continuing on

WOW.  Well year two is well under way, and it is a whole different game than didactic was.  In good, amazing, awesome ways and crazy, overwhelming, slightly terrifying ways as well.  I tried not to think too much about what clinicals would actually literally be like, and this is because of a variety of things.  Obviously I was busy right up until the last day of the semester, and spare brain space was a bit lacking at that point.  In Jamaica I actively suppressed any thoughts of the near future because when I did it made me feel physically ill, margaritas on the beach definitely aided the active suppression of scary thoughts, but that’s a whole other post! 

In any case, I had my first day last Tuesday, and most of my classmates started that Monday.  As you may imagine, I spent the better part of that Monday alternating between pacing my apartment, mindlessly flipping through textbooks at an impossible-to-read pace, wringing my hands and checking and rechecking my phone for news from classmates.  I talked with my friend Julia during her lunch break while she was hiding in her car eating and delivering her report of the day thus far while I tried to calm her nerves and reassure her that she would undoubtedly, or at least most probably, survive her first day in the emergency room relatively unscathed.  When Tuesday morning came I wasn’t actually as nervous as I thought I would be, I think I just needed to get the first day over with, because anything was better than the agony of my imagination.  

My first rotation is in Portsmouth, NH which is about (exactly) 51 minutes from my house.  I am doing my Internal Medicine rotation in the Intensive Care Unit (ICU).  My schedule is a bit insane, and adding my commute time makes it a bit more insane, but so far I have survived.  I work ten hour shifts rotating a little between day and night, so for day shift I get up at 5 in the morning to make it there for 7:00 rounds. 

The advice we were given from the class a year ahead of us was that on the first day, no matter how many dumb things come out of your mouth, or how many things you have never even heard of, just try to say one thing that is even marginally intelligent.  Gotta keep that bar high, eh!? I definitely bit my tongue the entire day to keep the illusion of intelligence at least somewhat existent, and my mind blanked out on basically everything I learned last year especially when I was being asked a question, but my one marginally intelligent thing was asking if they should do a bladder scan on a patient that had all but stopped producing urine and we were getting extremely concerned about her kidney function.  It turned out her foley was kinked, and after the scan it was adjusted, no need to worry about the kidneys at all! PHEW.  Marginal intelligence RESTORED.  

Now I’ve got a week and a half under my belt, and things are starting to get a little more familiar.  I had some delusions that this year would be less busy then last year, but so far it’s been just a busy if not more!  After my shift I have to log all my patients into this tracking system that my school uses to make sure we are seeing enough patients, doing enough and learning enough.  I know it will get easier with time, but right now it’s the slowest process in the world to try to figure out the ICD or CPT codes, and then recall what exactly we prescribed and what labs we ordered.  There are a million drop down menus and they are all kind of vague so it often takes me ten minutes just to find the section I am looking for.  Oh well, at least it is the same system for the entire year so soon I will master it and it won’t even feel like that much work.  Right? Right.  

So, that’s what I am up to lately.  Adjusting to working weird days and nights, standing and walking for ten hours instead of endless days of sitting and staring at powerpoints (thank god!), and figuring out the home dynamic as we move into this next phase of life.  Aside from all the moments of stupidity and overwhelming feelings, I already know that this year is going to be absolutely awesome.  It’s an incredible feeling to put the textbook down and actually see all the things I learned about!  I did a million physical exams on my classmates, all of whom are healthy, so it’s amazing to put my stethoscope to a patient and hear a murmur in their heart or crackles in their lungs.  Don't worry, I’m working on controlling my rubber face so that my eyes don't subconsciously open real big with my eyebrows raised all the way up and my mouth doesn't smile large when I hear something pathologic, which is probably not the best face to have just before I tell someone they have bilateral pneumonia.