Residency 1.2: Blue Team

Oh man, what a crazy month. My first inpatient month was on Blue Team = Cardiology kids and Cystic Fibrosis. It's so not as fun telling all the crazy stories when I have to explain all the medical jargon, so I apologize in advance that you may not understand everything.

And were there EVER crazy stories!

My first night was a 30 hour call, and despite not having a freaking CLUE about what I was doing or how to deal with a critically low potassium, I managed to get about 4 hours of sleep, and I thought, well this isn't so bad. Apparently, it was just an illusion. I think we did set some sort of record for number of transfers TO the PICU (supposed to be the other way around)--something like 12 or 15 for the month, including, get this, the same patient THREE TIMES! We literally just laughed the last time she came out to us, because the previous two times, she was on the floor less than 2 hours before she was back in SVT and back in the Unit. Our rounds were frequently interrupted by someone going into SVT (adenosine pushes can be fun!), someone developing a hemothorax from 3, count them THREE broken sternotomy wires (and the intensivists wondered why her breathing didn't improve with Lasix...cause you can't pee blood off), or someone whose heart just happens to pause for 6 seconds at a time on a regular basis. THAT was a fun EKG. And that's not counting the kid who came to the Pulm service from clinic on 15 L non-rebreather with sats in the 60s. Oh yeah, sounds like floor status to me!

Okay, enough medical jargon. I hope someone out there is reading this who understands all that and understands how ridiculous it all is.

Some more stories:

I had this really funny cystic fibrosis teenager who kept hiding her pancakes from us every time we came in cause she thought we were going to steal them. And another 8 year old post-heart-surgery girl who I told that she had to be eating and stooling normally before she left, so the next day when we walked in, she started singing "Eat and poop! Eat and poop!" It was hilarious. There were some frustrating cases, like the 23 year old end-stage cystic fibrosis girl that was too depressed to want to get better, and the kid whose mom disagreed with everything we said and thought we were intentionally hurting her daughter, like giving her Decadron that made her cross-eyed. Most days I laughed more than not, sometimes in disbelief at what was happening, but overall it was good.

In non-medical terms, I had 2 amazing senior residents watching my back and occasionally kicking my butt into gear; I eventually became comfortable making fairly minor decisions on my own; and I got really good at eating 2 breakfasts every day so that I wouldn't pass out on rounds.

And now, on to the Emergency Room, which terrifies me, but they say the kids on Blue are sicker than the kids in the ED, so I should be okay. See you in another month!

The doctor will see you now

Today reminded me why I want to be a doctor (wait, I already am, that's weird). I had 3 of the cutest patients in clinic today, including a well child check/sports physical for a 10 year old boy that are just at that phase between childlike bluntness and openness and teenage awkwardness and coming into their own personality. I love it. I love the chance to shape a life. And the four year old who told me right off the bat "I don't need no shots today" and wondered "Is this a place that gives cookies?" And despite the chaos of clinic, I really like being in a room with my colleagues and mentors, where we can just chat and get support and learn from each other.

Dear Patient...

When you are a patient in the hospital, your world is pretty small. All you know (especially if you're on isolation precautions and can't leave the room) is one tiny room, the TV channels that get streamed in (Nintendo Wii if you're lucky), the room service menu that's available, and the people that wander in and out throughout the day. If you're like most, you'll see your resident (and possibly a medical student) in the morning, then the whole team will come by on rounds, crowd your room, talk about you like you're not there, and gawk at you in general.

When they leave, that's it. You'll wonder what the heck goes on the rest of the day and where that doctor is and why they always seem so rushed. You're just focused on getting better and don't understand why tests take so long to run, why you have to stay another day when you're feeling so well, or why you can't stay an extra day to play Bingo (this happened today).

I know that for you, it may be your first time being sick, taking medicine, having surgery, getting an MRI, etc. So please be patient with us when we forget. Because for us, you are one of 18 patients we have to take care of. We spend the rest of the day writing notes, admitting new patients, discharging people who are ready to go home, calling consulting services, ordering new labs and medicines and tests, going to lectures, reading about your disease, and following that one patient who seems intent on a one-way ticket back to the ICU.

I say that not as an excuse, but so that you understand that I wish it were different. I wish I could spend all day with you and not in front of a computer. But know that even though we don't see you, we're thinking about you all day long, talking about you, learning about you, problem-solving for you. So go easy on us, and remind us when we forget, what it's like to be you.

More than fine

Yesterday I treated myself to one of my few indulgences...a double-tall half-caff, non-fat, 2 pump sugar-free extra hot vanilla latte. Mmmm. It makes me warm and fuzzy just saying it. But really, that's not the point of the story. As I walked up to the counter, the barista asked how I was. I answered my typical, "Pretty good, how are you?" without even giving it much thought. Her answer? "Better than blessed." It made me stop and think. And as I headed to the other side of the counter to grab my morning pick-me-up, I said, "Hope you continue to have a blessed day." She said, "Thank you, I needed to hear that." And the truth was that I probably needed to hear her answer in the first place. A reminder that even though we ask "How are you?" as a substitute for "Hi" and that we rarely listen for the answer, that doesn't mean that even this small interaction can't be a place to share God's grace, to touch a life. A reminder that every encounter with someone is a chance to brighten their day. My dad is so good at this, at taking the little moments and using it to really be present to someone, and it's something I strive to be better at. So thanks, Blessed Barista Lady, for being my real morning pick-me-up. And may you all have a better than blessed day!