I shake the elderly woman’s hand as I greet her. Two minutes later, she holds up her pointer and middle fingers and states “Most of the time, I just dig out the boogers with these.”
Ew. Double wash and purell on that one.
I am still tired. It’s not depression but actually frustration. Frustration that the past six weeks have been so long and drawn out. I sit around for most of the day because my attending thinks that having a student in the room is awkward. What’s the point of my being there then? I have been told that this rotation has not been accurately reflective of family medicine as a whole. I dont think I can practice medicine in the outpatient setting. I am an inpatient kind of lady. I like the intellectual challenge and that has been lacking for awhile. I know I would burn out if I had to see uncomplicated URIs and UTIs and annual physicals day in and day out. For some people, this is the perfect setting for them. Not me.
For the last 6 weeks, I have felt trapped in this rotation. I have been itching, clamoring for it to end. As of Friday, I think that I will feel a great sense of relief.
I am so tired. Emotionally. I can not stand being on family medicine. It is the most boring thing ever. Day in and day out, I see extremely wealthy people who have an outrageous sense of entitlement. A cough for 24 hours?? Call out the national guard. Call the President. This is an emergency! You want a Z-pack for that sore throat of 45 min without any associated symptoms? Of course! What the hell was I thinking with Centor criteria? Geez!
Ten days til this rotation is over. Amen.
I’m tired and my neighbor fed me two glasses of wine which have made me more tired. So I am going to sleep but I shall write again.
So as I approach the end of this rotation, I look back and realize it was a weird one.
Things I’ve learned or confirmed during my OB/GYN rotation:
1. Babies should breathe. When they don’t, it’s bad.
2. Fetal heart rates in the 30s warrant stat c-sections. Actually, I knew that but convincing my attending who was nowhere near the patient’s room took longer than I felt comfortable with.
3. Staff with whooping cough is bad.
4. Eat before surgery. If you don’t eat and pass out, don’t fall into the sterile field. (Don’t worry, I fell backwards. Two staples stopped the bleeding.)
5. I liked urogyn surgery. That is, I liked it until I had to do a pessary check. Upchuck reflex. If you don’t know, google it if you dare.
6. Re #5: Don’t vomit in the patient’s room as someone is changing a pessary. The nurse felt guilty after but happy she made it to the trash.
7. Labor and delivery is, in a nutshell, the following: Get pregnant, check fetal heart tone, check fundal height, check GBS status, check 1hr or 3hr GTT at 28 weeks. Go into labor, get epidural, pop kid out. Repeat. There are slight variations for c-sections.
8. Overnight call wasn’t too bad. Got 4-5hrs of sleep each time.
9. Jehovah’s Witnesses with Hct under 20 are not ideal candidates for a total abdominal hysterectomy.
10. The nurses who hate one of your attendings may love you just because they feel bad that you have to work with that attending.
11. Be nice to everyone.
12. Ask/Offer to do things. If you don’t do the little things, you’ll never get to do the big stuff.
13. Ferning looks really cool.
14. Have fun.
I ache… One solid week of OB done, including a 32 hour call with only an hour of sleep. I really like the field. I have been privy to an incredible amount of social issues that are kept behind closed doors and to the happiest or saddest moments of life. I’ve watched a mother refuse to acknowledge the child she just birthed. I’ve seen a young woman collapse upon learning her new ovarian cancer diagnosis. I’ve seen happy couples turn into happy families.
Oh but my body is so tired. Every muscle hurts. This week is going to be interesting… 3 call shifts…
Board scores came back. 221. I would have thought I’d be disappointed but actually, I don’t really care. I passed solidly.
Oh man. It’s only Day 1 of OB/GYN and already I’m tired. Most of it is getting up at 5am all week so as to set a new sleep-wake schedule but I can already tell I might be more than a bit curt or witchy post-call. I went grocery shopping and found myself in a zombie-like state. I wondered down aisle after aisle, forgetting at times why I went down that particular aisle. I came home and put the Ben & Jerry’s into a cabinet and not the freezer. FYI: Melted ice cream tastes almost as good as frozen.
Did you know that the full-term uterus can rise as superior as the xiphoid process? I kinda rethought the whole childbearing thing when I heard that…
Still no Step 1 score…
Moving is such a pain but thank goodness for music! I am amazed at how much stuff I have accumulated over the past few years. I’ve been throwing things out like crazy and still have so much to pack. T-minus 4 days to get the rest of my place packed into boxes, change my address, update said address with all the relevant loan sharks, and clean my place. The thing about having no other responsibilities right now is that I can go at my own pace and enjoy wine while doing so. I’ve been treating myself to a glass of vino and takeout every night and it’s been great.
Currently playing on the iPod: Classic Michael J. RIP
That s*@t was hard! I woke up and had a solo dance party with the Scissor Sisters. I got to the testing center at about 8:45 and was taking my test by 9:15. On one of my dry erase boards I wrote in large print: “BREATHE” and left it there for the day. It was frustrating at times as the test center staff could be heard talking at times. I’m glad I brought earplugs. They didn’t have them at the testing center, only a pair of sound-reducing headphones that were mediocre at reducing sound. I took a 5 minute break after every block and a 30min break for lunch. I kind of just wanted, and needed, to plow through it. I was finished around 3:30. I left there and I have no clue how I did. All I can say is that was the most challenging exam I have taken. Three-four weeks is the supposed turnaround. It will be either a great or a terrible way to get into my OB rotation. Yup. I start with OB. Delivering babies! That for sure will help drown out my own ticking biological clock (note sarcasm).
So I have a couple weeks until rotations start. I spent a day in the city enjoying the beautiful weather and have spent a couple days packing up my apartment for my upcoming move this weekend. I’ve spent most of this time, and probably the next couple of days, by myself. It’s been nice to focus on me for a little while.
So, to all those who have Step 1 coming up, good luck! Breathe! Take breaks. Eat candy (if that’s your thing).
So, in trying to relax before boards tomorrow, I’m watching crappy daytime TV. This includes the show “The Doctors” and I have found myself yelling at the TV more than once. For instance, the doctors on this show were covering what they felt parents should look for to determine when to take their child to the ED for an asthma attack. They talked about how a home pulse oximeter is a good tool. The show’s pediatrician said that a normal reading was above 90. Bullshit. If an asthmatic kid, or any kid short of breath, has a sat <95%, it’s a problem. Kids compensate for a long time before they crash. A resp rate greater than 40 or 60 was a signal to go to the ED according to the pediatrician on this show. He said a normal RR for an adult was 20/min and that normal for a kid can be 30/min. Depending upon the child’s age, this can be correct or incorrect. If any child is having difficulty breathing, don’t depend upon a home pulse oximeter or wait until the child changes color (the show actually inferred that if color is fine, a parent can wait). Call your pediatrician or go straight to the ED. And if the child is in mod-severe distress, call 911.
I’ve said it before, this show is so incredibly aggravating. The information provided by the show’s doctors is often misleading and can be so wildly inappropriate. I’m sure Oprah would love them.
Five days to go. Woohoo! Thanks for the positive comments! It’s crunch time and I know my areas of weakness so I think I can cover it.
I spent the day in the library, banging out hour after hour of bugs, questions, and drugs. It was a beautiful day out and I really wanted to sit by the pool and do nothing. But I resisted that temptation and actually got a lot done! And now, it’s time for… COPS! Yes, my secret indulgence is the TV show ‘Cops’.
My apartment is beginning to reflect the state of my life right, books everywhere. I haven’t done a full length test yet but probably will Monday. I’m looking forward to Friday because after that, I’ll be able to tend to the non-Step 1 things in my life that I’ve been putting off. I have to pack to move into my new place, see my family, run a bunch of errands, do laundry, clean my current apartment, and move. All before I start my OB/GYN rotation. Not a bad way to start off third year, delivering babies.
So five days left to cover neuro, antimicrobials, chemotherapeutics, and some more biochem.
