Sunday, July 27, 2014

Parachuting Caffeine Pills

That title is really just part of my commentary on the dire state of medical training, which is actually a lot less terrible than it used to be, apparently.  Let me give you an little inside look to training, civilians and prospective medical students:

Everyone hears their doctor friends "being on call."  They, including a younger version of me thought: "Whoa, that's really badass.  They're like saving lives and being all cool and respected."  

When really you're spending the 24 hours or so in the hospital managing blood sugars or putting your fist/forearm into a stranger's birth canal for an indeterminate amount of time to tamponade some post-partum hemorrhage, depending on your specialty.  

Call schedules disrupt your sleep schedule, and you end up eating a lot in order to feel better and comfort you psychologically and physically.  For example, I'll work a normal 6am-Xpm week.  Then, in the middle of the next week, I need to flip my schedule and take 24 hour call, then flip my schedule again to be as rested and functional as I can the next work day.  Ad nauseam.  

Multiply that by the rest of your life until you retire (unless you're a dermatologist or something), and you're probably a few pounds heavier and managed to shed a few years off of your life.  I guess being on call is supposed to test you and be extra education/training, but I'd rather do all my call shifts in a row, activate beast mode, and get through it.  Forgot to mention that when you're on call, it's usually just one attending, and you, taking care of anywhere from 10 to 90 patients.  Hooray.

Having all your call "shifts" in a row would be great, but that'd make too much sense.  I'm post-call right now and ready to fall asleep but there's so much I need to do right now.  cheers

Tuesday, July 22, 2014

When med school is less than educational

Sometimes teaching hospitals and the teams in them get so busy, teaching doesn't really happen.  Often times I've seen students be sent off to go fetch food, fax documents, or just be ignored.  There's also just not a lot students can do on surgeries.  90% of the time, students retract, and the other time they suture or cut sutures.  But don't feel bad, it's just the high risk nature. The more you prove yourself, the more you're trusted though.

Med school is a time to "put yourself out there" and impress your team by doing as much as you can for your team, though.  Volunteer to pick up a new patient or go see the new consult.  Teams remember that behaviour and the residents and attendings actually talk about students pretty often. 

Never run out of energy, keep working hard and never stop learning.

Saturday, July 19, 2014

How to make the most out of your rotation

Besides being active and volunteering to do more work, make a list of questions to ask your attending or resident to further your education.  It's best to write down questions as you read a text or clinical research.   You'll look like a star and you'll learn much more. 

Tuesday, July 15, 2014

Blogging on night call

It's quiet so far, some elective cases were done earlier and now things are tame.   Actually quite similar to my time on ortho trauma call, though I can't believe that was actually quiet.

Call is weird as a medical student, there's not really a lot you can do and you often get ignored or someone forgets to call you or text you.   It's a little different if you're on surgery, because then you get to go as a team and you can scrub in and retract and maybe even suture.  

The hardest part of call besides the medicine is flipping your schedule and staying healthy.  A lot of us eat a lot to stay awake or because we're bored and the we gain a ton of weight.  I was lucky to sleep a lot before call tonight, drank probably 3 cups of coffee, and probably 3 Clif shots and I'm less tired than a usual day but it's only 10 at night right now.

There isn't even a resident to follow here right now so I'm just reading and keeping an ear out for things.   Not really that educational of an experience, but that's what its usually like.  Well gotta run!

Taking call

Call night is interesting when you're just starting med school or you're an applicant.  It can be interesting or strenuous on the same service but a different day.  Sometimes you come in at your regular time and work for 24-30+ hours or you come in in the afternoon/evening and work until the next team shows up and sign out (patient handoff) is over. 

It stops being cool about after the first time you take call, honestly.   I feel that while med students should take call in order to get used to residency, a lot of call nights are slow and no one really teaches because they're too tired, or the service gets so busy all your educators are swamped.   I almost wish teaching hospitals had a dedicated educator on the team, who maybe had little to no clinical obligations and just taught a lot, but that's just unrealistic. 

I'm trying to develop more resistance to fatigue and the lack of control over my schedule as it'll only get worse as a resident.  One of the best quotes that helps me is from a WW 2 series called Band of Brothers: "We're airborne, we're meant to be surrounded."   I am accepting getting pushed to my limits as just an inevitability, without really desiring for things to get better.  It's sort of like surrender, I guess. 

Later on I take call twice in the same week with my last call after that.  It's tiring and I want to get through all my training without feeling like it cost me a lot of health and happiness.  Taking things one day at a time has really been helping me, instead of living on a countdown.  Also, planning dates or get togethers has been a great boost because it gives me something nice and non-medical to look forward to.

Wednesday, July 9, 2014

Therapeutic writing on rotations

Started my day around 430am and hardly slept at all last night.  I feel so worn out already and am doing my best to adapt to my new demands. 

I'm doing my best to stay positive and the recent changes I made in my life are doing a lot for me.  I started taking my dog out immediately once I get home and have been really patient and non-grouchy with my partner no matter how tired and stressed I am. 

I feel like everyday of my training is like an academic version of the military: early days, late nights, long hours, high risk situations and constantly feeling tired and hungry while trying to survive in a highly hierarchical system.  At least I haven't been shot at.  

I feel like the expression of negativity by some team members sticks with me more than the positive effects of upbeat coworkers, which is something I need to take care of.  I've seen a lot of depressed and stressed out residents and I really am scared of becoming like them.  I'm constantly hoping I'll have some control over things and just handle things well day by day. 

I'm already over-caffeinated by accident and feeling sick from it so I'm going to spend the next while trying to feel better at work.  Here goes

Tuesday, July 8, 2014

Low morale

I'm hitting the point in my training where I'm taking call more frequently and I miss my loved ones.  Everyone seems to be so excited about starting 4th year but all I really feel is just the heaviness and sense of dread about intern year right over the horizon. 

I'm hoping things go well this year and that I match and go onto more training.  It'll be pretty rough is all.  Oh well