Wednesday, July 30, 2008

Dumbass Medical Student Move

Okay, so I'm in this low-end procedures room, helping to do an excisional biopsy. I'm the non-scrubbed in person, grabbing non-sterile things, moving the table up and down, etc. etc. Then I offer to adjust the procedure light, the one on the arm. Now, the OR lights I am used to having a handle in the middle--which hardly ever actually positions the light the way you want--and very nice handles on the sides. So, first I try the handle in the middle. Then, making the ridiculous assumption without actually looking that this piece of crap light has the same side handles, I grab the side where the other handles usually are, firmly, to swing it around.
All I can say is I am damn lucky that I was wearing gloves, because even then I manged to burn the living @(*$%& out of my thumb, which I planted directly on one of the exposed bulbs. Then, being that there was a (conscious) patient and three residents trying to close up a giant wound about six inches from me , I had to pretend I hadn't just done that and it didn't hurt like a sonofabitch and I wasn't really, really embarrassed. I don't know how I managed to casually finish adjusting the light, pull off my gloves, and examine the giant blister on my thumb.
I quietly excused myself, taking my glove with me, to curse under my breath and find an ice machine and create a makeshift ice pack.

Which brings me to my next point: latex-free gloves are not very waterproof, and the only thing more embarrassing than burning your thumb on the overhead light during a procedure is dripping water from your makeshift ice pack onto the patient and the electrocautery plate during the procedure.

And I thought being a 4th year meant most of my bonehead moments were behind me...

Final side note: my favorite personal 3rd year bonehead moment was when, on my first day in the OR (actually, my first day of 3rd year!), the scrub nurse asked what size glove I wear (you have to know what size surgery glove you wear so they can pull the sterile gloves out for you). I said, I don't know, it's my first day. She said, hey, why don't you go next door to the other OR and ask Cindy to give you the glove sizer? I--and the other medical student--said, oh, okay! Sure! And like the pair of gullible brand new 3rd years that we were, went next door and asked for the glove sizer.

Well. The entire OR just looked at us like we rode in on goats. Then the circulating nurse kind of smiled and said, oh, yeah, the glove sizer. No, I think that's back in the other OR.

I'd like to say that we knew before the moment that we walked back into our OR and the ENTIRE OR--scrub nurse, circulating nurse, intern, resident, attending... hell, I think the anesthesiologists--were laughing heartily, that we had been had. But we didn't.

And they say doctors don't have a sense of humor. No one, of course, says that medical students aren't boneheads most of the time.

'Cause we are.

Okay, I am, anyway.

Monday, July 21, 2008

Whole New Scene

Well, today was my first day of 4th year medical school. It was great, and also scary. It was great to say out loud, "I'm a 4th year." It was scary to have people assume that somehow that means I know what I'm doing.

It's also great and scary because I'm no longer at my home base. I am doing a rotation at a somewhat nearby (also, major rival) school. In a field, which I love and want to enter, which I have not done, ever. With my limited, one-day experience, I have to say it has been pretty great. It's always scary for me to try completely new things, but I'm trying to focus on the positive, exciting parts of trying completely new things. Like, for example, it's nice to have new things to suck at, when all the other things I suck at start to get old.

No, but really, everyone was very nice today, and I think I am going to have a good month, which is followed by a super awesome two more weeks off. So, overall, I'm very pleased. Except...

Well, here's the thing I can't stop thinking about.

Vacation was awesome. You know what I really liked about it? The part where I don't have to do anything. It is actually making me feel kind of conflicted. Like, shouldn't I have been more excited to get back to things? Shouldn't I have at least been less depressed to be done with my vacation?

Here's the thing. I think that whole "Do for a living what you would do for free" thing is real nice in theory, but it hardly ever works out like that. I think that finding that job is like winning the lottery. I think that you are pretty damn lucky if you don't hate your job, and even luckier if you sort of like it.

I don't know... how many people do you know who would keep their job if they won the lottery? I'd like to say that I would, but I don't know that I would. I am trying to chalk some of this up to the fact that we are still not really moved in yet. The place is a mess, which I hate, but I hit a wall, and with the hubby on night float I'm not sure how much more I can do. I'm telling myself that if we can just make it through this damn night float that things will be better. And that's a whole separate post... how many times I've said that over the past 7 years of training. "If I can just make it through (insert whatever phase I'm in at the point), things will be better". But there's always something new.

But those are thoughts for another day. Today it is time to start some reading, and here's another reason to cheer: I'm reading to try and look like less of an idiot, but NOT FOR A SHELF EXAM. If that's not a reason to embrace novelty, I don't know what is.

Wednesday, July 9, 2008

My ERAS, my tormentor

Dude. Just when you think that the Parade of Menial, Banal Tasks that No One Should Ever Have to Do that is medical school is tapering off, they drop the bomb.

ERAS, which stands for... um, hang on, I have to look this one up... Electronic Residency Application Service... wow. That basically explains it. Nice job with the naming, residency people! Anyway, it's nice that it's electronic and all, except that the interface is slowly driving me insane.

They have boxes for everything--and I mean EVERYTHING. Now, normally I am a big fan of having boxes to fill in. That's just the kind of person I am. I color inside the lines, and I like to fill in forms. (Caveat: they have to be well-designed forms. I hate when I have to write outside of existing boxes on a form.) I know--I sound like a load of fun at parties, huh?

Anyway, I have spent hours thus far copying my CV into this ridiculous form. It's totally out of control. It is rigid, very detailed, and wants to know everything about everything I've done since I graduated from high school, which for me is 15 years ago*. Actually, I'm not totally sure they don't want to know about stuff I did in high school.

Look, ERAS, I don't remember what month that abstract I was on in 1997 came out, and PubMed doesn't either. But ERAS doesn't care, and won't save it unless I lie. I am being forced to lie by a stupid web-based application.

In any case I am TOTALLY sick of myself right now. I'm sick of my publications, my research experience, my teaching experience, and basically every other experience I've had. I'm sick of estimating how many hours a week I spend doing ANYTHING.

I will end this with a piece of advice. This is for everyone, but especially for mudphuds:

My husband did not do this, and his ERAS experience was exponentially more painful than mine, meaning that it almost killed him.

So, go forth and update your CV. Put EVERYTHING on there. You'll thank me later.

*I know. I'm old. Tell me something I don't know.

Friday, July 4, 2008

Hey, wait, didn't I use to have a husband around here somewhere?

So. We moved. Right now it feels like we relocated to the inner circle of hell, but I'm pretty sure that's just because I hate moving and unpacking and repacking and recycling zillions of those tiny little foam peanuts which get everywhere and under furniture and stuck in your dogs' fur and fly around when you try to sweep them up and eventually require you to set fire to your new home just to get rid of them.

There are a lot of things I still can't find, including my husband. I'm pretty sure I wrapped him very carefully in bubble wrap and put him in Styrofoam molds and labeled the box "HUSBAND--LIVING ROOM", but I thought that about the accent lamp that goes in the guest room, and that's nowhere to be found, either.

Okay, I didn't lose him in the move. He started internship this week, and his first month is night float. That means that he gets home around 9am, at which time he eats and stumbles to bed to pass out, sometimes still wearing his scrubs, then a few hours later he's up and out the door. It's so weird. Most of my time with him these days is on the phone during his commute. Turns out that Bluetooth headset was the perfect graduation gift for him.

In any case, I'm thankful to have so much stuff to keep me occupied while he's always away. I have about 2K years of unpacking and settling in to do. I have a few more rooms to paint. And, just so I don't forget that I'm still in medical school, I have a bunch of residency application stuff to do, a personal statement to write, my packet of random stupid crap to turn in for my last rotation, and some studying to prepare for my next rotation. How am I supposed to fit all of that around my Arrested Development marathon?

Well, it's time for me to turn in--I have a big day tomorrow, getting my VERY PROFESSIONAL (=black suit, white shirt, understated makeup) picture taken for my residency applications, and before I go to bed I have to practice my "I'm a serious, professional doctor but still fun to work with" expressions in the mirror. But first, time to page my hubby a kiss goodnight.

Tuesday, July 1, 2008

Medicine vs Peds

The main reason people will give you for choosing medicine over peds is, "I can't stand dealing with the obnoxious parents."

Here's the thing I don't get: when you go into medicine, the parents are your obnoxious patients.

Medicine was, in fact, more fun than I thought it would be. However, I discovered a not-so-pleasing fact about myself, which is that I don't enjoy taking care of people as much when what I am doing is trying to re-arrange the deck chairs on the Titanic. AND, the reason the Titanic is sinking is that the captain repeatedly and intentionally rammed it into every iceberg in sight, despite being told each time that if he did that again he was gonna sink the sucker.

It felt like 90% of our patients were in the hospital secondary to one of three reasons (and often a combination of all three):
1. Years of drug abuse (tobacco, alcohol, heroin, crack--I also include the HIV or hepatitis they contracted because they were using dirty needles).
2. Years of eating everything within reach (and never getting off the couch).
3. Years of either not going to the doctor or flatly ignoring everything doctors have told them.

Actually, now that I think about it, I think that you could combine 1 and 2 given that for many people food seems to be an addiction akin to any other drug.

In any case, I find it hard to enjoy taking care of these patients. It isn't that I don't feel empathy and pity for them. I do. I took care of a lot of people right at the moment that it occurs to them that they have thrown away their entire lives. That is not a happy moment. I suppose it's good that I can be there for them, but what am I supposed to say? You're right, you have thrown away your life, and now you're dying, and there's nothing we can really do about it. But buck up! It's sunny outside!

The thing is, I'm sure that they have horrible, sad life stories. I've heard a lot of them. My problem isn't that I can't find any compassion in myself. My problem is that I have what my dad calls "a strong bias towards action". I don't like to deal with problems that have no solution. I'm not proud of that, but I can't pretend that it isn't true. When I find a problem, my natural instinct--no, my need--is to solve it.

And, for most of these people, that can't be done. The best you can hope for is maybe postponing their eminent death for a short while, or making it more comfortable. Which, actually, I feel is a very honorable mission. It's just not my mission.

To survive in medicine, you have to have a mission. You have to have something that makes you excited and fulfilled. Because Lord knows you don't get money, or leisure time. You don't often get kudos either. When you do, it definitely feels great--but if you rely on those, that's a one-way ticket to Burnout Town.

Anyway, I like Peds because the proportions are reversed. 90% of the patients did nothing do themselves to get sick or hurt. 90% of them will get better and lead normal lives. They have problems which you can diagnose, treat, and solve. Yes, parents can be annoying. But as I said, I'd rather have them as parents than as my patients.