...And Other Such Tales of Adventure!

Sunday, June 22, 2008

Woah.

It’s been a year and I’m about to have my last call of Intern year Monday… there are definitely things I’m frightened about as a second year, but all the more motivation to crack the books open again. I’ve gotten lazier about studying over the past few months so it’s payback time.

My schedule seems pretty fun. Not only do I have almost two weeks off in September (ACL music festival! Who’s with me??), but I have all the rotations I wanted: Genetics, Cardiology and even some I don't so much (Endocrine... eeeek. I had enough Endo as a med student!). I start off as a supervisor resident at the county hospital… I’m not sure which genius is responsible for this decision-- I have to oversee four interns and six medical students! But, it comes along with a nice q7 call schedule so I’ll put up with the madness gladly. :-)

Just the other day I was thinking of all the kids I’ve known who have died this year, and I was thinking how nice Pedi was that I could actually fit everyone on one hand… my medicine friends tell me about least one person a night passing away on some services. But then my friend calls me to tell me she had to call time of death on a patient I knew at MD Anderson. That makes six.

I was at an M&M (morbidity and mortality) conference of another patient I knew who had died from complications following heart surgery to remove an enormous abscess. Most of the people in the room knew him; one of my friends was giving the talk since she took care of him on the floor when he coded. (Way to stay strong Di! You didn’t see me tearing up in the back row…) Was it a diseased heart that was inevitably going to fail? Was it the telemetry monitors that didn’t make his arrhythmias clear? Was it us? These are all such hard questions with no answers. But, it seems to have resulted in the hospital completely changing the way it cares for post-op heart patients on monitors.

It’s wild to think that in two weeks, interns will come to me with questions. Like, how do you write for Tylenol? What do I do if my pager falls in the toilet? (this has almost happened to me once while I was carrying four different pagers) Why do the nurses call me at 2am with normal lab values? Why does pharmacy never trust what I write for?* Why does this lack of trust always happen during nighttime hours? Why do I have dreams of rounding on my patients when I’m not on call and why do I start answering my regular phone as “Hello, this is Dr. _____"?

While I can't quite help with these (well, ok I can help with the Tylenol...), I can offer four very helpful pieces of advice: trust no one, know what you don't know, know who to ask for help, and when in doubt use Google. I too shall heed by this.

Welcome new interns! THANK YOU for being here. :-)


(*disclaimer- pharmacy has definitely prevented me from accidentally hurting patients on more than one occasion, and for that I am grateful. But, the ratio of good phone calls to useless phone calls at Hermann is <<<1, and this fact is universally agreed upon by most residents.)