12.21.2010
Crush
As much as I seriously hate to admit this, I think Kate Middleton is my new idol. If I could dress like her every day I would. I feel like that sums up my style in a nutshell...classic, classy, put-together, not too trendy or flashy, delicate, perfectly tailored...I could seriously go on and on. Unfortunately I will be wearing mostly scrubs in my day-to-day life for the forseeable future and I can't afford all the fancy clothes on a medical student's salary, but for now I have a big girl crush. I can't help it...can you blame me??
12.19.2010
Vacay
Well, it's Christmas vacation...finally! I was so stressed out about my paper that I haven't been excited about it at all. Now after writing 10 pages and using 51 sources in the end, I can sort of relax. Tomorrow I have to drive for another interview, so really Wednesday is when I can let it ALL go and just focus on Christmas and New Year's.
Last rant about my paper, I promise: I found out that the only other girl who is doing this elective right now (and we're the first ones to take it) only used 3 sources for her paper and only had to meet with him 1 time during her 4 week elective (I had to meet with him 3 times in person during my 3 weeks, costing me an additional $500+ in airfare flying cross country to do that). NOT happy, at all. But I can't say anything about it because my professor is a "big guy" in a residency program that will be high on my list...I can't be a complainer before I match there or else I might not match at all!
Now I am going to try to embrace the Christmas season, put school behind me for a few days, and be glad to spend time with my extended family. We'll only be missing my uncle, who is 6 months into his 1 year tour of Afghanistan...come home safe!!
Merry Christmas Season!
Last rant about my paper, I promise: I found out that the only other girl who is doing this elective right now (and we're the first ones to take it) only used 3 sources for her paper and only had to meet with him 1 time during her 4 week elective (I had to meet with him 3 times in person during my 3 weeks, costing me an additional $500+ in airfare flying cross country to do that). NOT happy, at all. But I can't say anything about it because my professor is a "big guy" in a residency program that will be high on my list...I can't be a complainer before I match there or else I might not match at all!
Now I am going to try to embrace the Christmas season, put school behind me for a few days, and be glad to spend time with my extended family. We'll only be missing my uncle, who is 6 months into his 1 year tour of Afghanistan...come home safe!!
Merry Christmas Season!
12.10.2010
Pressure
So many things to update, so little time!
1. My residency interview last week TOTALLY threw me for a loop. I thought for sure my first choice program would be at my home-base, but this last interview was AMAZING. The town is exactly the kind of place I always pictured myself living, where I feel like I really belong; the program has all kinds of cool features (tracks: during 2nd and 3rd year, you get 16 hours "off" a month to pursue particular interests, like toxicology or medical education (totally my thing); scribes: they have a pre-med follow you around and document everything you do while on shift, meaning no documenting/no dictating/way less hassle! This is amazing- documentation is the bane of every doctor's existance); it is close to some of my extended family, etc. It is a program that I would truly brag about being accepted at, and that is very attractive to me. Only downside: I feel that I fit in better with the residents here at home. Not that I don't get along with these other residents; they are very nice. I think it's that 3/4 of them are married and lots have families- they are just in a different place in their lives than I am currently. If I am going to pick up and move far away from everyone I know, I want people who have time to hang out with me outside work! I know that is selfish, but it IS three years of my life here! I am totally torn and very anxious for my upcoming interviews to throw more wrenches in the process.
2. This "reading elective" turned 10 page paper took a turn for the worse 2 days ago. I thought I could write a 10 pager with probably 10-15 sources (journal articles). Oh no. My mentor said he anticipated that I would need to cite 50-60 and that I had to include all of the trials that had been published recently. Whoa. So I did a literature search...1530 articles in the last 10 years only. So what choice did I have? I skimmed through all of their titles, throwing out ones that were definitely not related...that got me down to 620. Then I had to start looking closer at their abstracts (short summaries) to decide if they were worth my time...down to 200. I managed to do all of that yesterday (powered through!). 200 is still WAY too many, so I whimped out and contacted my mentor, telling him that it wasn't realistic to read all of those PLUS write my paper PLUS fly across the country and interview by next Friday, so I had to narrow my paper topic a bit. Luckily he agreed, but now I have to go through the 200 articles I have pulled and throw a bunch more out. Basically I am spending all day/night today doing that. So that means I have to read SO much tomorrow, write a TON on Sunday, and have a rough draft to give to him on Monday (the day I fly out of town til after Christmas). This is SERIOUSLY stressing me out! Luckily, D went out of town so I can hole up in the apartment alone and just pound out the work without any distractions.
3. I only have 5 months and 3 days left until graduation. This is I-N-S-A-N-E. I am not ready for this. I am not ready to leave school behind forever. I am more nostalgic than ever for college. Even though residency is a lot like school still (presentations and tests and assigned reading), I am going to miss school dearly. I am sure once I'm done with residency I'll start working on my BA in Philosophy (something I have always wanted to go back and do). I'll be in school forever!
That's all for now, I need to get back to sorting through articles. The pressure is on in so many ways right now! And I wonder why I have no time for a personal life?!? More on that later...
1. My residency interview last week TOTALLY threw me for a loop. I thought for sure my first choice program would be at my home-base, but this last interview was AMAZING. The town is exactly the kind of place I always pictured myself living, where I feel like I really belong; the program has all kinds of cool features (tracks: during 2nd and 3rd year, you get 16 hours "off" a month to pursue particular interests, like toxicology or medical education (totally my thing); scribes: they have a pre-med follow you around and document everything you do while on shift, meaning no documenting/no dictating/way less hassle! This is amazing- documentation is the bane of every doctor's existance); it is close to some of my extended family, etc. It is a program that I would truly brag about being accepted at, and that is very attractive to me. Only downside: I feel that I fit in better with the residents here at home. Not that I don't get along with these other residents; they are very nice. I think it's that 3/4 of them are married and lots have families- they are just in a different place in their lives than I am currently. If I am going to pick up and move far away from everyone I know, I want people who have time to hang out with me outside work! I know that is selfish, but it IS three years of my life here! I am totally torn and very anxious for my upcoming interviews to throw more wrenches in the process.
2. This "reading elective" turned 10 page paper took a turn for the worse 2 days ago. I thought I could write a 10 pager with probably 10-15 sources (journal articles). Oh no. My mentor said he anticipated that I would need to cite 50-60 and that I had to include all of the trials that had been published recently. Whoa. So I did a literature search...1530 articles in the last 10 years only. So what choice did I have? I skimmed through all of their titles, throwing out ones that were definitely not related...that got me down to 620. Then I had to start looking closer at their abstracts (short summaries) to decide if they were worth my time...down to 200. I managed to do all of that yesterday (powered through!). 200 is still WAY too many, so I whimped out and contacted my mentor, telling him that it wasn't realistic to read all of those PLUS write my paper PLUS fly across the country and interview by next Friday, so I had to narrow my paper topic a bit. Luckily he agreed, but now I have to go through the 200 articles I have pulled and throw a bunch more out. Basically I am spending all day/night today doing that. So that means I have to read SO much tomorrow, write a TON on Sunday, and have a rough draft to give to him on Monday (the day I fly out of town til after Christmas). This is SERIOUSLY stressing me out! Luckily, D went out of town so I can hole up in the apartment alone and just pound out the work without any distractions.
3. I only have 5 months and 3 days left until graduation. This is I-N-S-A-N-E. I am not ready for this. I am not ready to leave school behind forever. I am more nostalgic than ever for college. Even though residency is a lot like school still (presentations and tests and assigned reading), I am going to miss school dearly. I am sure once I'm done with residency I'll start working on my BA in Philosophy (something I have always wanted to go back and do). I'll be in school forever!
That's all for now, I need to get back to sorting through articles. The pressure is on in so many ways right now! And I wonder why I have no time for a personal life?!? More on that later...
11.28.2010
Chugging Along
Well, I guess a month has passed. How is it that when I have more time outside of work/school, I post less? Weird.
My radiology rotation came and went, interrupted by 3 interviews and Thanksgiving. The rotation was easy hours (8-4 M-F), no responsibilities...basically I sat and looked over the radiologist's shoulder all day watching them read films. They were all very nice and tried to involve me, but not much I can do as a student. I am glad I had it as a rotation though, nice and easy and hopefully I learned something.
Now comes some drama. Originally I had the next 5 weeks off for interviews and Christmas. However, I decided last minute to sign up for a "reading elective" (aka 1 hour of reading a day, 1-2 meetings with my mentor = 4 weeks of credit. Sweet!) with an attending at my current first choice EM program, both to learn something as well as hopefully impress them. I laid it out very clearly in my first email that I would not be around very much due to interviews and that if they could be flexible with me, I would love to do this elective. He agreed. I signed up. Then I came to find out that I am expected to meet in person with him at least once a week, read/work about 45 hours/week, and write a 10 page paper. What?!?!?!? I am SO upset about this, basically because this is NOT what I signed up for and if I had known that, I would have asked him to do an informal "reading list/discussion" with me for no credit. However, now that I am signed up, I can't very well back out just because it is a little more work. Alas, I have to spend the next 3 weeks juggling interviews, travel, and all of this work. There goes my vacation!
Interviews are getting to me. They are just fine to go on (although airports and hotels get tiring), but I wish I were getting more offers. After 29 applications, I have gotten 8 interviews, 9 rejections, and have not heard from 13. That is more flat out rejections than I was expecting, and at this point if I haven't heard anything I am not planning on hearing anything. I wanted to go on at least 12 interviews, so this is a bit of a let down. My last ditch effort is to email programs and basically beg for an interview. We'll see how that goes. Frustrating! I still know that everything will work out, but I am getting tired of this process.
My radiology rotation came and went, interrupted by 3 interviews and Thanksgiving. The rotation was easy hours (8-4 M-F), no responsibilities...basically I sat and looked over the radiologist's shoulder all day watching them read films. They were all very nice and tried to involve me, but not much I can do as a student. I am glad I had it as a rotation though, nice and easy and hopefully I learned something.
Now comes some drama. Originally I had the next 5 weeks off for interviews and Christmas. However, I decided last minute to sign up for a "reading elective" (aka 1 hour of reading a day, 1-2 meetings with my mentor = 4 weeks of credit. Sweet!) with an attending at my current first choice EM program, both to learn something as well as hopefully impress them. I laid it out very clearly in my first email that I would not be around very much due to interviews and that if they could be flexible with me, I would love to do this elective. He agreed. I signed up. Then I came to find out that I am expected to meet in person with him at least once a week, read/work about 45 hours/week, and write a 10 page paper. What?!?!?!? I am SO upset about this, basically because this is NOT what I signed up for and if I had known that, I would have asked him to do an informal "reading list/discussion" with me for no credit. However, now that I am signed up, I can't very well back out just because it is a little more work. Alas, I have to spend the next 3 weeks juggling interviews, travel, and all of this work. There goes my vacation!
Interviews are getting to me. They are just fine to go on (although airports and hotels get tiring), but I wish I were getting more offers. After 29 applications, I have gotten 8 interviews, 9 rejections, and have not heard from 13. That is more flat out rejections than I was expecting, and at this point if I haven't heard anything I am not planning on hearing anything. I wanted to go on at least 12 interviews, so this is a bit of a let down. My last ditch effort is to email programs and basically beg for an interview. We'll see how that goes. Frustrating! I still know that everything will work out, but I am getting tired of this process.
10.30.2010
Lighter
On a lighter note: a patient's friend asked me if I was Miss Arizona when I walked into the room the other day. Thought it was pretty funny. Vets always say the darndest things.
10.29.2010
Nail Biter
Patient of the day: 19 month old who was lethargic. She had a lot of other medical problems and had had an endoscopy yesterday. Since then she had been lethargic and vomiting brown. In the ED, she looked pretty bad...very lethargic, kind of hypotonic, pale. She got a LOT worse pretty quickly. PICU came down and we had probably 7-8 people around the bed for this one little girl. Her glucose finally got checked (somehow this order from when she first got into the ED had been overlooked) and it was 1. ONE! Glucose should be around 100, and below 40 is SCARY low. Hers was ONE. I have never seen anything that low, and I have no idea how she wasn't having seizures or how she wasn't dead yet. She was so dehydrated that they couldn't get an IV in, so they had to put an interosseous line in (basically punching a hole in her leg bone to run fluids directly into her bone marrow). She got some glucose which put her blood sugar at 187 and started looking better. She kept oscillating back and forth from looking a bit better to being really lethargic again. We never intubated her and she made it out of the ED to the PICU, but it was a REALLY scary situation. I hope she will end up doing ok. Lesson learned: always check a glucose on anyone with altered mental status...low glucose really can happen even when you're not expecting it!
10.21.2010
The Other Shoe
I should have been waiting for the other shoe to drop after a "fun" trauma. And boy did it drop today.
First patient: 14yo boy in a car accident. Intubated at the scene. Arrives in a c-collar (neck brace) thrashing around because he needs more meds to sedate him/paralyze him/take away his pain. It takes at least 15 minutes to get an IV in him to give him any meds. I felt for this kid the entire way. He ended up having a pretty significant bleed in his head and a number of other things but will hopefully do ok. Naturally it didn't stop there...
Second patient: 20yo man ejected from his car. Intubated at the scene. Helicoptered in. Went into cardiac arrest literally while walking in the door of the ED from the helicopter. His pulse came back for a while, then went away again. About 45 minutes of pushing meds, doing CPR, putting in 2 chest tubes, 2 femoral lines, and finally cracking open his chest and beating his heart for him, he was pronounced dead. If that wasn't bad enough, it was at that point turned into what I'll call a "teaching opportunity" for all the residents, students, and anyone else who wanted to to put their hands in his chest, learn the anatomy, etc. I politely declined to participate, but in reality I am immensely offended that this took place. He did not consent for his body to be donated to science, we were not doing anything to try to save him at that point, and while I understand some people would argue that if he died he might as well be "useful" to teach and learn on I do not agree. I heard stories about this at the beginning of 3rd year (ex. practicing intubating on a patient who had just died, etc.), and always thought "oh that would never happen and I would just say no anyways". Well, it happened today, and I did say no (which I'm proud of), but I'm afraid that it might come back to bite me ("she passed up a great learning opportunity", "she doesn't care about becoming a great doctor", etc.). Even if it does, I'm sticking to my ground and respecting this incredibly unfortunate young kid who died today. I hope everyone will be reasonable and respect my decision.
Didn't really want to tell this story, but it's the first time I've had a patient go from "alive" (with a pulse) to dead right in front of me. It was especially hard with it being a young guy. He was married (wedding band). Just heartbreaking. Definitely shed just one tear for him in the trauma bay before having to pick up and go back to my other patients with a headache and abdominal pain. Puts everything in perspective. Hard day, but I guess if I can't take it I shouldn't be doing this. No choice but to pick up and carry on.
First patient: 14yo boy in a car accident. Intubated at the scene. Arrives in a c-collar (neck brace) thrashing around because he needs more meds to sedate him/paralyze him/take away his pain. It takes at least 15 minutes to get an IV in him to give him any meds. I felt for this kid the entire way. He ended up having a pretty significant bleed in his head and a number of other things but will hopefully do ok. Naturally it didn't stop there...
Second patient: 20yo man ejected from his car. Intubated at the scene. Helicoptered in. Went into cardiac arrest literally while walking in the door of the ED from the helicopter. His pulse came back for a while, then went away again. About 45 minutes of pushing meds, doing CPR, putting in 2 chest tubes, 2 femoral lines, and finally cracking open his chest and beating his heart for him, he was pronounced dead. If that wasn't bad enough, it was at that point turned into what I'll call a "teaching opportunity" for all the residents, students, and anyone else who wanted to to put their hands in his chest, learn the anatomy, etc. I politely declined to participate, but in reality I am immensely offended that this took place. He did not consent for his body to be donated to science, we were not doing anything to try to save him at that point, and while I understand some people would argue that if he died he might as well be "useful" to teach and learn on I do not agree. I heard stories about this at the beginning of 3rd year (ex. practicing intubating on a patient who had just died, etc.), and always thought "oh that would never happen and I would just say no anyways". Well, it happened today, and I did say no (which I'm proud of), but I'm afraid that it might come back to bite me ("she passed up a great learning opportunity", "she doesn't care about becoming a great doctor", etc.). Even if it does, I'm sticking to my ground and respecting this incredibly unfortunate young kid who died today. I hope everyone will be reasonable and respect my decision.
Didn't really want to tell this story, but it's the first time I've had a patient go from "alive" (with a pulse) to dead right in front of me. It was especially hard with it being a young guy. He was married (wedding band). Just heartbreaking. Definitely shed just one tear for him in the trauma bay before having to pick up and go back to my other patients with a headache and abdominal pain. Puts everything in perspective. Hard day, but I guess if I can't take it I shouldn't be doing this. No choice but to pick up and carry on.
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