am TIRED. So here's the scoop: Being an intern is hard. We have a team that has a "light load," meaning we have fewer patients than normal. This is great for me as a new intern. The catch is, I am terribly inefficient, slow, and my medical knowledge is best described as "rusty." There are several things I know I know, but my brain just isn't clicking. What's really hard is how difficult it is to picture that knowledge growing. I cannot possibly see how my brain is going to retain so much in so little time. I know it will happen, it has to happen, right?

The other really hard part is missing and worrying about Jordan. As busy and tired as I've been, I am pretty sure it is amplified about 7 times for her. I am sure she is doing great and I have come home both days so excited to hear how her day has gone (someone was a primary surgeon on a C-section today!!!!!!! I have to brag about my wife!)

I think I have to end this entry here because I am not really sure what I just said and I am practically falling asleep at the keyboard. Early morning tomorrow.

~vaya con dios

Here we go

Tomorrow. I can do nothing but stare at that word: "Tomorrow." I don't particularly have much to say, other than to ask for your thoughts and prayers as Jordan and I officially begin our careers as physicians tomorrow. Here goes nothing...

Crossroads

It's here. I am a resident physician. Those words keep resonating in my head. How is this possible?! Tomorrow will conclude my first week of my first full time, salaried job. The week has been a little more tough than I anticipated in some ways and better in other ways. I am having to get up early again and this is just reaffirming my fears about sleep (or lack thereof). Starting orientation so early has been tough for me. I have just come to terms with the fact that I like my sleep. That has been one of the tough parts. The other tough part really happened today. We had a day-long series of lectures and group sessions on critical care. During the lectures, we were all realizing the magnitude of our responsibility. We are expected to know more, to do more, to take responsibility. We will be pushed in a way we have never experienced. The fear of the unknown has been consuming this week. I think I just need to start already! Anyway, the whole point of this little rant is really for myself. I am curious what I will think next year when I am looking back. Will I laugh and think, "It wasn't that bad," will I think to myself, "I had no clue what I was getting myself into?," or more likely it will be some other response I can't even imagine?

My last thought is a verse an old friend from high school had posted on her facebook today. The verse really spoke to me and I think it is something I will use a lot in the coming year: 

Trust in the LORD with all your heart and lean not on your own understanding; in all your ways acknowledge Him, and He will direct your paths. -Proverbs 3:5-6

 ~vaya con dios

"Life doesn't end on June 23rd, son"

Thanks Mom, you are completely right! The other day I was talking with her about all Jordan and I have been doing getting prepared for residency. I was telling her the things we were doing around the (new!) house, the shopping that needed to be done, and the hours of fun and entertainment we have been having, all as a part of "getting ready to start residency." When she so astutely told me that I was acting like I thought I was dying on June 23rd or something, I realized, she was right! I had been taking the approach that I needed to get it all done. I was trying to have fun while I still could. I was getting matters in order. Once I realized she was right, it seemed a lot easier to just change my attitude and enjoy. So here is a list of all the "things we need to do before the apocalypse" :

Stock up! We decided it was appropriate to stock up on groceries and household items since we are unsure of how often we can go. We recently became members of Costco, so a large shopping trip was easy.  Boy did we ever shop. After all, who can possibly make it in this world without 6 tubes of toothpaste? 

This picture was one I took at Costco to send to my mom showing her that Kudos do in fact still exist, in bulk!

Seeing my grandparents for graduation. Do I even need to say more? It was so wonderful to see them, I love them so much! This picture is actually from a long time ago, but it always makes me smile!

Flea Market?! I hadn't been to a flea market since I was a little kid when my mom and grandparents would take me. It was actually pretty fun. I think the highlight for me was watching some guys stack about 10 mattresses in the back of a tiny little truck and try to tie them down. Classic.

 
Time with friends and family. Earlier this year, we had decided to buy tickets to a show at Red Rocks with Kathleen and Chris as sort of a last hooray in case we matched in a different city. Since we ended up staying, it was more of just a super awesome show with super awesome friends. We saw John Butler Trio for my first ever concert at Red Rocks, and they were fantastic

R

Rockies. What's a summer in Denver without going to Rockies games? Jordan and I went last night to see Ubaldo pitch and it was a blast! The game was delayed about 2 hours for rain. They managed to start the game and then it poured! We had so much fun, even though Jord was freezing.

The rain ponchos are so dorky, but they worked great.

I suppose that is all for now, but I definitely wanted to share what we've been up.

~vaya con dios

"School's out for Summer, School's out FOREVER!"

It was so awesome to hear Alice Cooper singing it on the drive home tonight. Jordan and I blared "School's Out" and loved it! Since we have finished, I have done a bit of reminiscing and looking forward as well. It was actually pretty interesting to talk with Jordan about our specific fears of residency. The thing that shocked me was that by far the scariest thing for me is not what I would have expected. So here you go, the top 5 things I am afraid of regarding residency:

5. Mean attendings/residents- This is lower on my list since I am going to Joes. If it were any other hospital the unknown aspect would probably make this jump to number one. Since I know a good chunk of the residents and attendings I am much less worried about this, but there is still the possibility.

4. Gaps in knowledge- Medicine is such a cerebral specialty with lots of tests and data and things to think through. I often find myself wondering if I have what it takes to do this. I want to be good at it, and I hope interpersonal skills are what will define me as a doctor, but there is still a fundamental base of knowledge that is so important. I am coming to realize medical school is less about teaching you the material you need to know to be a doctor and more about teaching how to think like one. Granted, it created a pretty good foundation of medical knowledge, but residency is when the real learning begins.

3. Missing Jordan- This one is pretty self explanatory. We have been talking about how we think we made such a good choice by getting married in December rather than waiting until this spring. We feel like we have created such an awesome foundation and have cherished all the time we have been able to spend together. Now we are trying to see residency as an opportunity to develop our separate lives and careers in a healthy way.  We know that spending 80 hours a week apart at work is not the healthy way, but we think it will help us appreciate each other all that much more when we do get time together.

2. Killing/harming a patient - Again, pretty self explanatory. I think if you are any new resident and you aren't afraid of this, then you are dangerous. This career path is high stakes. All of the sudden we have responsibility that can drastically affect an entire family and their lives. This is scary stuff. Medical training hierarchy will help alleviate some of this, but with each passing month and year we will have more responsibility and the stakes will be higher. Really scary stuff.

The last one seems really silly after spelling this all out, but bear with me. Trust me, it is by far what I think about the most and makes me the most scared:
1. Being tired- In addition to just enjoying sleep and feeling like my whole world is better when I'm rested, I am just plain terrified about this. I have functioned on little sleep during medical school, but I still managed to get more rest than most (especially more than the interns). I am afraid of feeling tired all the time. I am afraid of making judgment errors because I am fatigued. I am afraid of feeling down or sick just because I haven't had a good night's sleep. I am afraid of being the resident that gets in a car accident because I fell asleep at the wheel (happens all too often). I have sleep issues as it is, so to have sleep deprivation added to that, yikes! I am hoping that it ends up not nearly as bad as I'm building it up to be, but my goodness I'm scared.

Anyway, this post ended up being pretty long, but I was excited to write it down after my conversation with Jord earlier.

~vaya con dios

39 days!

39 days and counting. WOW! In just 39 short days I will be standing in a hospital with my first job as a physician with real responsibility and a signature that ends in MD (actually my signature will end in MD in less than 2 weeks!) I am pretty sure I have never experienced the level of anxiety, nervousness, and anticipation I am currently experiencing. I think the reason it is all hitting me right now is because it is so real. I have filled out the hours of paperwork that come with a real job. I now know which service I will be starting with (I will be covering a medicine team that takes care of under served patients both on a general medicine floor and in the ICU, I think). And most of all, it is only 39 days away! With residency fast approaching, Jordan and I have been trying really hard to cherish our time and just enjoying life together.

Looking forward to residency isn't the only thing keeping my mind preoccupied these days. As this next chapter of life is getting ready to begin, I have found myself reflecting on the chapter that is now ending. Med school has brought so much change to my life, I hardly recognize it anymore. The personal growth I have experienced is more than I ever could have imagined at the beginning. One story I want to share that I think sums up a lot of struggle I have experienced so far (and I know I will continue to experience). The following is taken from my personal statement that I had to write for residency applications:

     
  "Identifying a patient as a unique individual is an easy concept in theory, but is exquisitely difficult in practice.  It is far too easy to think of a patient as a diagnosis rather than as an individual. Take for instance, Mr. N., a severely ill patient with AML. Instead of a father, a brother, and a veteran, he became “AML guy,” a title that overlooked his individuality. Every day while I tried to convey treatment plans to “AML guy,” he would tell stories of friends, families, relationships, losses, and personal struggles. I became invested in his story, and through our conversations, I realized that what was important for Mr. N was not necessarily a cure. What he valued was to see his granddaughter graduate from high school. After long discussions with this patient, his treatment plans changed, and his demeanor and outlook immediately improved. I am grateful for Mr. N. He reminded me that I must maintain my focus on compassion, patient autonomy and strong communication in order to become a good physician and maintain patient-centered care."

Whether it's looking back at my medical school, or looking forward to starting life as a physician, I feel pretty blessed and lucky to have such wonderful support. You all mean the world to me, thanks for reading!

~vaya con dios

It's been a while

Jordan inspired me tonight. In reading her blog, I realized I haven't gotten to mine in too long. I will just quickly update for now, but hopefully I will remember to jot down some more soon. I actually really want to get some of the feelings I am experiencing in anticipation of graduating and starting residency while I am experiencing them. But for tonight, I figure I won't steal Jordan's thunder.

I was thinking about posting a few Jamaica pics, but I think that would be beating a dead horse since I posted so many on facebook (but if you haven't had the chance to see, you can go here). 

So I guess that doesn't leave me with much for tonight. So I will just tell you about our house! We are under contract on an awesome town home at a really sweet, central location. The funny part is, one of our classmates is selling the place and we had no idea until we saw his picture in the house. If you would like to see a virtual tour, you can go to http://www.visualtour.com/applets/flashviewer2/viewer.asp?t=2147902&sk=13. 


That's all for now, but let me know how you are doing!

~vaya con dios