Today is the last day of our first rotation (we switch rotations every month). Since the rotations are 4 weeks each (not actually 1 calendar month), there are 13 rotations total for the year. It so happens that I have the luck of being the last person on call for the block. Presently I am at the hospital in my call room. It has been an uncharacteristically slow day so far (keeping my fingers crossed that it holds out), so I thought it was about time that I start a new blog entry. I'll try and summarize the last few weeks as best as I can.
By way of update to my last blog, the guy who we diagnosed with a brain tumor ended up getting surgery and is doing quite well. He went to the ICU after surgery (standard for neurosurgery), but I was able to go visit him pretty much everyday even though I wasn't responsible for taking care of him while he was in "the Unit." We've developed a really good relationship through all of this. On Thursday, he came out of the ICU and back to the regular medical floor, so I'm taking care of him again. He was really weak right before he had his surgery, but he's recovering a lot now and I'm really happy to see him progress so much. He has definitely been the most interesting, and my favorite, patient so far (... don't tell my other patients, though).
In retrospect, this first month has gone by pretty quickly. I'm sure this year will be long gone before I know it. It hasn't been until recently that I've truly felt like I have completely eased into everything, though. The first week or so was pretty rough - I found myself trying to fight back the nearly constant thoughts that maybe I had chosen the wrong career. Stepping into the role of intern, there is a very steep learning curve just with respect to medical knowledge, let alone the fact that being at a new hospital requires that you relearn a bunch of basic stuff on top of that: how to use a new electronic medical record system, who to talk to for discharge planning resources, where records are kept in the ER when admitting patients to the hospital, what the proper procedure is for entering orders for your patients - the list really could go on and on. It was nearly overwhelming.
I think that it wasn't until I had a conversation with my good friend from medical school, Tim, who's also at the beginning of his internship in Ear, Nose, and Throat surgery out in North Carolina (at Wake Forest, where I'll be next year), that I really started to feel better about things. Tim started his internship in the surgical ICU - even more intense than what I'm doing. About a week after we each had started, we caught up with one another and had a short conversation - I think we were both a little surprised to learn that the other had been going through the same sorts of feelings and thoughts. After commiserating a bit, we each left the conversation feeling a little better. I'm sure it is a common experience among interns to go through those feelings of inadequacy and self-doubt. Having friends to go through it with can be quite therapeutic though.
By way of update to my last blog, the guy who we diagnosed with a brain tumor ended up getting surgery and is doing quite well. He went to the ICU after surgery (standard for neurosurgery), but I was able to go visit him pretty much everyday even though I wasn't responsible for taking care of him while he was in "the Unit." We've developed a really good relationship through all of this. On Thursday, he came out of the ICU and back to the regular medical floor, so I'm taking care of him again. He was really weak right before he had his surgery, but he's recovering a lot now and I'm really happy to see him progress so much. He has definitely been the most interesting, and my favorite, patient so far (... don't tell my other patients, though).
In retrospect, this first month has gone by pretty quickly. I'm sure this year will be long gone before I know it. It hasn't been until recently that I've truly felt like I have completely eased into everything, though. The first week or so was pretty rough - I found myself trying to fight back the nearly constant thoughts that maybe I had chosen the wrong career. Stepping into the role of intern, there is a very steep learning curve just with respect to medical knowledge, let alone the fact that being at a new hospital requires that you relearn a bunch of basic stuff on top of that: how to use a new electronic medical record system, who to talk to for discharge planning resources, where records are kept in the ER when admitting patients to the hospital, what the proper procedure is for entering orders for your patients - the list really could go on and on. It was nearly overwhelming.
I think that it wasn't until I had a conversation with my good friend from medical school, Tim, who's also at the beginning of his internship in Ear, Nose, and Throat surgery out in North Carolina (at Wake Forest, where I'll be next year), that I really started to feel better about things. Tim started his internship in the surgical ICU - even more intense than what I'm doing. About a week after we each had started, we caught up with one another and had a short conversation - I think we were both a little surprised to learn that the other had been going through the same sorts of feelings and thoughts. After commiserating a bit, we each left the conversation feeling a little better. I'm sure it is a common experience among interns to go through those feelings of inadequacy and self-doubt. Having friends to go through it with can be quite therapeutic though.
Tomorrow all of the interns will be switching roles since we're starting a new block. Since I'm on call all night tonight through tomorrow, I'm bridging the two blocks - I'm actually the one intern doing two months straight of inpatient medicine from the beginning. Even though it would be nice to have a little break after this somewhat busy month, I'm glad that I can knock out two of my busier months at the very start. And since the interns that are taking over tomorrow have all been doing something else this first month, it will feel nice to be the "experienced" one for a little bit.
Ok, my call night is over now. I just thought I'd add one thing to this blog before posting. While I was on call, I was awoken by a phone call from one of the nurses at about 5:30 AM; the conversation went something like this:
Me: "Hi this is Dr. Tower."
Nurse: "Hi, Dr. Tower this is ____ up on the 6th floor. Could you please come up here and pronounce patient so-and-so dead?"
Me: (Long pause) "Ummm ... ok."
Now, this was not an unexpected death - it was a patient who had been really sick and who's family had decided it was his time to go. Regardless of the situation, though, unless you work around death a lot, I think it can still catch you off guard. This patient belonged to one of the other interns, so I was just covering that night - however it was my responsibility to go and perform the death examination. There is a somewhat standard set of things you are supposed to do to determine that a patient is actually dead, and these things comprise the death examination. This was my first experience as a physician performing the examination and declaring, "Time of death - 5:45." I guess officially you haven't really died in a hospital until a doctor declares that you have died. In any event, it was another one of the 'firsts' that I have now gone through since starting internship. I've checked off a lot of those boxes now. I wouldn't be too disappointed if it were also my last.
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