Reality TV

Medical dramas crack me up. I used to watch House during my first year of medical school and try to guess what was on the differential as they went through the case (lupus was always on the list...it's not lupus). It cracks me up how Hollywood portrays medicine. Doctors specialize in everything, you can always find the right answers if you get enough clues, and everyone's make-up is always perfect. Oh, and no one ever knows how to pronounce basic medical terms (drives me CRAZY!). [Side note: I'm watching "Body of Proof" and up until this point, the episode was fairly believable, but Dr. Hunt just opened a guy's belly with a steak knife in his kitchen and didn't even have to cut through any muscle or fascia. That was easy!] In reality, medicine is far less glamorous. There's way too much out there to know everything. I know on House, they do their own CT scans and brain surgery, but we each have our niche, and we learn it very well (This month, mine is catching babies and airway, unless they're sick; then it's catch and get the heck out of the way). We almost never find all the answers, and often we send patients home with a very unsatisfying, "We don't know what it was but it's better now." And I look less than put-together after a 30 hour call (the pillow lines on my face from my half hour of sleep, and the scrub cap that I had to wear half the night didn't help). But I think our version is better. In our version, you get the ecstatic grandmother screaming "Alleluia. Gracias a Dios!" when her granddaughter is born, you get the crazy mom hugging you at 2 in the morning for taking good care of her son when she couldn't, you get a 5 year old drawing pictures of ducks and butterflies for you at her check up. Makes the scrub-cap hair worth it.

Pange lingua gloriosi

As the entire church kneels in utter silence, the altar is stripped of its white linens, the table cleared, even the candle, which is always burning in every church around the world, is extinguished, like the Life given for us. It's a feeling of complete emptiness. One I imagine I would feel every day if it weren't for the Sacrifice that we celebrate this weekend, the Eucharist and the saving act of Our Lord on the cross. Though I often take it for granted amidst the business of my life, tonight, I am truly grateful. May you all have a very Blessed Triduum.

The miracle of life

Got paged last night to a delivery because the infant's heart rate was dropping. Got into the room all bleary-eyed and out of breath, only to stand there and wait for an hour. The patient, a 21 year old with bipolar disorder who had also recently gotten a steroid burst for asthma (NOT helping her mood stability), was having a little bit of trouble figuring out the difference between "push" and "scream and writhe all over the bed and kick the nurse". The poor nurses and OB residents were being so patient (yet firm) with her, but our peds nurse almost went over and said, "We're about to intubate your baby right now if you don't push him out." At one point, she got tired of pushing and said, "I'm ready for the vacuum cleaner." (I think she misunderstood...haha). The attending, who was called in as a last resort to make sure this baby came out, was very patient as well. As they were whispering about the baby's position and failure to descend (and despite all that effective pushing no less!), the patient goes, "What's going on?" His reply: "You're having a baby." Everything is funnier at 4 in the morning.

I'm now about a third of the way through the NICU rotation over at Truman, and despite a rough start wherein we had no computer or badge access (kinda hard to get work done), we are trudging along. Still don't know much about taking care of tiny babies, but I'm getting really good at calculating how much they're eating. One of my fellow interns says that the OB refresher is really coming in handy as he studies for Step 3. "I suddenly remember what they're talking about. PROM is not a dance you go to and drink fruit punch. Premature rupture of membranes. Boom."

Still have 5 calls left, including 3, count 'em THREE, Saturday calls--yuck! But someone's gotta do 'em. And turns out I don't have a single call by myself (how did that happen?). Someone's watching out for me. And now, if you'll excuse me, gotta enjoy this post-call sunshine while it lasts.

Residency 1.9: Owl Team, Part Deux

Just got done with my second month of nights, and despite missing the sunshine and socialization in general, I have to say it was a blast! I had such an amazing team, which made all the difference. We had family dinner every night and would laugh so hard our faces hurt. We had a good balance of some very busy nights (almost 20 admissions, spinal taps, PICU transfers, near codes in the ED) and some very chill nights (12 episodes of Friends, 5 episodes of Castle, fondue night).

About halfway through the month, our master schedules came out for next year. And guess who gets to start off with yet another month of Owl Team? You betcha! In my first month as a senior, I'll be basically in charge of half the patients (we have 2 senior residents on at night in the summers) and supervising a bunch of squirrly interns fresh out of orientation (does anyone else remember how totally worthless I was in my first month of residency? Exactly!). Terrifying!!! And so the second half of this month, I essentially tried to function as a second-year. I tried to think through everything and come up with a plan before going to my senior resident, rather than just asking her, "What do you think?" right off the bat. It made me realize that A) I have learned so much in the last 9 months in terms of triaging, assessing, managing, and knowing when to ask for help; and B) There is still a TON that I don't know. It's going to make for a very interesting (read: STRESSFUL) July, but I know that at the end of it, I will feel ready for just about anything. Plus, there's always Friday morning Happy Hour!

Until next time, kids!