Thursday, December 31, 2009

Happy New Years Eve!!

In a few hours from now, it will be 2010, and another year in med school will be done. It's almost hard to believe that this time next year, I'll have already applied for the match, hopefully be in the middle of interviews, and be close to graduating! This time last year, I was getting ready to head back for my final semester in SXM. Since that time, I've finished basic sciences, taken (and passed) step I, completed two core rotations, and I'm currently a month through my third. I guess that things are moving right along and honestly, going pretty well!

So, I wish everyone a very happy New Year. To my friends who are still on the island, about to finish up...only one semester left, and it goes by fast! I know that the island is very difficult to enjoy while you're still there, but try to at least enjoy the'll miss a little of it when you're gone. To those in clinicals with me...have a great New Year in the states, not having to worry about going back to SXM in a couple days!! It's good to be back.

Tuesday, December 29, 2009

Saturday, December 26, 2009

Tuesday, December 22, 2009

finally get to be comfortable

Each day, my IM rotation is enforcing the fact that it never hurts to ask. Today, I asked if we could wear scrubs over the holiday. I mean, they're making us work the holiday, so isn't it the least they can do? Fortunately (and surprisingly), they said it was fine. So, tomorrow I will be wearing pajamas to work...or at least it'll feel that way. Can't wait until surgery when I get to wear them every day! A shirt and tie looks nice, but it's just a pain to get dressed in it every day, so early in the morning!

Monday, December 21, 2009

In other news

Aside from my current disdain for Obama and the democrats, today was a pretty good day. We switched services today, and I'm now in the CCU (coronary care unit). For those not in the medical field, it's an intensive care unit for people with heart problems. The hours are better, there is far less running around the hospital involved, there are less people to deal with, there is no call, and there is good teaching. So, all around, I think I'll like this rotation much better than the other units. Unfortunately, I'm on this unit during christmas break, which means I spend half the time here. I would have rather been on the floor for the break, so I'd only have to be there for one week. But, I guess I'll have to take what I can get. The last two weeks, no one is rotating in the CCU, so I'll see if I can get myself back there again, since I didn't get as much time there the first time around! By the end of the rotation, I have a feeling I'll be more than ready to be done, so it might be a nice way to end things.

I also got to see a cardiac cath and bronchoscopy today. The doctors doing both procedures were very friendly and both tried to teach me as much as possible about the procedures. I've seen a cardiac cath before, but only from behind the lead glass. It was much better to actually be in the room, with the doctor telling me everything he was doing. He was way to fast for me to catch everything and remember everything he said, but at least I understood what was going on this time. Funny with every other specialty I've seen, someone has commented that I won't want to go into that field anymore once Obama is done screwing with reimbursements. I've been hearing an awful lot of negative lately about this health care plan and really no positives from anyone. Maybe that's because MOST americans are opposed to the healthcare bill and only 25% of Americans approve of the job congress is doing? Maybe the congress people should pay attention!?

Dear Obama...

you're an idiot!

Obama is not qualified to run a restaurant, more or less a country. You can disagree with me if you want, but you will see soon enough. It may take a few years, but if you think that US healthcare is bad haven't seen anything yet.

Think it's a good idea that health insurance companies can't turn people down for health insurance anymore? Well, they may not turn them down, but they will make it so that it's unaffordable. Think it's good that the insurance companies are going to be taxed out the ass on "premium" health care plans (read: the better insurance plans)....not so fast. The insurance companies aren't going to just eat those costs...they're going to pass them on to the people who buy insurance. Think that lowering medicare funding is going to help people with medicare and medicaid find a doctor who will accept their insurance? I cannot emphasize enough what a victory the republicans scored (thanks to an independent) in keeping out the public option, but damage is going to be done, and a lot of it. Oh...and so much for reproductive rights, or a women's right to choose.

Change is probably coming, but you'll soon enough find out that it's not the change you were hoping for. You don't need to believe me now, and you can comment what you want, because you'll see soon enough. Fortunately, there is work left to be done. The senate bill has not yet passed, and if it does, it needs to be combined with the House bill. I can only hope that they either can't figure out how to do that, or that the republicans can stall it long enough to get themselves more votes in 2010. And make no mistake...they will have more votes in 2010, after the disaster that Obama and the democrats have created.

Wednesday, December 16, 2009

some good news today

I found out that I passed both my peds and psych subject exams, which I took two weekends ago. And, although I was a little worried about failing them, I wound up doing a lot better than I had expected. So, since I got good evals in both and passed the exams, I will honor my first two rotations. Now I just have to hope that I can continue to keep up this pace. At the moment, I have most of the residents at my IM rotation loving me for finally getting a major computer program fixed. I've managed to go 6 weeks, twice, without pissing anyone off, so I just have to make sure I can do it for 12 weeks straight now ;)

To everyone who thought I couldn't keep my mouth shut when I really had to...I told you so!

Oh and by the way...Rome pictures have been added to flickr.

Saturday, December 12, 2009

one week down

...and 11 more to go! I have a feeling that this is going to be a long rotation. Internal Medicine is a whole lot of talking and writing, and not a lot of actual do-ing. For your info, I'll give you a little run down of how our day goes:

Get there around 6:30 and update the sign-out (a database with all of the patients assigned to our team). Once that's done, I usually walk around or check the computer to see how my team's patients did overnight. At 7:25, there is a short meeting, just to see how many patients everyone has, and redistribute as necessary. From then until noon, it's mostly just rounding and seeing patients. At noon, is noon conference (appropriately named). Some are more interesting than others, but all of them are a full hour lecture, so not terribly exciting. They do serve lunch there sometimes though, which is nice. I really love drug reps!

After noon conference, you see patients some more. Again, there is usually plenty of time to study, research, or do whatever you have to do. This may change though once I get on another team, since there are no teaching rounds on my current team. I did get lucky though, and I think I'm on the one team of two students that will get both Christmas and New Years off! We also change teams every two weeks, so I'll get the chance to work with many different doctors and patients. The day typically ends around 4-5, although sometimes a little earlier or later. We do not ever have overnight call, and we don't work many weekend days, so it's a pretty nice schedule!

I also like the hospital so far. Despite rumors I've heard, all of the residents have been very nice to me and very easy to get along with. Some are better teachers than others, but no one has ever been nasty when I've asked a question. There is a huge variety of patients and I think that by the time this is over, I will have seen pretty much anything the step wants to test me on. They also have a pretty nice computerized medical record system, which makes everyone's life easier. So, my current conclusion is that it's a good program with good residents, if not the most interesting rotation. But, that's just because I'm not personally particularly interested in IM.

Wednesday, December 9, 2009

First real day of call

Today was the first day that I stayed at a hospital past 5. Not only that, but it's also the earliest I've ever gotten to a hospital (just before 6:30AM). I wound up getting out just before 8PM, after a very busy long call. We started the day with 4 patients. After call, we now have 8, and my partner team also got 4 more. Fortunately, only one doesn't have insurance, so that's the only one we'll have to round on.

I also earned myself some brownie points, although most people won't realize it until tomorrow. There's a little program we use called signout, to update the patient information sheets every day (or a couple times a day). Even though just about every resident and student in medicine has to use it, it was only on 2 computers. I managed to get it working on another computer, and am working on a few more. But, at least there are now 50% more computers running the program!

Monday, December 7, 2009

Well, that wasn't so bad

The first day of IM went OK. Given, it was just orientation, but could have been much worse. Turns out, I overestimated (rather, was given wrong information) on how often I'll be working late. Actually, I'll only be there late once every 4 days, and even that is only until around 8PM. My senior resident seems to think that on most days, we'll be out around 4. Still a long day, considering we have to be there around 6:30, but not awful. I'm also not sure what's going on with holidays. Unfortunately, and for absolutely no good reason that I cant think of, students currently have to work either Christmas or New Years. There's really no good reason for this, but fortunately one of the senior residents agrees, and is working on having it changed. I'm not holding my breath for the change to happen, but it would be nice. It was also nice to see that of all the senior residents we heard from today, all felt that it was a medical student's job to learn, not to be scutted out all day. We do have to update the patient information every morning, which is basically scut work, but it shouldn't be that bad. Like the other rotations that I've completed, it seems like for the first week or two, I'll just be figuring things out as I go.

One exciting piece of news...I got a pager today! Well, it's not really that exciting and I'll probably wind up hating the thing, but I like it at the moment. Since no one in the world except doctors use pagers anymore, it makes me feel very doctor-ish. I've also ordered a new lab coat (without AUC's logo) and some books to go in the lab coat, so that's even more doctor looking. In less than 2 years, I won't have to pretend anymore...that will be nice.

Sunday, December 6, 2009

goodbye, sleep

Today was my last day of "vacation." Tomorrow begins 7.5 months of a minimum of 70 hours a week, with absolutely no vacation. I have to be at St. Agnes tomorrow at 8am for orientation, but I'll probably have to be there around 6:30AM after tomorrow. From what I hear, IM is 70-75 hours/week. Surgery and ob/gyn will both likely be worse, and I have no break in between any of them. I was also just thinking tonight...I'm glad that St. Agnes IM apparently doesn't have night call, but I will have late call every 4th day. That means I'll get home somewhere around 11-11:30 PM (after getting in at 6:30AM), just to go upstairs, fall asleep, and wake up a few hours later to do it all again.

It's been fun, sleep. I'll miss you....

Saturday, December 5, 2009

two subject exams down

...three more to go. today, I took the psych and peds subject exams. Neither one was unfair, but they were not easy either. Peds was harder, but psych was definitely trickier than I expected. But, I'm not really worried about them anymore! Right now, I'm just happy that it's snowing here!!! Having been in the caribbean for the last two winters, it's been a while since I've seen snow, and I sure did miss it. It's very pretty outside, at the moment. Unfortunately, I won't have any time this year for a real ski trip.

I did get to talk to a coupe people who did IM at St. Agnes recently. They were able to tell me the schedule, which is actually not as bad as I was expecting, but they gave completely conflicting reports on how it was. One girl liked it, the other person thought it was the worst thing that could happen to her. I'm guessing it probably depends on the person, like most rotations. Many people hated my psych attending, and didn't do well, but I liked him a lot and did very well, so I guess I'll just have to find out on my own on Monday. Fortunately, I found out that I get every other weekend off, and the opposite weekend, I only have to work either Saturday or Sunday. There is also no overnight call!

Now that I have a bit of a break, I think I'm going to edit some pictures and then go to the firehouse later tonight!
It's snowing!!!

It's actually a lot prettier out now than this picture (it's from a couple hours ago), but it's getting dark, so probably not enough light for an iPhone pic. That, and I'm lazy

Friday, December 4, 2009

One holiday gift, figured out

Mom: What's this passport studio thing that just came in the mail today?
Me: It's the gift I asked for that you apparently ordered for me. Thanks!
Mom: Oops.... [hangs up phone]

Wednesday, December 2, 2009

surgery is awesome!

I know I still have yet to do my surgery core, but I'm pretty certain that it's what I'm going to go into. Yesterday, an ENT let me go in with him to two of his surgeries...a tympanoplasty and a neck resection. So, I got to spend about 6 hours in the OR, which made me very happy! The surgeries were both very different and very interesting to watch. The tympanoplasty essentially involved cutting most of the guy's ear off from behind, and then fixing the ear drum through that hole. The neck resection involved cutting open a guy's neck and then removing the submandibular gland and nearby lymph nodes....very cool stuff! The attending that took me and his residents were all very friendly and willing to answer any questions. Fortunately, I read about the cases the night before, because they also did just a little pimping. 3 months cannot come fast enough! But, I'm still a little excited to start IM.

I also found out yesterday that heather tried to have Target print a picture that I had taken and edited for a gift. They declined it saying they believed it was a professional picture with copyright. I'm kind of happy about that.