Well, I am still in shock, but I have managed to get everything I hoped for. Yesterday I found out that I matched into my top choices for preliminary year (pediatrics) and my advanced year (dermatology)!
Match day was kind of bitter sweet. Lots of friends leaving, lots staying; lots got what they wanted, some were disappointed. I was a lucky one, getting what I wanted, sticking around. I'm sure I will be even more excited as days go on, but for now I'm kind of still in stunned disbelief.
Here's the thing: I can't tell you how excited I am about dermatology!! I love, love, LOVE it. It is just about perfect for me. I've said it before, but I get to do everything I love. Great diagnostic work, surgery, and kickass immunology. Plus, my daughter will probably even know what I look like!
As for intern year, I am also very excited, but nervous. It's such a huge leap, going from not doing anything without four levels of permission to basically being able to make decisions on my own. Also: the hours. Scary. And even scarier... Capstone has given me a very clear understanding of just how much stuff I've already managed to forget in just a few months. But I'm not thinking about that now. Right now all I'm thinking about is packing for a short, weekend getaway with my hubby which we have been looking forward to for months. :)
For those of you out there who matched, I hope you are as happy as I am. For those with the match still ahead... sitting on this side of things, I can tell you that keeping up with that hard work and studying does pay off! Hang in there! And enjoy the first day of spring.
Friday, March 20, 2009
Thursday, March 5, 2009
Changing gears, Step 2 CS, and OHMYGOD MATCH DAY
Well, clearly I have not been 100% on top of updating this thing, which is probably appropriate since things will be moving on soon. I have been trying to decide if I will blog about this next great phase in my training--moving from being a student to being a resident--and I'm undecided. With a baby on the way and a husband who will also be an intern, there may not be time. On the other hand, Lord knows I always have lots to say.
These days things have become considerably more peaceful. It's nice, but almost frightening--I feel as though I keep waiting for the other shoe to drop. My husband has completed chemotherapy. He gets his port out soon and in another couple of months will have his follow-up PET scan. Waiting for that is certainly a source of anxiety; I try not to think about it, and to just rejoice in seeing him slowly return to his old self. Another huge source of anxiety, which was finding appropriate child care for next year, is now gone. We found a wonderful situation which we both feel great about, with the tiny exception that it will take MY ENTIRE RESIDENT SALARY to pay for it. That's right, folks. My. Entire. Salary. Repeat after me: MD/PhD training is worth it... MD/PhD training is worth it... MD/PhD training is worth it...
The following year we will probably be able to use considerably cheaper child care, but for now this is really the only way that we can both do our jobs. I keep reminding myself that this is still an investment, and that one way or another we will be able to survive on one resident's salary. Hey, it isn't really that different than what we did before, so I guess we'll be okay.
The big YIKES on the horizon right now is: MATCH DAY. Yipe. I think that a week from Monday is when we learn if we matched or not; official Match Day, where we learn where we will be, is March 19th. Now, I know that a lot of MS4s out there are feeling anxiety about this, but allow me to put it in perspective for you: I applied to dermatology. And ranked two programs. TWO. It is the height of madness, but luckily, I have to say that the PET is scarier, so there you go. In any case, hopefully I will at least have a prelim spot for next year, and if I am a REALLY lucky girl, I will have a place to call derm home after that. One way or another it will be nice to know for sure.
I also took Step 2 CS. I don't want them coming after me so I won't say anything about it except that I expected it to be really stupid, and it exceeded those expectations like a champ. I have never been forced to do anything that was such a racket, so pointless and aggravating, in medical school or graduate school, and those of you have done either or both know that is saying something. I urge anyone with the power to do so eliminate this charade, this rip-off disguised as an exam. Everyone knows you make us do it for the money. Why give us that final slap in the face after we've crawled through the sewer tunnel to graduation? I'll say no more.
These days I am all done with rotations, and am back in my dissertation lab for a while to help out with progressing my old project. Going back to research, changing gears again, is a strange experience. It's both harder and easier than I thought it would be to come back to it. My main issue right now is fatigue. It's hard to focus, hard to care as much as I did when I was here almost two years ago. I'm trying, but it ain't easy. It's also interesting to see how my perspective has changed with just a few years of clinical work under my belt. It's a good thing, and it makes me more certain that in the end I've done the right thing with the MD/PhD. A nice place to be.
No other big insights here for now. I have a Capstone course coming up, and my forecast for that is Stupid with occasional chance of Helpfulness. It sounds like most medical schools have these, so I might post a little something there. Also expect a triumphant or tragic post regarding match results. And wherever you are, whatever stage you are in, I wish you godspeed in your endeavors. We all have it pretty tough no matter where you are in this drawn out hot mess of physician-scientist-dom. Hang in there. I can honestly say that things keep getting cooler with each passing year.
These days things have become considerably more peaceful. It's nice, but almost frightening--I feel as though I keep waiting for the other shoe to drop. My husband has completed chemotherapy. He gets his port out soon and in another couple of months will have his follow-up PET scan. Waiting for that is certainly a source of anxiety; I try not to think about it, and to just rejoice in seeing him slowly return to his old self. Another huge source of anxiety, which was finding appropriate child care for next year, is now gone. We found a wonderful situation which we both feel great about, with the tiny exception that it will take MY ENTIRE RESIDENT SALARY to pay for it. That's right, folks. My. Entire. Salary. Repeat after me: MD/PhD training is worth it... MD/PhD training is worth it... MD/PhD training is worth it...
The following year we will probably be able to use considerably cheaper child care, but for now this is really the only way that we can both do our jobs. I keep reminding myself that this is still an investment, and that one way or another we will be able to survive on one resident's salary. Hey, it isn't really that different than what we did before, so I guess we'll be okay.
The big YIKES on the horizon right now is: MATCH DAY. Yipe. I think that a week from Monday is when we learn if we matched or not; official Match Day, where we learn where we will be, is March 19th. Now, I know that a lot of MS4s out there are feeling anxiety about this, but allow me to put it in perspective for you: I applied to dermatology. And ranked two programs. TWO. It is the height of madness, but luckily, I have to say that the PET is scarier, so there you go. In any case, hopefully I will at least have a prelim spot for next year, and if I am a REALLY lucky girl, I will have a place to call derm home after that. One way or another it will be nice to know for sure.
I also took Step 2 CS. I don't want them coming after me so I won't say anything about it except that I expected it to be really stupid, and it exceeded those expectations like a champ. I have never been forced to do anything that was such a racket, so pointless and aggravating, in medical school or graduate school, and those of you have done either or both know that is saying something. I urge anyone with the power to do so eliminate this charade, this rip-off disguised as an exam. Everyone knows you make us do it for the money. Why give us that final slap in the face after we've crawled through the sewer tunnel to graduation? I'll say no more.
These days I am all done with rotations, and am back in my dissertation lab for a while to help out with progressing my old project. Going back to research, changing gears again, is a strange experience. It's both harder and easier than I thought it would be to come back to it. My main issue right now is fatigue. It's hard to focus, hard to care as much as I did when I was here almost two years ago. I'm trying, but it ain't easy. It's also interesting to see how my perspective has changed with just a few years of clinical work under my belt. It's a good thing, and it makes me more certain that in the end I've done the right thing with the MD/PhD. A nice place to be.
No other big insights here for now. I have a Capstone course coming up, and my forecast for that is Stupid with occasional chance of Helpfulness. It sounds like most medical schools have these, so I might post a little something there. Also expect a triumphant or tragic post regarding match results. And wherever you are, whatever stage you are in, I wish you godspeed in your endeavors. We all have it pretty tough no matter where you are in this drawn out hot mess of physician-scientist-dom. Hang in there. I can honestly say that things keep getting cooler with each passing year.
Wednesday, January 28, 2009
No, I do not have any more #@*$&! questions about the program, or anything else
Interview season has come to a close for me. My interview season was relatively very short and painless; with my husband having a spot at a nearby university for residency, I only applied locally. Let's not talk about what that means for my matching chances, especially given that I am attempting to match in dermatology. We will pretend that this is NOT the scariest thing ever, and move on. Very well.
In any case, I only had five total interviews, and had to travel for exactly zero of them. Given how ecstatic I am that I am all done, I have to wonder--how do people DO this? Most people have 10-25 interviews, all over the country. I was ready to stab myself in the eye after just five. Plus, I actually liked all of the places I interviewed, which makes it even less painful.
However, there is something weird about interviewing only where you have done rotations. It leaves a lot more blank space where there would have been questions, and as anyone who has gone through interviews can tell you, there is already a lot of blank space where they expect questions that don't exist. After you've gone through two or three lectures about the place and met with residents and faculty both formally and informally, there just aren't. Any. More. Questions. But yet they ask, at some point during every individual interview: "Any questions for me? Anything you'd like to know about the program?"
It is especially tough for derm interviews, where you have to meet with essentially ALL of the faculty individually, typically at least 10 or more people. It's nice in these situations to have a Blue Ribbon Pony of a question all picked out that you can parade in front of any faculty member, especially if you care about the answer. My personal Pony was: "What do you see as the most important goals for the future of (fill in name of residency program here)?" Interviewers love this question, and it gives a lot of helpful information to you, too.
That is my one useful tip for today. I have been heavily engaged in recruiting for our MD/PhD program, which is fun but busy and stressful. It is also very weird to have just finished being on the interviewee side of things, and then being on the interviewer(-ish) side of things. Now I have been chained in the garage by my husband to help him sort through the mind-boggling amount of ridiculous crap we have in there. It's nice, but now I need a nap.
I had something else to say, but it's gone now. Will post more when brain working again. Unless I inadvertently put said brain in one of the to-donate boxes in the garage... hmmmm....
In any case, I only had five total interviews, and had to travel for exactly zero of them. Given how ecstatic I am that I am all done, I have to wonder--how do people DO this? Most people have 10-25 interviews, all over the country. I was ready to stab myself in the eye after just five. Plus, I actually liked all of the places I interviewed, which makes it even less painful.
However, there is something weird about interviewing only where you have done rotations. It leaves a lot more blank space where there would have been questions, and as anyone who has gone through interviews can tell you, there is already a lot of blank space where they expect questions that don't exist. After you've gone through two or three lectures about the place and met with residents and faculty both formally and informally, there just aren't. Any. More. Questions. But yet they ask, at some point during every individual interview: "Any questions for me? Anything you'd like to know about the program?"
It is especially tough for derm interviews, where you have to meet with essentially ALL of the faculty individually, typically at least 10 or more people. It's nice in these situations to have a Blue Ribbon Pony of a question all picked out that you can parade in front of any faculty member, especially if you care about the answer. My personal Pony was: "What do you see as the most important goals for the future of (fill in name of residency program here)?" Interviewers love this question, and it gives a lot of helpful information to you, too.
That is my one useful tip for today. I have been heavily engaged in recruiting for our MD/PhD program, which is fun but busy and stressful. It is also very weird to have just finished being on the interviewee side of things, and then being on the interviewer(-ish) side of things. Now I have been chained in the garage by my husband to help him sort through the mind-boggling amount of ridiculous crap we have in there. It's nice, but now I need a nap.
I had something else to say, but it's gone now. Will post more when brain working again. Unless I inadvertently put said brain in one of the to-donate boxes in the garage... hmmmm....
Friday, January 2, 2009
It's not just good things that must come to and end
Bye, bye, 2008. Please be sure to let the door hit you in the ass on your way out.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
Wednesday, November 26, 2008
PICU
HOLYMOTHEROFGOD...
PICU is like all the hard rotations I've had so far, but put together all at once, at 10x the speed, in a foreign language. And with more sad stories.
Remember waaaaaaaaaaay back when I posted this about not understanding medical abbreviations and jargon? Well, I look back on that post and laugh, it's so second-nature to me now. But PICU is like starting right back there. Most of the time I just either stare vapidly or, when that gets old, I nod. But I have no idea what people are talking about at least 30%, and probably more like 50% of the time.
I picked up a highly recommended book about the rotation which I will be reading in between bites of turkey. At least I get Thanksgiving off, which is good, because I need to sleep for at least 24 hours straight. I will let you know if said reading helps me understand what the #$(*& is going on in that place.
Until then, happy Thanksgiving!
PICU is like all the hard rotations I've had so far, but put together all at once, at 10x the speed, in a foreign language. And with more sad stories.
Remember waaaaaaaaaaay back when I posted this about not understanding medical abbreviations and jargon? Well, I look back on that post and laugh, it's so second-nature to me now. But PICU is like starting right back there. Most of the time I just either stare vapidly or, when that gets old, I nod. But I have no idea what people are talking about at least 30%, and probably more like 50% of the time.
I picked up a highly recommended book about the rotation which I will be reading in between bites of turkey. At least I get Thanksgiving off, which is good, because I need to sleep for at least 24 hours straight. I will let you know if said reading helps me understand what the #$(*& is going on in that place.
Until then, happy Thanksgiving!
Friday, November 21, 2008
'Round and 'Round
A random brief post about rounds... some new 3rd years have asked, so here is what to expect:
SURGERY ROUNDS
Start time: 6am
End time: 6:15am
What to know about your patients: If they have eaten, pooed, or started bleeding from any orifice
What to present about your patients: If they are still alive
How many seconds attendings usually listen to your presentation: 0 (To be fair, they are not usually present.)
PEDIATRICS ROUNDS
Start time: 8 or 9am
End time: 11am
What to know about your patients: Medical stuff plus their birth history, growth and development history, grade in school, favorite subject, teacher's name, pets, names of pets, stuffed animal's name, symptoms expressed by stuffed animal (if present)
What to present about your patients: Significant overnight events, abnormal vitals, lab results
How many seconds attendings usually listen to your presentation: Usually to the whole thing (!), unless the attending is a cardiologist, in which case, 5
PSYCHIATRY ROUNDS
Start time: Between 10am and whenever everyone feels emotionally ready to round
End time: Depends directly on the quantity of both the patients themselves and the amount of crazy present in each individual patient
What to know about your patients: If they still think that you are an alien and they are communicating with the reincarnation of Elvis through a transmitter in their teeth
What to present about your patients: If they fought off the 8pm dose of Haldol
How many seconds attendings usually listen to your presentation: Often the whole thing, while nodding thoughtfully
MEDICINE ROUNDS:
Start time: 8am
End time: 5pm (on a short day)
What to know about your patients: Every health issue or experience that has happened to the patient and the patient's relatives or close acquaintances from when they were in the womb until now.
What to present about your patients: Any overnight event, including what time patient turned over, all vitals including trends in vitals since admission or possibly before, lab results for patient and patient's first degree relatives, or as much of this as you can get in before someone on the team interrupts you
How many seconds attendings usually listen to your presentation: They may pretend to listen for up to 60, but often not well enough to avoid asking you a series of questions which were answered in the first 60 seconds of your already given presentation
SURGERY ROUNDS
Start time: 6am
End time: 6:15am
What to know about your patients: If they have eaten, pooed, or started bleeding from any orifice
What to present about your patients: If they are still alive
How many seconds attendings usually listen to your presentation: 0 (To be fair, they are not usually present.)
PEDIATRICS ROUNDS
Start time: 8 or 9am
End time: 11am
What to know about your patients: Medical stuff plus their birth history, growth and development history, grade in school, favorite subject, teacher's name, pets, names of pets, stuffed animal's name, symptoms expressed by stuffed animal (if present)
What to present about your patients: Significant overnight events, abnormal vitals, lab results
How many seconds attendings usually listen to your presentation: Usually to the whole thing (!), unless the attending is a cardiologist, in which case, 5
PSYCHIATRY ROUNDS
Start time: Between 10am and whenever everyone feels emotionally ready to round
End time: Depends directly on the quantity of both the patients themselves and the amount of crazy present in each individual patient
What to know about your patients: If they still think that you are an alien and they are communicating with the reincarnation of Elvis through a transmitter in their teeth
What to present about your patients: If they fought off the 8pm dose of Haldol
How many seconds attendings usually listen to your presentation: Often the whole thing, while nodding thoughtfully
MEDICINE ROUNDS:
Start time: 8am
End time: 5pm (on a short day)
What to know about your patients: Every health issue or experience that has happened to the patient and the patient's relatives or close acquaintances from when they were in the womb until now.
What to present about your patients: Any overnight event, including what time patient turned over, all vitals including trends in vitals since admission or possibly before, lab results for patient and patient's first degree relatives, or as much of this as you can get in before someone on the team interrupts you
How many seconds attendings usually listen to your presentation: They may pretend to listen for up to 60, but often not well enough to avoid asking you a series of questions which were answered in the first 60 seconds of your already given presentation
Sunday, November 16, 2008
Like a 12 step program
One day at a time. And so time has moved along, and for the most part, been good to us.
My husband had his PET scan, and it was good news. He still has enlarged nodes, though they are smaller, and none of them took up the label, so they consider the therapy a success. 6 months of chemo instead of 8, and most likely no radiation needed (thank God). I finally feel like I can breathe again.
On the bad side, chemo sucks so much. I guess I have realized how caviler we are with prescribing things for our patients, how quickly we are to dismiss them as "not too bad", when really they are pretty horrible and life-changing. To be fair, we were basically warned pretty accurately about the chemo, but there are parts of it that were downplayed to a ridiculous degree. For example, Mr. Dr. Dr. VonB had to get a central port, which they really blew off as not a big deal. In fact, the VIR (vascular interventional radiology) guys who did it didn't even prescribe pain medicines, they told him that Tylanol would be more than sufficient. What a joke! He was absolutely miserable for at least three days after that procedure, unable to sleep, unable to be comfortable, and in lots of pain. It was so much worse than his lymph node biopsy that he was using the pain medicine they'd given him for that (which he used once right after his surgery, and then had gotten by fine with Tylanol).
It's still a struggle to try to find something that doesn't make chemo so horrible. He just feels awful for 4-5 days after each treatment (and each one is getting a little worse). We keep switching around his medicines to help treat the nausea but most of them make him feel bad too. It is indecribably sucky to watch your partner suffer like this and be completely powerless to do anything.
In other news... OldMDGirl was actually right, though not about what my worst nightmare is. I found out the day after my husband's official diagnosis that I'm pregnant. It isn't that I'm not happy, it's just... nice timing, right? The first trimester was just... well, it was pretty miserable. I was worried about the baby, worried about my husband, worried about how much I was worrying (anyone else catch the study published right around that time linking maternal stress in the first trimester with schizophrenia in the child?), and oh yeah, yacking every single day while trying to continue rotations. Good. Times.
But things are better now. We got the Happy PET Scan News, the scary 1st trimester is behind me, along with the yacking, and I'm 5 short weeks from being essentially done with medical school. I took and passed Step 2, and surprisingly managed to to better than OK, which really blew my mind. I am done with my AI in three days (well, almost four, since one of those days is a call day) and it was pretty good even though I reaaaaaaaaaaalllllllllly didn't want to be working. Then I have four weeks of PICU and I'm outta there. Well, there's this crazy two week long course we all have to take in March. Oh, and I have to drive to FREAKING ATLANTA to take the Biggest Rip-Off in Existence (aka Step 2 CS) in February. But other than that... done.
And did I mention the baby is due the day after graduation? I don't care if I have to wheel myself, in labor, across the stage... I WILL ATTEND GRADUATION AND BE HANDED MY FREAKING DEGREE AND BE HOODED AND ALL THAT. This little munchkin is either going to have to be a little early, or a little late. Hear that, munchkin?
Anyway, that is a quick update of stuff here. I had actually meant to write more about the AI and what that's like, but I will have to do that another time. Here's a preview: overall, it's pretty awesome.
Until then... thanks so much for all of your thoughts, prayers and well-wishes. For those of you in graduate or medical school, keep the faith, because I am proof that even with random hideous life curve-balls, you do eventually get through it and move on.
My husband had his PET scan, and it was good news. He still has enlarged nodes, though they are smaller, and none of them took up the label, so they consider the therapy a success. 6 months of chemo instead of 8, and most likely no radiation needed (thank God). I finally feel like I can breathe again.
On the bad side, chemo sucks so much. I guess I have realized how caviler we are with prescribing things for our patients, how quickly we are to dismiss them as "not too bad", when really they are pretty horrible and life-changing. To be fair, we were basically warned pretty accurately about the chemo, but there are parts of it that were downplayed to a ridiculous degree. For example, Mr. Dr. Dr. VonB had to get a central port, which they really blew off as not a big deal. In fact, the VIR (vascular interventional radiology) guys who did it didn't even prescribe pain medicines, they told him that Tylanol would be more than sufficient. What a joke! He was absolutely miserable for at least three days after that procedure, unable to sleep, unable to be comfortable, and in lots of pain. It was so much worse than his lymph node biopsy that he was using the pain medicine they'd given him for that (which he used once right after his surgery, and then had gotten by fine with Tylanol).
It's still a struggle to try to find something that doesn't make chemo so horrible. He just feels awful for 4-5 days after each treatment (and each one is getting a little worse). We keep switching around his medicines to help treat the nausea but most of them make him feel bad too. It is indecribably sucky to watch your partner suffer like this and be completely powerless to do anything.
In other news... OldMDGirl was actually right, though not about what my worst nightmare is. I found out the day after my husband's official diagnosis that I'm pregnant. It isn't that I'm not happy, it's just... nice timing, right? The first trimester was just... well, it was pretty miserable. I was worried about the baby, worried about my husband, worried about how much I was worrying (anyone else catch the study published right around that time linking maternal stress in the first trimester with schizophrenia in the child?), and oh yeah, yacking every single day while trying to continue rotations. Good. Times.
But things are better now. We got the Happy PET Scan News, the scary 1st trimester is behind me, along with the yacking, and I'm 5 short weeks from being essentially done with medical school. I took and passed Step 2, and surprisingly managed to to better than OK, which really blew my mind. I am done with my AI in three days (well, almost four, since one of those days is a call day) and it was pretty good even though I reaaaaaaaaaaalllllllllly didn't want to be working. Then I have four weeks of PICU and I'm outta there. Well, there's this crazy two week long course we all have to take in March. Oh, and I have to drive to FREAKING ATLANTA to take the Biggest Rip-Off in Existence (aka Step 2 CS) in February. But other than that... done.
And did I mention the baby is due the day after graduation? I don't care if I have to wheel myself, in labor, across the stage... I WILL ATTEND GRADUATION AND BE HANDED MY FREAKING DEGREE AND BE HOODED AND ALL THAT. This little munchkin is either going to have to be a little early, or a little late. Hear that, munchkin?
Anyway, that is a quick update of stuff here. I had actually meant to write more about the AI and what that's like, but I will have to do that another time. Here's a preview: overall, it's pretty awesome.
Until then... thanks so much for all of your thoughts, prayers and well-wishes. For those of you in graduate or medical school, keep the faith, because I am proof that even with random hideous life curve-balls, you do eventually get through it and move on.
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