When you're in the PICU, it's hard to find moments of normalcy. Working 70+ hours a week with a 4:40 am alarm is NOT normal. Putting in 5 chest tubes in 3 days (not me personally; I only did one of them), watching a rhythm strip progress towards asystole in a DNR patient with 25 family members in the room, running to 3 codes in one night, constantly pacing from one end of the 1/8 mile unit to the other...NOT normal.
So, imagine the treat it was to sit out on a back porch post-call, drinking Boulevard, listening to feet-tapping music, eating jalapeno-cream-cheese-and-bacon-stuffed mini peppers and homemade pizza (yeah, my friends know how to cook like whoa), and playing Mexican dominoes. Barefoot and blissfully happy.
If I can have a few of those moments every week, I may make it out of this month between a 3 and a 7.
Monday, April 15, 2013
Tuesday, April 2, 2013
Residency 3.9: Green Team
"I'm tired. The kind of tired you can't sleep off."
I'm watching 'Blue Bloods'--my new favorite past time--and Frank's talking about retiring. I'm not ready to retire quite yet, but I am tired. This month was long. If you'll remember, Green Team is our senior-only inpatient team. This month, due to some unforeseen scheduling difficulties, our teams were restructured and we ended up with a bigger team and a bigger census. Made for busy days and sometimes painfully long rounds. Even with having my favorite attending on for two weeks of the month, it was draining.
I think one of the things I'll take away from this month is just an appreciation for the breadth of our training. When you're on inpatient, you hear about every interesting kid who comes through the hospital, even if they aren't on your team. Every diagnostic dilemma, PICU transfer, bizarre test result. We see some really weird things; things that you only read about in textbooks, and have access to awesome specialists. Part of the reason it's hard to reflect on these months is that we see SO much that by the end, it's somewhat of a blur. It's hard to retain anything when you never have time to sit down. But I know that some of it must stick.
Yesterday, I took checkout on two different kids who were being transferred to our team. Both were complicated stories in their own right, and as I listened to the check out, I found myself formulating and adapting a differential and a plan on the fly, anticipating what my next five steps were going to be. And I realized that the scope of our experience prepares us really well. When you've seen just about everything that can cause abdominal pain or seizures, it makes it a lot easier to look for the zebras, or to rule them out.
So, I suppose it should be a good tired. Because it means I'm becoming a better doctor. Which won't make it any easier to get up at 4:40 tomorrow morning to head into the PICU. So off to bed I go.
I'm watching 'Blue Bloods'--my new favorite past time--and Frank's talking about retiring. I'm not ready to retire quite yet, but I am tired. This month was long. If you'll remember, Green Team is our senior-only inpatient team. This month, due to some unforeseen scheduling difficulties, our teams were restructured and we ended up with a bigger team and a bigger census. Made for busy days and sometimes painfully long rounds. Even with having my favorite attending on for two weeks of the month, it was draining.
I think one of the things I'll take away from this month is just an appreciation for the breadth of our training. When you're on inpatient, you hear about every interesting kid who comes through the hospital, even if they aren't on your team. Every diagnostic dilemma, PICU transfer, bizarre test result. We see some really weird things; things that you only read about in textbooks, and have access to awesome specialists. Part of the reason it's hard to reflect on these months is that we see SO much that by the end, it's somewhat of a blur. It's hard to retain anything when you never have time to sit down. But I know that some of it must stick.
Yesterday, I took checkout on two different kids who were being transferred to our team. Both were complicated stories in their own right, and as I listened to the check out, I found myself formulating and adapting a differential and a plan on the fly, anticipating what my next five steps were going to be. And I realized that the scope of our experience prepares us really well. When you've seen just about everything that can cause abdominal pain or seizures, it makes it a lot easier to look for the zebras, or to rule them out.
So, I suppose it should be a good tired. Because it means I'm becoming a better doctor. Which won't make it any easier to get up at 4:40 tomorrow morning to head into the PICU. So off to bed I go.
Sunday, March 31, 2013
He is not here
Alleluia! This morning my heart is light and my God is risen. Lent this year brought many opportunities for me to face my humanity and brokenness, and also many opportunities to draw near to the foot of the cross and cling to the feet of my Savior. And many glimpses of grace from a God after my heart. The sun breaking through the clouds, the right song at the right moment, a memory of joy surfacing at an unexpected time, a much needed call from a friend, and of course the more substantial things of finding a job, being affirmed by my supervisors, seeing my family. We are not in easy times as Christians, and especially as Catholics. The world hated Him before us, and if we imitate Him like we should, it will hate us too. Yet as much sadness and despair is in me when I look at our broken world, still death has been conquered and hell is overcome. The empty tomb means everything. I am so grateful.
Tuesday, March 19, 2013
Introducing...
I just accepted a job at the Children's Hospital in Denver, doing urgent and emergency care in the satellite centers. It's scary and exciting at the same time. But since being terrified has never been a reason not to do something, I'm diving in. I've been doing a Novena to St. Joseph in honor of his feast day today (I started a day late, so I'm not quite done yet!), and I've been praying for our new pope and my new job, so today seems like a great day to accept the job (and a great day to install a pope). Thank you to everyone for your (continued) prayers as I plan to embark on this next great adventure.
Sunday, March 17, 2013
Things I like
Fun things from the last week--
*Lunch at Maggiano's with the whole fam. Accidentally licked my finger after getting sauce on it and endured an epic glare from Mary. Hilarious.
*Getting done with clinic way early
*The gorgeous day on Friday and getting to sit outside for a bit in the new chapel garden
*Two job offers back in the Centennial State--gonna make a decision this week--stay tuned.
*New pope! And he's awesome!
*The amazing green frosted chocolate chip cookie I just ate 'cause it's Sunday
*Checking Irish Car Bomb off my '30 Before 30' list (also accompanied by maybe the best mac'n'cheese of my LIFE
*Getting to work out 3 whole days this week (assuming I kick it into gear after this)
*Baking lazy Irish beer bread (hopefully this ends up a success and not a flop)
*Mom likes Blue Bloods as much as I do; and the library has the second season on hold for me
*Got a GREAT complement from someone I look up to a lot
*Good book: The Elegance of the Hedgehog
*My favorite attending on service
*Lunch at Maggiano's with the whole fam. Accidentally licked my finger after getting sauce on it and endured an epic glare from Mary. Hilarious.
*Getting done with clinic way early
*The gorgeous day on Friday and getting to sit outside for a bit in the new chapel garden
*Two job offers back in the Centennial State--gonna make a decision this week--stay tuned.
*New pope! And he's awesome!
*The amazing green frosted chocolate chip cookie I just ate 'cause it's Sunday
*Checking Irish Car Bomb off my '30 Before 30' list (also accompanied by maybe the best mac'n'cheese of my LIFE
*Getting to work out 3 whole days this week (assuming I kick it into gear after this)
*Baking lazy Irish beer bread (hopefully this ends up a success and not a flop)
*Mom likes Blue Bloods as much as I do; and the library has the second season on hold for me
*Got a GREAT complement from someone I look up to a lot
*Good book: The Elegance of the Hedgehog
*My favorite attending on service
Tuesday, March 5, 2013
Residency 3.8: ER
I was looking forward to this month as a chance to cram in as much learning as I could, being that I'm interviewing next week for an urgent care job, and this could be my life for the next few years (and even if/when I end up in private practice, there's lots to be gained from good ER training). While the respiratory season is slowing down, it was still a decently busy month, with plenty of opportunities to practice my diagnostic and technical skills.
Two successful lumbar punctures, a deep leg lac requiring a three-layered closure with vertical mattress stitches (something I haven't seen since medical school), nail trephination (cauterizing through the nail to release blood), trauma, shock, new onset seizures, abscess drainage, ingestions, appendicitis, plenty of fractures, asthma, influenza. All the good stuff.
It makes me smile that I think of all that as the good stuff. I've decided I really enjoy the quick pace, the challenge of having a limited amount of time to see a patient and trying not to be lulled into complacency by so many similar complaints, because you never know which vomiter is going to be the pyloric stenosis and not gastroenteritis. And as I've said before, the doctors that work in the ER are some of the most fun people to be around, because they love their jobs and they have to keep things light because otherwise it gets to you.
Things like seeing a little girl in foster care come in with belt marks across her back. Or a teenager who came in after a suicide attempt and you almost pray that he's not resuscitated, because a brain-dead kid with a pulse is harder on everyone than just pronouncing him. Or the boy who was found in a car abandoned after a police chase, with no name and no family. Those days make this job hard. And for me, I think one of the hardest parts is that it doesn't get to me like it used to. But I know that a big part of that is that I've learned to protect myself from it, so that I can still do my job. It's hard to do chest compressions if you're having to think about the outcomes if you succeed in bringing a kid back. Or if you fail.
To end on a lighter note, I finished out the month by swapping arterial sticks with one of the other residents. We need to prove that we can do them in order to graduate, and neither of us have had a chance to do one on a patient, so we offered each other our wrists and stuck each other. Watching the disbelief on the nurses faces while we did it was by far the best part. Well, that, and the fact that now I can graduate.
Pray for my job interviews next week. Hopefully all this experience isn't going to go to waste.
Two successful lumbar punctures, a deep leg lac requiring a three-layered closure with vertical mattress stitches (something I haven't seen since medical school), nail trephination (cauterizing through the nail to release blood), trauma, shock, new onset seizures, abscess drainage, ingestions, appendicitis, plenty of fractures, asthma, influenza. All the good stuff.
It makes me smile that I think of all that as the good stuff. I've decided I really enjoy the quick pace, the challenge of having a limited amount of time to see a patient and trying not to be lulled into complacency by so many similar complaints, because you never know which vomiter is going to be the pyloric stenosis and not gastroenteritis. And as I've said before, the doctors that work in the ER are some of the most fun people to be around, because they love their jobs and they have to keep things light because otherwise it gets to you.
Things like seeing a little girl in foster care come in with belt marks across her back. Or a teenager who came in after a suicide attempt and you almost pray that he's not resuscitated, because a brain-dead kid with a pulse is harder on everyone than just pronouncing him. Or the boy who was found in a car abandoned after a police chase, with no name and no family. Those days make this job hard. And for me, I think one of the hardest parts is that it doesn't get to me like it used to. But I know that a big part of that is that I've learned to protect myself from it, so that I can still do my job. It's hard to do chest compressions if you're having to think about the outcomes if you succeed in bringing a kid back. Or if you fail.
To end on a lighter note, I finished out the month by swapping arterial sticks with one of the other residents. We need to prove that we can do them in order to graduate, and neither of us have had a chance to do one on a patient, so we offered each other our wrists and stuck each other. Watching the disbelief on the nurses faces while we did it was by far the best part. Well, that, and the fact that now I can graduate.
Pray for my job interviews next week. Hopefully all this experience isn't going to go to waste.
Tuesday, February 26, 2013
Cabin fever
Stuck inside. Again. Two record-breaking winter storms in the last week have buried the city under almost 2 feet of snow (minus some much needed melting over the weekend). Even though I have 4WD, no one else seems willing or able to venture out, so my social calendar cleared itself pretty rapidly, leaving me BORED. I shoveled, watched TV, baked bread, vacuumed, wandered the grocery, wrote a letter...still BORED. Almost makes me wish I were at work. ALMOST.
My fellow residents have been rockstars during these storms, showing up with overnight bags, pillows, and smiles in a not-so-smiley situation to make sure that the kids were cared for. The chiefs have gone above and beyond to fill gaps and keep spirits up. One of the attendings went to Costco before the storm got bad to stock us all up on snacks. The docs in the ER last night kicked as many of us out early as they could, making sure we got home safe. It makes me proud to be a part of such a program, not that I need another reason, and just a teensy smidge jealous that I somehow made it out of the last 4 major storms without ever getting put up in a hotel for a slumber party.
My fellow residents have been rockstars during these storms, showing up with overnight bags, pillows, and smiles in a not-so-smiley situation to make sure that the kids were cared for. The chiefs have gone above and beyond to fill gaps and keep spirits up. One of the attendings went to Costco before the storm got bad to stock us all up on snacks. The docs in the ER last night kicked as many of us out early as they could, making sure we got home safe. It makes me proud to be a part of such a program, not that I need another reason, and just a teensy smidge jealous that I somehow made it out of the last 4 major storms without ever getting put up in a hotel for a slumber party.
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