Monday, May 31, 2010

Flushing pics

I decided to put up some pics of the hospital and the area.  Here's the hospital:

Flushing and Flag

The entrance I don't use

Flushing Hospital

Flushing Hospital entrance

And here is one I took on the street, on my way to the metro.  I know, it's hard to believe that this is in the US (and outside of Chinatown), but this really is just another street in Flushing...

US, believe it or not

Happy Memorial Day!

To celebrate Memorial Day, the hospital has graciously given us the day off!  Unfortunately, being in Flushing, that leaves me with very little to do.  However, I did spend the weekend in the city with Lauren, which was a lot of fun!  On Saturday, we walked around Times Square, and got tickets to see Fela!  Very good true story, very good show (up for about 11 Tony awards).

After the show was over, Lauren's friend, who is the show's stage manager, got us backstage.  It was pretty neat to be backstage of a broadway show, but surprising how little room there was back there.  Afterwards, we went to dinner with the stage manager, learned a lot about the show, and saw Kelsey Grammer, who's starring in Le Cage next door, walk by.

Sunday, we spent most of the day hanging out on one of Lauren's friend's roof deck.  It was a beautiful day in the city, so a good time.  After some sushi (the food all weekend was much better than what I'm used to in Flushing), I headed back here, only to wait about 40 minutes for a bus to finally show up.  Had I known the bus was going to take so long, I would have just walked!  Have I mentioned that I don't like Flushing?

Thanks to Lauren for a good weekend!

Empire State Building at Night

No Access

Party on the roof deck



Thursday, May 27, 2010

Restaurants near me

These are the top results for restaurants near me, presented in the same order that Yelp provided them.  See any trends?

  1. Southern Spice
  2. Bownie Restaurant
  3. Hahm Ji Bach
  4. Sam Wok Gak
  5. Kum Gang San Restaurant
  6. Mapo
  7. Main St. Imperial Taiwanese
  8. Phobang
  9. Tong Sam Gyup Goo Ee
  10. A Fan Ti
  11. Ah Rhee Soo
  12. Happy Garden Restaurant

Going down to number 20 is much of the same.  Awesome!!  Or not....

OB....almost one week down

For my first two weeks, I'm working in the OB department, which means I spend much of the day either helping to cut out or catch babies. There is enough down time to study, but there is also plenty to do, and lots of opportunity to learn. Already, I've been in a few c-sections (enough that I don't particularly feel the desire to do anymore), seen a bunch of vaginal deliveries, and caught a couple babies. Those things are slippery!

So far, the rotation is going fairly well. The residents have been pretty cool so far, which can make or break a rotation. I've already had my first overnight call, last night, and the resident was awesome! Between delivering babies, which came extremely fast last night for some reason (apparently nobody wanted to be in labor for long), I spent time sticking my fingers into foam holes, learning how to judge cervix dilation just by feel. However, I was not able to try out my new skills, since after I was comfortable with it, the patients were muslims, and they don't allow males in the room. I am not particularly taken with this practice of their's, but there's nothing I can do about it. Much to the husband's disappointment, they did wind up having a male deliver their baby, since he happened to be the attending on-call. Overall, the residents were cool, the nurses were friendly, the deliveries were pretty exciting, and I even got some sleep...not too much to complain about.

Today, I'm post call, but I'm at a loss for what to do! I woke up at around noon, but I really don't have anywhere to go. Although the actual rotation is going well, I do not, at all, enjoy being in Flushing. There doesn't seem to be anything at all to do within walking distance, the restaurants are mostly Asian, and driving anywhere is a pain in the ass due to horrible drivers, traffic, and complete lack of parking. I probably could go into the city, but it's more of a hassle than it's worth since I'd either drive and not find parking, or have to take the subway, which takes far longer than it ought to. This weekend, I'm going into the city to hang out with Lauren (my sister who I suppose I've never mentioned), so that should break up the monotony. It's supposed to be a beautiful weekend, and I have a three day weekend, so looking forward to that!
How dilated are you?

Sunday, May 23, 2010

I'm trying really hard to be positive

I have arrived safely in Flushing, NY.

Here's what I can come up with so far.
1. The place I'm staying is nice enough, and it's literally right around the corner from the hospital
2. This rotation is only going to be 6 weeks, and then I get to go back to MD!
3. I'm only about a 15 minute drive from the city

Although I've seen the hospital from the outside (and it is not promising at all), I will reserve judgement until I see the inside for myself.

Friday, May 21, 2010

4 down, 1 to go

Today was my last day of surgery, meaning I've now completed the two long 3 month cores, two of the short 6 week cores, and only have one 6 week core (ob/gyn) left!  It really is amazing how quickly time goes by in med school.  I'm not at all looking forward to 6 weeks in NY, particularly in Flushing, and particularly doing OB, but I know that shortly, it will be over too.  And then, it's only another few short months of electives before med school is over.

For those interested, here is my review of the St. Agnes surgery core:

Daily Schedule: I typically arrived sometime between 5:15 and 5:45, depending on the day.  On Mondays and Thursdays, you get in closer to 5:45, because there is no lecture and rounds begin at 6:30.  On Tu, Wed, and Fri, there is a 7:00 lecture, so rounds start at 6:00am (tuesday is M&M, wed is resident lecture, and friday is surg grand rounds).  About twice a week, there is a student lecture which typically follows one of the other morning lectures.  These lectures take priority over anything else.

After lecture, you usually go to the OR for the day, depending on how many cases there are.  There are days that you don't leave the OR until afternoon rounds (or you may miss rounds some days), and others that there are only 1 or 2 cases for the whole team, so you may not be in the OR at all.  OR takes priority over everything else but lecture.  So, if you're in the OR, you don't have to see consults or deal with floor scut, which is nice.  If you're not in the OR, you may be able to do some procedures around the hospital (sutures, I&D, pull drains, etc), you'll likely be asked to see a consult or two, and there is also actually plenty of free time to go to the library and study!  You also have to make sure and keep up with what's going on with your assigned patients (depending on the size of the list for the day, you'll probably have around 5 patients).

Surgery Teams: You spend one month each on blue, red, and gold team.  Blue team is primarily bariatric and some general.  You definitely get plenty laparascopic experience on this team, and the bariatric surgeons are some of the best you'll find.  However, the cases can get a little old after a while, and you'll probably be ready to move on by the end.  This is also the thoracic team, but there is really only one thoracic surgeon (the program director).  When you have surgeries with him, you better know about your patient!  Finally, there is a pretty renowned surgical oncologist on this team who does the HIPEC procedure, which you'll likely see at least once.  The surgeries can be pretty neat, but there is unfortunately no open heart here.  This team usually gets out the earliest at the end of the day.  Depending on who's on your team and what's going on, you'll probably be out between 4:30 - 6:00pm.

Gold team is primarily general surgery.  By the end, you'll probably feel like you could do a lap cholecystectomy, appendectomy, and cyst excisions on your own (although you never will, of course).  There is also a decent amount of open surgery, which can be pretty cool to see.  Lots of cancer colon resections.  Unfortunately, you also have to go to clinic twice a week (half day each) on gold service.  It's pretty standard clinic type stuff...some pre and post op underserved population patients.

Red team is primarily vascular surgery, with some plastic, urology, and hand cases.  You will primarily work with three surgeons, all with very interesting personalities.  They are mostly nice to students, very smart, and spend a decent amount of time teaching, but you are likely to hear some choice words in the OR, and may see some instruments thrown.  These are the longest cases, it's definitely the most demanding team, and you'll get out the latest (sometimes after 7pm).  The plastic surgeons are amongst the most polite in the hospital, but you don't get to do much in those surgeries (they suture themselves).

In the OR: In general, you don't really get to do all that much in the OR, because of the large number of resident, who want to do most everything.  You will, however, get in plenty of suture long as you want to and are not an idiot.  Mostly, you spend time retracting, suctioning, watching, and often times closing at the end (the longer you're there and the more interested you appear, the more you do).  You may occasionally get to use the bovie, cut, tie, or staple something, but it's pretty rare.  You will probably never touch a laparascopic tool, other than the camera (which you drive pretty frequently).  Fortunately, you scrub into just about every case, so you're always somewhat involved.  Teaching in the OR is very attending dependent.  Some will pimp the hell out of you (rare), some teach, some don't acknowledge you at all (also rare).  You may get yelled at infrequently, but don't take it personally, especially on red team.  You also help get the patient ready, including moving around the bed, draping, putting in a foley, etc.    At the end of a surgery, you typically write the post-op note.  A few hours later, you should find the patient and write a night of service note.  Both of these are very fast and easy to do.

Call: Fortunately, this rotation has a pretty light call schedule.  Depending on how many people are in the rotation with you, you are on short call every 4-5 days, and long call every 12-15 (most likely 4, and 12).  On short call, you stay later than the rest of your team to help finish up whatever is going on.  This may mean taking a later surgery, seeing an extra consult, or something similar.  You usually are out around an hour or two after everyone else, but it could be more or less (rarely more).  Long call is overnight; you leave the next morning after rounds.  If there is morning lecture, you unfortunately have to stay for that too, but you don't have to stay for afternoon lecture.  You do not have any OR or floor responsibility (other than rounds) on post call days.  If you're short call on the weekends, you're really only there to round and should be out before noon (sometimes out before 9am).  Long call on weekends is still around 25 hours.

Residents/ Staff: It's really hit or miss, as with most places.  There are excellent residents, and there are some not-so-excellent residents.  The prelims are mostly foreign, and the categoricals (at least the new ones) are almost all US grads.  Unfortunately, the dept chair does not particularly care for caribbean grads, although all the students are from the caribbean!  The attendings are much the same...some fantastic, some not so much.  In general though, the staff is good.  There is plenty to learn, and plenty people willing to teach.  The scut work is present (as it is anywhere), but it's really not bad.  I was scutted much less in surgery here than I was in IM.  There is a good chance I'll return here for SICU rotation or a surgical sub-I.

I realize this is a lot, but it should cover just about everything.  Every surgical rotation is different, but this should give you some idea of what to expect.  It is tiring, and I'm glad to be done, but it's not as killer as some say...certainly not as bad as it was in years past before the 80 hour work week!  As I said, there is plenty time to study during the day too.

Thursday, May 20, 2010

Exciting day!

Today is exciting because it is that last day that I have to wake up and come into surgery at St. Agnes! In addition, it is the last time that i will ever come into St. Agnes as a 3rd year medical student! I only have 6 weeks left until I can officially declare myself a 4th year, although i actually have less than a year left of med school. However, i am the lucky person who is the last long call of the rotation. I consider this a good thing, because it means that I'll be post call on the last day of the rotation. I'm not positive, but I have a feeling that they'll let everyone go early, so it may wind up not being that much of an advantage after all.

Before the end of the day today, I have a lot of studying to do, in preparation for the shelf exam on Sunday. I also have to find time to complete my case logs for the rotation, and take care of the stuff I'm actually supposed to be doing for the rotation. And finally, I've got an a/v fistula revision as my last official case of the rotation (something could come in overnight though, giving me more surgery). So, I guess I should stop procrastinating and get to it.

- Posted using BlogPress from my iPad

Location:S. Caton Ave, United States

Monday, May 17, 2010

OK, so here's the thing...

I have really meant to continue posting, most of the time.  I've considered quitting posting, but usually, I really have wanted to keep posting!  But, I just haven't had any time!  Surgery is crazy.  I know other bloggers have done it, but I'm not sure how.  In fact, the craziness of surgery is pretty much exactly what has made me come to a pretty big change in my thinking...I'm not going to go into surgery!

I really wanted to be the guy that loves surgery so much, they just want to be in the OR all the time, no matter what that might mean.  I wanted to be a hardcore surgeon.  But, I'm just not that guy.  Unfortunately (or fortunately, depending on how you look at it), I love to do lots of things, and those other things are difficult to do as a surgeon.  Already, as a student, I feel like I just wake up (way too early), go to work, get off late, come home, maybe watch a TV show, and then go to bed.  There's really not much time to do anything else.  And, I work less than any of the resident.  I probably do around 60-70 hrs a week, but there's no way that the residents are under the 80 hour work week.

So, instead of surgery, I will likely be going into emergency medicine, which is probably what I should have been looking at from the beginning.  I love riding the medic, and being an ER doc is really the best continuity with that.  I've also found that through the last 6 months in St. Agnes, I really love being in the ER...more so than the OR.  It's fast paced, shift work, your work does not come home with you, you don't follow patients, and there's no rounding!!  I haven't mentioned it since I haven't been blogging, but I despise rounding.  Really really despise rounding!  Yeah, there is a lot of BS that comes into the ER, but I've been finding that there's a lot of that in all of medicine.  However, you can get rid of that BS in the ER a lot faster than you can most anywhere else.  And, strengthening my decision to go into EM, there are also fellowships in EMS and trauma/critical care.  I could actually do the EM residency, plus two fellowships, in the same amount of time as general surgery residency!  I wanted to be a trauma surgeon anyway, so I can do a lot of the same stuff with a trauma fellowship, and I can also stay involved in EMS (as part of my job).  Seems pretty good all around.  Just to make sure i'm not crazy though, I'm doing two months of electives in EM.

Unfortunately, not much else new in my life to write about...just hasn't been a lot of time for it.  Today was my last Monday of surgery!  Since I have overnight call on Thursday, I get out early Friday morning, take the surgery shelf exam on Saturday, and then off to NY for OB/Gyn.  Not looking forward to that, but it's only 6 weeks, so I'll survive.  If I can survive IM, I can survive anything!

So, I'm going to really try hard to post much more often now.  Happy everyone?  Here is a picture showing my current level of sleep deprivation (and what it makes me do):


Saturday, May 15, 2010

A day of yes

YES, I have been absent for a while
YES, I am sorry
And YES, I am coming back

Maybe tonight, maybe tomorrow, but updates are coming soon

Oh, and YES, I successfully placed my first central line today!
Check back for more updates soon, and sorry for the extended absence