Destination Medicine

Friday, June 17, 2011

Umm, yeah, almost 2 years

So Steven asked me if I had blogged in a while. . .When I looked, I realized time really does fly. In all my enthusiasm for a weekend, I feel I should type something, but as the end of third year quickly approaches, the realist in me says that won't happen. Maybe another day. . .

Sunday, August 16, 2009

Summer Ends

So again, I have so much to do and here I am jotting down a few thoughts. Probably because I realize I won't get to blog again until December! So I didn't get near as much done around the house as I had hoped during this "last summer ever." Steven & I are going to try to prioritize tasks and work slowly but surely on them as the days and weeks go by. We'll see how long that lasts! I have some stuff ready for tomorrow, but I am not totally to the realization that everything starts NOW. It has been an amazing summer.

I have had some great experiences in the ER this summer, gaining confidence and experience but also making me realize that I have a ton to learn. I will continue to worship Dr. Oakes, as her amazing ability as a physician is combined with the gift of being an outstanding educator. Not everyone can say that! I am going to head on in tomorrow with chocolate chip cookies for my classmates as we begin the great endeavor that is second year leading to STEP 1. Blech. I don't want to think of that now.

I attended retreat, had a great time, laughed so hard at the skits and films that were put together for the incoming class. They seem to be a great group of people. Well, I must attend to the long list of things to do before I rest. Good Luck, MS2s!

Sunday, July 26, 2009

11 pm - 7 am

A Saturday night in the county ER can bring out the best, worst and weirdest in people. I shadowed last night (again) for the 3rd time in 3 days. I had been at Hermann for 2 days with true shadowing. There are so many people available to do things there, it is just hours of watching. Very interesting watching, but still watching. The county ER is another matter. There is always something for someone willing an able to do, for example, an arterial blood gas, a rectal exam or a pelvic exam or place a Foley catheter. And throw in a lot of good watching, too.

I guess that I will have to start a secret Dr. Oakes society/fan club in which I collect her toe nail clippings and wear them in a vial on a necklace. She is incredible and seems to have decided to have incredible confidence in me. I feel quite honored and humbled by her attention and insight, but I keep wondering when someone will decide I am just an imposter who happens to have a coat, badge and some doctor toys. It still amazes me that I am able to go up to someone in the ER and say "Hi, (person I have never met before) Let's talk about that vaginal discharge." and then they actually tell me things.

Last night there was a woman who had been found unconscious, brought to the ER by EMS using the "thumper" which provides CPR. It really looked bad, but the entire team really worked hard to stabilize her and eventually she was to be transferred to another hospital for more testing. Majority of places in the world, she would not have a chance, many places in the US she wouldn't due to distance to a facility able to handle her complex problems. But she was lucky, getting very sick in the right place at the right time and having the right people taking care of her. She might never recover, she might be dead right now for all I know as I write this, but the ER staff was able to give her a fighting chance and that is where hope begins.

Hope was ending for another woman who was going to miscarry, sad and in pain but no baby was present during the ultrasound. I got to do the ultrasound and learn how to do that but it was not the happy occasion where we were looking for a heartbeat.

There was also a man who was very altered from whatever he had been ingesting. He had more tattoos than you could imagine and would smile and smile. Until security had to be called. His coming down was not as good as getting high apparently.

So don't drink, don't do drugs, don't ride motorcycles, bicycles or ATVs, don't get pregnant, don't drive or have any fun. But if you do, know where the nearest ER is and hope it is not me coming in to interview you! ;-)

Wednesday, July 15, 2009

Blog Fail

So I guess that my hope of blogging more will just go down in the annals of a failure. But this week, the kids are at VBS with Grandma and I have some time. Now I should be doing other things, but I thought I would like to update myself for these last couple of weeks. I can officially say a few things:

1. I am an MS2. I passed. I will be moving on up (well actually down a floor) in the fall. I get to look forward to pharmacology, pathology and a mish mash of other classes to prepare me for USMLE Step 1 and life in the wards.

2. Maine vacations are wonderful. I would love to bottle the coolness and views.

3. I do not want to practice Family Medicine. I spent 2 weeks with a fantastic doctor in her clinic. She practices alone, really knows her stuff, was so helpful and kind to me, but I don't want to do that for the rest of my life. That removes one of the possible options from my list. Now if I can't do anything else, it wouldn't be that bad, but it is not a top choice. I equate it to my teaching days of someone failing a test and coming to me to talk about it. We go over all of the things to do to change the direction they are going in, doing homework, taking better notes, coming for tutoring, asking questions, coming to test reviews, lists of resources and often tons of time from me. Then on the next test, they fail, sometimes even worse because they chose not to listen to anything that I said. It can get even better when they blame me for their situation.

I just can't see myself repeating the don't smoke, don't drink, don't do drugs, don't suck down milkshakes and donuts, don't sit on your fat behind all day and expect to be a supermodel who lives to 125 years old. You are not going to put that on me, bucko. I could see the sarcasm, bitterness and resentment creeping in within about an hour.

3. I really liked my peds preceptorship. Kids just put a smile on my face and my preceptor who happens to also be my kids pedi is fantastic. She has a great manner with kids, parents and staff and YOU WILL COMPLY! But she always has the best interest of the kids in mind even if the parents have broken every rule in her book. But she will let them know that! There is a simple gratification in making the kids feel better, parents more relieved and problems solved.

4. I REALLY still like ER. I have shadowed several times this summer and have seen some very interesting things. I have done an ABG in the femoral artery, started an IV, assisted in draining a knee effusion, done a rectal and taken quite a few histories and mad my feeble attempts at presenting. I even kinda diagnosed a guy with shingles. I have worked in the ER overnight twice and if I am able to sleep within a couple of hours of getting home, I am not too worse for the wear. It is also neat seeing the MS3's in clinic and knowing that in just a year I will be there! I have been so blessed to have been taken under the wing of Dr. Oakes, just an amazing clinician, instructor and now in my book, friend. God works in wonderful ways.

I have seen some unpleasant things in the ER, especially since I have mostly been at the county hospital. People in difficult situations made more difficult by the economy struggling with deciding when to seek health care. I again thank my lucky stars for good insurance and the ability to get care when I need it.

I saw the last minutes of life on 2 people. One had collapsed at home and was brougt to the ER receiving CPR and oodles of drugs. He had been unconscious for a while and never regained consciousness at the hospital. His large family was sequestered in "the room" where the news was broken that he had died. I followed along to listen and learn how to do this one day. Never an easy task that can be made worse by accidently changing verb tense from is to was before you want to do that. The other gentleman had tried to chase down someone who had burglarized his neighbor's house. I heard his last words before he was taken to surgery. He was a difficult case that needed to be moved to the OR sooner than later and those few minutes were precious time lost.

But even with all of that, I still love to go to shadow and I am excited about the second year.

Thursday, May 21, 2009

Time Machine

This time tomorrow, I will have finished the last test of my first year of medical school. Wow, that seems impossible. I was musing over all the stuff that I put myself and my family through to get to this point and now we have made it through one year. Wow. Wow. Wow. I should be studying right now, but I needed a break from microbiology. Too many bugs on the brain. I am also a little sleepy from having shadowed in the ER last night until 10 pm. It was a more depressing day to shadow, but also more gratifying in some ways. I really love the ER though, and I could definitely see myself working there. I am so impressed with the physicians that I meet in the ER, they really know their stuff. I on the other hand, feel like a complete idiot. Since I am a geezer as far as the class is concerned, I think sometimes people think I know more than I actually do. I am going to be scrambling to look up journal articles, clotting cascades, febrile seizures and types of anemia just to fix my understanding of some of the cases that I saw last night.

I can look at how far I have come, but there is still SO much to learn. I am going to enjoy the summer, but I will be ready to get back at it in August. I need to alter my plans for studying some and start thinking about the best way to cram all of the pharm and path in my head without forgetting all of the 1st year material. That will be challenging.

I also can't believe that in just a week my baby girl is going to graduate from kindergarten. Where did that time go? I can track my medical school journey back to 9 weeks after her birth, when I took my first tentative steps toward med school with an undergraduate math class. That seems like eons ago. I know the rest of it will fly by all too fast, as my kids grow, I develop into a physician.

I am also so deeply blessed to have Steven along for the ride. He has been my rock (how appropriate) and is the love of my life. At our wedding, we danced to "Grow Old Along with Me" by Mary Chapin Carpenter. The rest of the line continues "the best is yet to be." I certainly feel that way when Steven is holding my hand.

Saturday, May 09, 2009

Finals, Finally.

I knew it would happen this way. I was trying on that white coat for the first time, just last week, right? I have made it through every lecture, clinical correlate, and lab thrown at me and now all that I have left is finals. Not that the rest is a cake walk, but now, it kind of looks manageable. Except for neuro. I am having a problem with neuro. The last test just wasn't what I expected. I studied for hours, including arriving at the LRC at 4:15 in the morning of the test to get a nice 8 hour block in before the test. The test was just not what I studied for, it was an imposter. So I finally graded it and failed. Not by much, but fail. The really frustrating and gnawing evil is what I missed because of the test. At my daughter's school there was a Mother's Day breakfast. She sang and danced and at the end, runs to mom to give her a big hug. Except it wasn't mom. It was my mom, which was fine. I just can't believe that I worked so hard and ended up failing and letting my mother's day hug be placed on anyone else but me. It was one of the only time this year that I feel I really let her down. There have been other instances, but this was a biggie in my book. No one else can fill in for mom on mother's day. Abigail didn't seem to mind that much and told me all about it and gave me the book that all the kids presented to the moms. In it, she answers questions like "What is a mom's job?" Her answer: "To study." and "What does your mom want for Mother's Day?" Answer: A syringe. I hope no one thinks I am an IV drug user from that answer. Another little girl whose mother works for the DEA stated that her mom's job was "killing bad guys." so maybe the syringe part isn't so bad.

I still really love everything that has happened this year. I have made wonderful friends, seen amazing stuff and been able to meet and interact with amazing faculty. I am in a great place and I don't want to be anywhere else. That includes repeating Neuro next year, so I had better get back on the ball and study! Six more exams and a little freedom!

Thursday, April 09, 2009

Why yes, I should be studying. . .

I have a micro test tomorrow. I really don't want to study. So, I am taking the time to do everything else that I can think to do other than study. Hence, I blog. I have made a fairly important decision that will impact my entire future. I want to go into Emergency Medicine. I have been shadowing as much as I can with the full time schedule at school and family. I have only shadowed ER, but it is so great. It really matches my profile. . .It is fast paced, you never know what is going to come into the door, you can really impact people's lives for the better and you get to see all sorts of stuff. I had come to the realization in my teaching career that I was great at getting a project going, starting quick, writing curriculum, managing the initiation of new projects, organizing people and events. My downfall was always the continuation of the project. I guess that I get bored with the nitty-gritty detail work that continues forever. So I have come to realize that I don't want to do the same thing day after day (ie specialize) nor do I want to treat patients year after year for problems that they aren't doing anything about. Well how about that cough, didn't we talk about you not smoking on the last 20 visits? Or, how about you put down that bag of Cheetos long enough for me to look at your non-healing wound on your arm. And how long have you not followed the diet and exercise plan? And is it really more important to have all the movie channels to watch instead of paying for your medicine? And do you here the sarcasm that will get me run out of any family practice?

But I know there will be crappy stuff about ER, but it will be a different, rotating crap. I can be bitter about different things, not the same thing. I say hopefully. That is if I pass neuroscience. I hate neuroscience. It is interesting, but just TOO MUCH. It needs some retooling. Some of the class is fantastic. There is a neurologist who presents clinical correlates that are great and tempt me to become a neurologist. But not for long. Today's test for example was an exercise in failure for me. I am not looking forward to grading those scantrons. Hopefully they will put the scantron copies in our boxes tonight so I can grade it tomorrow in private, so no one hears all the x-ing I have to do and then the subsequent cursing.

But again, I still love it. There is this inner happiness that I feel that I am in medical school, almost one year in and ready to tackle the next. I am so looking forward to the clinical years. I realize that there is SO much I have to go back and review, but there is a lot that has stuck. And that is exciting.

I have also gotten two preceptorships lined up for this summer. I will spend 2 weeks with a family doctor in a nearby town and then 3 weeks with my kids' pediatrician. She is really a neat person and I am looking forward to that experience.

I am not looking forward to getting up at 3 am in the morning to start my day, but is the last day of tests for this block, so there is some relief that we just have one more block and then finals. I think I can, I think I can, I think I can. . .