Day 2877: Happy St. Patrick's Day, indeed

I had such a great day today.

We had a new attending, as we do every Monday, and I impressed him enough for him to tell me so! Our fellow is great, she preps up for each upcoming attending -- how they like presentations on morning rounds, what to include, what not to include, good posture, etc. Well, I did what I've been working on all month, which is give my presentation without looking at my sheet, and it has been paying off. The attending last week thought I gave a great presentation and the attending this week told me so today. It was how and what he told me that is worth blogging about.

It was a good day on rounds, and then I scrubbed in to the first case with said-attending. When you walk in to an operating room, you (a student) are supposed to write your name on the whiteboard so they know who the heck you are. As I was doing that, my attending turns to me and says, "Jessica, you are doing everything right. You gave a great presentation today, and you are writing your name on the board, and you are really doing everything right." After thanking him profusely for his compliments, he continued on, saying "Really, Jess. Your presentation today was probably the best I've heard from a medical student in a few years." Insert more profuse thanks.

And! On top of all of this, my fellow and I were chatting before the surgery and she said that I "talk like a surgeon" and she was persuading me to pursue surgery (rather than medicine or med/peds) as a career. "Med/Peds is, what, four years?" "Yes." "You are most likely going to specialize, which adds at least another year to your training, which makes it five years. At that point, you might as well be a surgeon." "Huh." She did make a valid point. I have always fantasized about being a bad-ass surgeon. And the praise that day didn't hurt. But the hours are long, and I'm tired, and I need to remember that just because I do well in this specialty doesn't mean it's necessarily for me. It just means I'm a good team player and learn quickly.

But still...it's fun to dream and it's even more fun when people think you're good when you're only a lowly junior medical student. Almost makes the 5:30am call times worth it. Almost.

Day 2876: Suture clinic

Hey all, I forgot to post these pictures the day they happened but better late than never.

On March 4th, we had suture clinic. We were taught how to suture and tie in different manners. We cut in to pigs' feet to get the feel of skin and subcutaneous tissue and fat. Here are my results:

Vertical mattress sutures

Simple running stitch

Running subcuticular stitch

Simple interrupted sutures

Not bad, eh?

Day 2874: I am not a surgeon

I did my first of four overnight calls Monday night. I was at the hospital at 5:30am and left at 8:30am Tuesday morning. I slept for 30 minutes, from 3:15am to 3:45am, when I asked my senior resident if I could nap before I scrubbed in to a surgery for an incarcerated hernia (= a benign hole in you muscle tissue that your intestines can protrude through; incarceration = stuck = bad = possibly dead intestines = sad face).

In the operating room, I was dead tired. I was bored out of my mind. I didn't do anything. And of course at 4 o' clock in the morning, my attending decides to teach and ask questions. I could barely keep my eyes open, much less tell you about the incidence of incarcerated inguinal hernias.

Then, Wednesday, my next day back to the hospital, I was out of it. I was tired all day, I couldn't scrub in to surgeries properly, I was cranky, I was crabby. I feel like all of these things suggest rather obviously that I am not a surgeon. I don't love being woken up in the middle of the night to operate on kids. Maybe if I was doing the operating, it would feel cooler. And, per all the surgeons, operating is fantastic because you get to directly affect change and see results pretty soon thereafter. Versus medicine, which is what I want to pursue, relies a lot on patient compliance and is a slower process for any form of success.

I don't know kiddos. I like procedures. But I think I like my life more than I like doing stuff. So, goodbye surgery. You were never on my list of to-dos (you kind of were with urology, but certainly not general surgery) and it seems to have stayed that way.

Day 2865: PS - All Things Round

In an attempt to keep posting, I have drummed up a new series. Themed pictures! Why? Because themes are fun! And pictures are even more fun! :) The only rules for this series are to have recent pictures featured (within one month).

The first of our series, all things round.

Day 2864: Where has the time gone?

I am really hoping to ramp up my posting from here on out because 2 posts in the past 62 days (since the beginning of 2014) is a little ridiculous. Also, have two posts in a row discuss time (and how bad I am at it) is another sign of what a bad blogger I have been to you all.

Anyway, I completed my internal medicine rotation on the 28th and...I have to tell you something. I loved it. I didn't think I would inpatient medicine at all (inpatient = I see and take care of hospitalized patients), based on my enjoyment of outpatient medicine (outpatient = seeing a patient in the clinic) and my complete lack of inpatient medicine exposure. But I gotta tell ya, I truly enjoyed it. The cases were varied and extremely interesting. My attendings over my two-month rotation were fab-tacular. I had a great team on wards (wards = students, residents, and one attending taking care of a number of hospital patients), which I contribute to my continued desire to pursue medicine.

I have officially put urology to bed and I will be pursuing a residency in either med-peds (outlined in this post) or solely medicine. It's exciting to know I am moving in the direction of my future, wherever that will take me.

More posts (of varying substantiality and length) to come within the week.

I PROMISE.

Day 2833: I don't know where the time goes

I feel like I just wrote my blog post yesterday and I feel like I just had my New Year's Eve fun two days ago. I honestly don't know how this month is almost over.

Today, I met up with my Step 1 group. Have I told you about this? I (along with two classmates) am mentoring/guiding second-year medical students about their upcoming board exam; giving them tips about what to look out for on the test, ways to remember stuff, etc. It's crazy to me that I was in their shoes just last year, and what's crazier is that I actually remember stuff. If only I hadn't let the fear of my future paralyze my ability to hold information in my brain. It feels overwhelming still, to study for Shelf exams (more standardized exams, at least this time they are about one focused subject, such as internal medicine or psychiatry), but it's nice to have these sessions where I am reminded that a) I do actually know something, and b) I have actually progressed.

Being in the hospital is great because I interact with patients and feel way more like a pretend-doctor than I have so far. It's also tough because I am constantly reminded of how little I know. I have a long way to go, and I am learning now why that is. If I could learn all this stuff in two years, and know it, well, anyone could. Everyone could be a doctor in two years. The 7+ years of training that physicians go through (medical school and residency) is for a good reason. You have to know this stuff in-and-out before it's time to actually have the responsibility of other people's lives on your shoulders. It's scary, but cool to know that when I am five years into my MD, you can actually trust me to know something. Have no expectations before then though ;)

Day 2824: Hello 2014!

...14 days later.

I am currently on the first of my two-months of internal medicine. And. Surprisingly. I love it. I am currently on the hospitalist service (a hospitalist is someone who takes care of emergency-department-admitted patients in the hospital. They do zero time in the clinic/outpatient setting) and I really enjoy it. I didn't think I would like in-patient anything, but I was surprised by the continuity of care. I also like the diverse patient population (young folks, old folks, weird diseases I learned about in pathology but didn't think were real, exacerbations of chronic issues like diabetes). And the hours aren't awful either (the hospitalist service where I work/learn are two weeks on, two weeks off).

I had an epiphany last week that I might want to ditch family medicine for an internal medicine-pediatrics combined residency. It is a four year residency (compared with the three-years it takes for family) and I would be double-boarded (aka certified) in internal medicine and pediatrics. That means I will be supah smaht and can work in whatever field (inpatient or outpatient settings) and with whomever (kids or adults or both) I want. Sounds pretty sweet, huh?

In addition, I am learning that I like my free time. I like being able to sleep (in). I am also learning that I work to live, not live to work. I want to enjoy my work, don't get me wrong, but I don't want it to a) define who I am as a person, or b) take over my entire life. And I worry that urology, at least the five-year surgical 80-hour-work-week residency, may not be it for me. I hear attending life (life after residency) is good, but I am having a truly difficult time looking beyond those five years. Those five years will be marriage and baby-making time if I have any say in it! And a surgical residency is not the time to be planning weddings and popping out fetuses...or at least I don't think it is. I don't know. I really don't know. All of this is a lot to think about and I still have to learn stuff that I am constantly forgetting and I still have to be awe-inspiring. Ugh. I'm going to bed.

Talk soon. xxx