Friday, August 4, 2017

Saturday night in the ICU

I have a flood of memories.  On a night where people are usually going out and enjoying themselves in dim bars or or under bright club lights, a family member waits outside an ICU room while their loved one is intubated. 

The patient wanted everything done despite a terminal prognosis of a few days of life at most.

The family sat outside, in shock as everything sank in.

Later on the patient passed away intubated unable to tell their family they loved them. 

Not many people choose comfort care because they think they're giving up.  But if you're not expected to live for more than a few days, there's nothing wrong in having your air hunger treated and receiving medicine to help you be comfortable and give you the best chance to say goodbye, since it's extreme difficult and uncomfortable to communicate while on a ventilator. 

Flashback to intern year

I've been reflecting a lot about previous months over residency as each year goes by. 

A long time ago I was working in the ICU and can't forget hearing sobbing in the hallway at all hours of the day and night. 

Every other day seemed like it had an emotional end of life discussion.  I pronounced a patient dead and filled out all the paperwork during pre rounds. 

Families who wanted everything done often saw their family member just get put on more and more pressors or require higher mechanical ventilation settings. 

I've met some med students who are so interested in critical care but the emotional aspect took such a toll on me that I could never consider it as a fellowship. 

This week I will have my first day off in 2 weeks of 12 to 14 hour work days and I can't wait to just get away and think and reflect and be at peace. 

I'm going to spend time with my family and hug them and catch up with them and feel some of my sadness and stress bleed away. 

Thank you to everyone who continues to read my blog. Thank you for being a part of my lonely journey.

Sunday, July 30, 2017

I feel so weary.  I feel like I'm beyond coffee helping me feel like I can cope with the day.  By the end of this week I'll have gone 2 weeks without a day off.  I'm so emotionally exhausted and I don't think I've had enough time when I'm not exhausted physically to just decompress and reflect. 

Sometimes I wish I were simpler and didn't think so much.  I'm getting through life one day at a time and sometimes an hour or a task at a time.

I miss my upper level resident friends who graduated and moved away, too. I feel like that adds to things.

Maybe one day things will get better

Friday, July 28, 2017

A nurse asked me to write for opioids for a hypoxic fluid overloaded patient in acute renal failure. 

How are these people paid more than me?

Wednesday, July 26, 2017

Been working so hard and been so busy since I started residency that I only eat one meal every 24h.  You kind of enter a stress state that suppresses your appetite sometimes.  But I feel like I'm making progress, especially with challenging high risk procedures

Tuesday, July 25, 2017

Just trying to get through this rotation a day at a time.  Yesterday was my worst day a work in a few months, absolutely terrible.

I'm hoping today is better.  A good bit of residency is also getting over things and suppressing bad memories.  This week has to be better.

I'm going to likely try "micro blog" style from now on because my time is so limited but I don't exactly want to open a Twitter account. 

I just really need a place to express myself and maybe someone will hear my voice and listen.  I've tried talking with other doctors about my situation but we all get busy and lose touch. 

Thanks to everyone for their kind messages of support.  Residency is difficult and made worse when you have the blues. 

Thursday, July 6, 2017

Alone in the fields of medicine

This year is the first year I've been alone on a service on call.  I felt anxious and directionless at first and now I feel mostly lonely and melancholy.  There aren't many emergencies here to stress me out but there are a lot of new situations I find myself in.  Fortunately I have some time to learn on my own and make decisions. 

In residency which is a time where you learn to be a proper doctor, there are many times you don't receive teaching, instruction, or advice.  The culture of medicine can be extremely impersonal and isolating, and I find myself continuously enduring waiting for it all to end.

If you find yourself feeling alone, some of the things are to bring food from home or a place you like to order from, and carry things in your backpack like a small speaker or a tablet or some drinks you like.

Remaining hopeful is the most important thing, as hard as it is.  I know I'm frequently sad and stressed and this year will be no exception.  Hopefully I'm stronger than last year though. 

There is so much pressure and stress in medicine that I'm not sure if I'd choose it again.  I miss my loved ones everyday and I know they have been damaged by my medical training. 

If you're a lonely intern in July by yourself, remember there's someone out there thinking about you and cheering you along.