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Family, Life, School, Work

I lost 10 pounds in 2 weeks on the MS3 plan. Ask me how!

07.14.11 | 3 Comments

Sooooo hi. Life on the wards. My first rotation is internal medicine at the county hospital. My team was on call the very first day. It was a harrowing, soul-sucking, what-the-eff-have-I-gotten-myself-into 30 hours and I was 99% certain I would not return for another minute of it. But I did. And after that day, I was 99% certain I would not return for another minute of it. Lather, rinse, repeat. I’m off today, and chances are better than not that I WILL return tomorrow, so at some point the scales tipped in favor of continuing this path. I’m trying not to analyze it too much, but I’ll offer a few things that may have contributed: investment of all involved, including but not limited to the $100K+ student loan debt, encouraging words from my family and friends, wanting Zoe never to see me give up, and all the previous analyzing I’ve done when I wanted to quit. Last but not least is the fact that I just started this part, and I shan’t expect to be an expert yet. I’m doing the best I can every day, which admittedly is inadequate, but if I keep trying it has to get better. Right? RIGHT?

Things I do like: the hospital. I’m weird but I’ve always liked hospitals. They’re kind of like airports – everywhere you look there’s something to experience, often a deep human emotion that, if you’re tuned in enough, enriches your life in a way you never expected. Turns out there are people who spend their days as bystanders, onlookers, people-watchers at malls and airports and even hospitals – I could have joined them for this experience alone and not tortured myself with medicine, but I think there’s not a lot of money to be made just sitting there, and my family likes groceries.

Plus there are other things I’m enjoying, like my team. My team is awesome. There are five third-year students (MS3 from now on, for medical student year 3), one MS4 (guess what that means), two interns (first-year residents), two residents (one post-graduate year 2, one PGY3), and our attending physician. It’s a large team. If you’re a long time reader you’ll know that I haven’t been my class’s (as a whole) number one fan, but as I’ve gotten to know people I’ve appreciated them more in most instances. I’ll be professional and work with anyone, of course, but I actually LIKE working with these people. All four of the residents and the attending are super, take time to teach us, and are helping us ease into this. My team has figured out a way to make the hours more tolerable, and we work well together. And really, it goes by quite quickly – I’m never bored, for sure. Anyway my team: good.

A few other details (sorry if it’s too much but this is my blog and my memory is bad): once a week we also have a core faculty session with another team and different attending, and so far I’ve learned SO MUCH from these short sessions. Yesterday we focused on the physical exam and everything you can tell about the patient just from seeing him or her, before looking at labs or imaging or anything in the chart. Awesome. I actually prefer to have a little more intensity/higher expectations because I think I learn more that way. Sure, I die a bit when I don’t know um, all of it, but as long as I’m not being personally attacked I think it’s character- and knowledge-building. For example: one thing we do is called Fred Rounds, where a seasoned and very respected doctor who has been practicing for near as I can tell approximately 120 years puts a resident in the hot seat to teach us all important things. The take home is to be precise and thorough and the very best doctor you can be. I’m sure it’s painful, and I was sweating bullets on behalf of our resident. People dread it but I really think it’s one of the best learning experiences we’ve had so far. What else… we go to conference and grand rounds during the week, and those are extra learning opportunities, too.

And of course: the patients. That’s why I’m here, really. Our main job as MS3s is to know everything – EVERYTHING – about our patients. We carry two or three each right now, and our team caps at 20 patients. (Later we’ll have up to five, then as residents oh, ten.) So there’s no excuse not to know absolutely everything about our two. There’s always something else to learn about a disease process or treatment, so I’m doing a lot of reading. We write our notes in the system, and I’m getting that down slowly but surely… All the while I’m adding to my knowledge which I hope will help when I take my boards – this year we take the internal medicine shelf exam after only two months, whereas in the past there have been three. Frightening. I need to study more. But already having a patient to associate with everything I’m learning really helps me retain it.

The only person being mean to me is this girl named Blake. She just won’t let up! Her expectations are ridiculously high. I mean, we just started, and she’s acting like we have to know all the answers already. She tells me my grades and scores are bad, that I’m not doing as well as everyone else seems to be doing, that every time I speak I’ve said something embarrassing, and that I shouldn’t even be here – there’s no way I’ll make it, and when I don’t, my daughter will be angry with me about all the time I’ve missed. She always has something critical to say about me, and I’m tired of her negative attitude. STEP OFF, B*+CH. Plus she’s really crabby when she doesn’t get enough sleep, and between you and me, I think she’s insecure and anxious.

Other than that B, shortly and sweetly, the main problems are exhaustion at times, and the runaround. The system. The frustration at the larger forces at work. The claustrophobic feeling I have when I consider the human condition. Being sick…SUCKS. I know first hand. I think that is the true soul-sucking part – I have the unfortunate awareness to realize that there is no way to avoid suffering in this world, and some people have more of it than others, and sometimes we can’t do anything about it. You guys, death is not the worst thing that happens to us. My heart aches in these cases.

Oh and presenting. I’ll get better at it – I know I will – but DAMN I’m bad at it. I want to melt into the floor and erase everyone’s memory every time I speak. Sometimes I know answers, and sometimes I even say them aloud. But when I have to present a patient – summarize their condition and spout off all pertinent information, including lab values that should be memorized – I tank. TANK, I tell you. It’s terrible. I’m getting sweaty just typing this. Ugh no more.

I’m making a conscious effort not to focus on what I don’t like. Because this is my life. It WILL get better. I’ll get better. I just have to take it one little bit at a time.

In other news: Zoe and Joel seem to be holding up well in my relative absence. Right now Zoe is entertaining her Cap’n and Gigi in Garland – she had been begging to go see them, and I’m really happy it worked out. I love that she loves all her grandparents and talks about them often. There’s a lot of love here.

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