Alright, first of all, I've clearly continued to be a horrible blog updater. I don't even really have an excuse, as I've had a fair amount of free time the last couple of months. Oh well. I guess I'll start with a quick synopsis of what the start of 2009 has been like:
- Did 2 weeks of ER after returning from Christmas break. ER is a lot different from a lot of the specialties that we rotate through, as you get to be the first person to see the patient and hear their complaints. Most of what I saw was pretty medium acuity (chest pain, shortness of breath, etc), although as the level 1 trauma center in NOLA we did also get our fair share of gunshot wounds. I participated in my first code (read: helped do chest compressions), which lead to having my first patient die. All in all, I really enjoyed my ER experience.
- Followed that up with 2 weeks of radiology, belovedly known as radiholiday. Basically 2 weeks of coming in for a couple of hours and sitting in a dark room while residents talked about what they saw in different images. A great way to spend two weeks. Definitely never anything I could ever see myself doing as a career.
- Spent the last month on psychiatry. I came into med school thinking that this would be what I wanted to do, but kind of expecting to change my mind. As I completed the rotations that I thought would compete for my attention (peds, internal med), I still found psychiatry more interesting. After I finished my rotation, I'm pretty much set that this is what I want to do. I feel like it is the specialty where you get to spend the most time with actual patients (who are almost always interesting), but there is still a strong science component (understanding how psych meds work and side effects, which are huge). One of my attending described it as the speciality with the most in common with the humanities, which I think is true. So, I'm pretty excited that I've found something I love, even more excited that I'm doing a child psych elective next.
- Outside of school, survived my 3rd Mardi Gras. It was crazy, amazing, and ridiculous, as usual. I'm always extremely excited for it to get here, and almost equally as happy when its over. This year was about the same. Oh, save for 6 people getting shot in front of my apartment. Yay New Orleans.
I think that's been the last 2 months in a nutshell. I'll do better to keep this updated as I finish up third year and start the process of applying for residency. Yikes.
Sunday, March 1, 2009
Monday, December 22, 2008
Livin on a Prayer
So here it is, half-way through 3rd year. The time has gone by so fast, its scary that at this time next year we'll all be making decisions on where we want to go. I guess it has been 2 months since I've written, so I'll give a little update as to where that time has gone. I managed to survive the end of medicine and moved on to pediatrics. I was looking forward to peds because a, I generally enjoy kids more than adults, and b, we got to spend 1 of our 2 months in outpatient pediatric clinics and the nursery/NICU, so there was a little more variety compared to the 2 months of inpatient, q4 call that we got to enjoy on medicine. My first month was in clinics and the nurseries, both of which I really loved. The clinics that I was at had pretty much every pediatric specialty you could think of under one roof, and we got to pick and choose who we worked with, which was awesome. I really enjoyed the NICU too, we got to go in on all the c-sections, I definitely enjoyed the peds side of that more than the OBGYN side.
My second month was inpatient general pediatrics, which, for all intents and purposes, is a lot like adult inpatient medicine. It was fun, but I don't think general inpatient medine is for me. I hate rounding, and by the end of the month, I felt the same about asthma exacerbations and RSV as I had about chest pain and shortness of breath on medicine. I did get to spend a week in the pediatric ICU, which I loved. I got to learn a lot of cool medicine that we don't really get to see anywhere else.
So now I have finished my 3rd of the "big 4" 8 week rotations (I only have surgery left). I have 2 weeks off now, and then go back for 2 weeks of ER, 2 of radiology (aka radi-holiday) and a month of psych. It will be pretty nice to have a lower stress couple of months to look forward to.
I still can't believe how fast this year is going, although it feels like its been ages since I was a second year and studying for boards. Third year is definitely an experience like no other. Its kind of like starting a new job....every 2-4 weeks. We change rotations every 8 weeks at least, and within those rotations usually change locations, activities, and attending every couple of weeks. On top of that, in most cases you feel like you need to be "on" at every minute, being prepared to present a patient, do an exam, or know the answer to an obscure question. Don't get me wrong, I'm loving 3rd year more than any other year in med school. At the same time, I think we're all constantly feeling a sense of instability, there's not really time to get to feel as if you've gotten a grasp on something before its time to move on to something else. To add to that, its also getting closer to time for us to make decisions about what we want to be when we grow up. I know within my group of friends, people are starting to make serious decisions about what to specialize in and where they want to go. I feel like everyone has some underlying tension in worrying about what the next year and a half holds, and knowing that, after this year of new beginnings, we're all going to have to start over again somewhere else., without the families that we have forged here. Its scary and exciting at the same time. Stay tuned.
My second month was inpatient general pediatrics, which, for all intents and purposes, is a lot like adult inpatient medicine. It was fun, but I don't think general inpatient medine is for me. I hate rounding, and by the end of the month, I felt the same about asthma exacerbations and RSV as I had about chest pain and shortness of breath on medicine. I did get to spend a week in the pediatric ICU, which I loved. I got to learn a lot of cool medicine that we don't really get to see anywhere else.
So now I have finished my 3rd of the "big 4" 8 week rotations (I only have surgery left). I have 2 weeks off now, and then go back for 2 weeks of ER, 2 of radiology (aka radi-holiday) and a month of psych. It will be pretty nice to have a lower stress couple of months to look forward to.
I still can't believe how fast this year is going, although it feels like its been ages since I was a second year and studying for boards. Third year is definitely an experience like no other. Its kind of like starting a new job....every 2-4 weeks. We change rotations every 8 weeks at least, and within those rotations usually change locations, activities, and attending every couple of weeks. On top of that, in most cases you feel like you need to be "on" at every minute, being prepared to present a patient, do an exam, or know the answer to an obscure question. Don't get me wrong, I'm loving 3rd year more than any other year in med school. At the same time, I think we're all constantly feeling a sense of instability, there's not really time to get to feel as if you've gotten a grasp on something before its time to move on to something else. To add to that, its also getting closer to time for us to make decisions about what we want to be when we grow up. I know within my group of friends, people are starting to make serious decisions about what to specialize in and where they want to go. I feel like everyone has some underlying tension in worrying about what the next year and a half holds, and knowing that, after this year of new beginnings, we're all going to have to start over again somewhere else., without the families that we have forged here. Its scary and exciting at the same time. Stay tuned.
Sunday, October 19, 2008
Last Call
Alright, so I realize that it has been over a month since I've updated here. In reality, not a lot has really been going on, so I'll try and do a recap. I just finished my last day of medicine call (it's the first time I've ever been happy to hear the words "last call"). It was a Sunday, and there was a Saints game on, so we sat in the hospital for 12 hours without getting any patients before we finally got sent home. So I only have 3 days of work left before this rotation is over! I feel like I've learned a lot, but I've been burning out the last couple of weeks. We've seen some interesting cases, but for the most part its trying to manage the complications of a lot of long term diseases (hypertension, diabetes, heart disease, a lot of AIDS). I start pediatrics a week from Monday, I"m definitely looking forward to that, I think working with kids is definitely more my thing.
In non med school life, the weather is finally getting nice, tonight is actually a bit chilly. I always forget how nice New Orleans weather is once its not summer. Haven't really been up to much aside from work, studying, and trying to hang out with friends when I can. I'm looking forward to next weekend, when I'll finally have 2 days off, in a row! Got to watch the Saints game while I was at work today, kinda wish I didn't. I'm thinking this isn't going to be their season.
Other than that, not much going on here. I'll update soon when I'm done with this rotation.
In non med school life, the weather is finally getting nice, tonight is actually a bit chilly. I always forget how nice New Orleans weather is once its not summer. Haven't really been up to much aside from work, studying, and trying to hang out with friends when I can. I'm looking forward to next weekend, when I'll finally have 2 days off, in a row! Got to watch the Saints game while I was at work today, kinda wish I didn't. I'm thinking this isn't going to be their season.
Other than that, not much going on here. I'll update soon when I'm done with this rotation.
Monday, September 15, 2008
A day in the life...
After our unexpected week of "hurrication", I'm now about a week into my medicine rotation. Medicine is a rotation that I think most of us approach with a sense of intimidation; the schedule is notoriously tiring and the amount of information that you're expected to know is pretty much limitless. So far, that's probably been the hardest adjustment after coming off of OBGYN: going from having about 12 major possible issues to deal with to facing literally infinite possible diagnoses anytime you see a patient. It's pretty interesting though, I feel like I'm finally getting to see how all the stuff we learned in the last 2 years applies in "real life".
I realize for most people, the logistics for how inpatient hospital medicine works is kind of a mystery (it was for me until about a week ago). I figure I'll try and explain it here, so that my schedule is a little easier to understand. First of all, internal medicine docs are organized into "teams"; in our case, 1 attending (the "boss"), 1 resident (a 2nd or 3rd year), 2 interns (1st year residents), and 3 med students (that would be us). We are on a q4 schedule, which means that we're on call every 4th night. On days that we are on call, any patients that come in (usually through the ER) are admitted by our team and followed by us for their entire stay in the hospital. When a patient comes in, one of us will be assigned to see them and do their history and physical, as well as come up with what we think the problem is. An intern and the resident will see the patient as well (which explains why, if you're ever admitted to a teaching hospital, it may seem like you have about a dozen doctors seeing you).
As far as our daily schedule, on days we are not post call we have "work rounds" with our resident at 8am. Before this, we need to see our patients and write up our notes so that we can discuss them and clean up our presentations with the help of our resident and intern. At 9 we have usually have morning report, where an interesting case from the week is presented, and then we round with our attending at 10. This can last anywhere from an hour to 3, depending on how many patients we have (our first day we had 14, luckily that is not the norm). During this time we finalize treatment plans for our patients, decide who can go home, etc. After that, we do whatever work needs to be done (writing orders, calling consults, etc). If we're not on call, we are done whenever our work is done (although most week days we have classes in the afternoon). If we are on call, we stay on until we've admitted at least 1 patient (usually til around 11pm, but this can vary). We get to go home on call nights, since the hospital doesn't have anywhere for students to sleep, but the residents and interns stay all night to admit new patients and take care of any problems that come up with any of the patients on the floor. The morning after call, we round at 6:45 and 7:30, and try and get our work done so we can get out early. This is great when its a weekend, not as nice when we have lecture until 5pm!
So, that was a very long description of what my life will be like for 7 weeks. So far, I like it pretty well. Internal med is notoriously Tulane's strongest program, the organization and enthusiasm among everyone involved is amazing. I'll update more as I get more experience, things are sure to get even more interesting when I go over to University hospital next month (aka the new Charity).
Some random, non-medical thoughts:
- We obviously did not end up having to evacuate for Ike. As horrible as I feel for everyone in Texas, I think everyone here breathed a big sigh of relief.
- Went to the Saints opening game last weekend. Hadn't been to an opener before, it was pretty awesome (esp. since we won). Too bad we couldn't follow it up this weekend.
I realize for most people, the logistics for how inpatient hospital medicine works is kind of a mystery (it was for me until about a week ago). I figure I'll try and explain it here, so that my schedule is a little easier to understand. First of all, internal medicine docs are organized into "teams"; in our case, 1 attending (the "boss"), 1 resident (a 2nd or 3rd year), 2 interns (1st year residents), and 3 med students (that would be us). We are on a q4 schedule, which means that we're on call every 4th night. On days that we are on call, any patients that come in (usually through the ER) are admitted by our team and followed by us for their entire stay in the hospital. When a patient comes in, one of us will be assigned to see them and do their history and physical, as well as come up with what we think the problem is. An intern and the resident will see the patient as well (which explains why, if you're ever admitted to a teaching hospital, it may seem like you have about a dozen doctors seeing you).
As far as our daily schedule, on days we are not post call we have "work rounds" with our resident at 8am. Before this, we need to see our patients and write up our notes so that we can discuss them and clean up our presentations with the help of our resident and intern. At 9 we have usually have morning report, where an interesting case from the week is presented, and then we round with our attending at 10. This can last anywhere from an hour to 3, depending on how many patients we have (our first day we had 14, luckily that is not the norm). During this time we finalize treatment plans for our patients, decide who can go home, etc. After that, we do whatever work needs to be done (writing orders, calling consults, etc). If we're not on call, we are done whenever our work is done (although most week days we have classes in the afternoon). If we are on call, we stay on until we've admitted at least 1 patient (usually til around 11pm, but this can vary). We get to go home on call nights, since the hospital doesn't have anywhere for students to sleep, but the residents and interns stay all night to admit new patients and take care of any problems that come up with any of the patients on the floor. The morning after call, we round at 6:45 and 7:30, and try and get our work done so we can get out early. This is great when its a weekend, not as nice when we have lecture until 5pm!
So, that was a very long description of what my life will be like for 7 weeks. So far, I like it pretty well. Internal med is notoriously Tulane's strongest program, the organization and enthusiasm among everyone involved is amazing. I'll update more as I get more experience, things are sure to get even more interesting when I go over to University hospital next month (aka the new Charity).
Some random, non-medical thoughts:
- We obviously did not end up having to evacuate for Ike. As horrible as I feel for everyone in Texas, I think everyone here breathed a big sigh of relief.
- Went to the Saints opening game last weekend. Hadn't been to an opener before, it was pretty awesome (esp. since we won). Too bad we couldn't follow it up this weekend.
Saturday, September 6, 2008
No me Gustav: My first evacuation
It's been a pretty eventful week since I last posted. The potential evacuation for Hurricane Gustav that we were all talking about on Friday morning became a definite evacuation by Friday afternoon. As I was posting last time, I thought I may head out to Houston sometime on Sunday if it became necessary. After having lunch with some friends, we decided that leaving Saturday might be a better idea, and decided that we'd head to Tampa (a ten hour drive at least) sometime Saturday afternoon. As the evening wore on and I talked to more people, I found out that some of my friends were getting a beach house in Destin for a few days to wait out the storm. Destin is only four hours from here, and the thought of spending a couple of nights at the beach sounded like the best possible way to face a potential disaster. So, in the end, I left Saturday morning to head east. The drive wasn't bad, there was some traffic getting over the bridge to Slidell, but the trip only ended up taking about 6 hours. Leaving early was a good choice,some in our group who left in the afternoon took 11 hours!
The next few days were kind of a blur. There were 16 of us staying in a house on the beach, drinking, sunbathing, and cooking up all the food that we had salvaged from our refrigerators. As much as we all wanted it to be a stress-free last minute vacation, there was definitely an undercurrent of anxiety as we kept our eye on Gustav. As of Sunday, the forecasts were looking pretty catastrophic, so we tried to keep it a pretty media-free day.
Monday was the anticipated day of landfall, and we all watched with relief as the storm that was potentially a category 5 swept slightly west of New Orleans as a cat 2. The levees that were still very questionable held, and the city was spared too much damage. It looked like we would have a home to come back to.
We were able to relax more the next few days, as we waited to here when we would be allowed back in the city. We only had the house until Wednesday, but since it wasn't clear if the city was open yet (and it was pretty clear that no one would have power), we stayed a night up in Pensacola at a classmate's condo. On Thursday, after everyone had the all clear to come back, we all took of, eager to finally be home. Traffic was surprisingly light, and the city was in relatively good shape. My apartment, along with others, still didn't have power, so we dispersed to stay with those who did. My power came back on yesterday, and things are starting to get back to normal. Restaurants are open (as are bars, of course) and the grocery stores are crazy. The Saints are playing their opening game at the Dome tomorrow, as scheduled. We start back to school on Monday.
With everything that happened in the last week, I think I may love my class even more, if that's possible. The way everyone came together, and found the best in what could have been a horrible situation really showed how much of a family we've become in the last 2 years. Hopefully we'll all have an uneventful rest of the hurricane season, the city definitely needs it. We're all keeping a watchful eye on Ike, as it starts to head toward the gulf. As for now, though, we'll sit back, relax, and cheer for the Saints tomorrow!
The next few days were kind of a blur. There were 16 of us staying in a house on the beach, drinking, sunbathing, and cooking up all the food that we had salvaged from our refrigerators. As much as we all wanted it to be a stress-free last minute vacation, there was definitely an undercurrent of anxiety as we kept our eye on Gustav. As of Sunday, the forecasts were looking pretty catastrophic, so we tried to keep it a pretty media-free day.
Monday was the anticipated day of landfall, and we all watched with relief as the storm that was potentially a category 5 swept slightly west of New Orleans as a cat 2. The levees that were still very questionable held, and the city was spared too much damage. It looked like we would have a home to come back to.
We were able to relax more the next few days, as we waited to here when we would be allowed back in the city. We only had the house until Wednesday, but since it wasn't clear if the city was open yet (and it was pretty clear that no one would have power), we stayed a night up in Pensacola at a classmate's condo. On Thursday, after everyone had the all clear to come back, we all took of, eager to finally be home. Traffic was surprisingly light, and the city was in relatively good shape. My apartment, along with others, still didn't have power, so we dispersed to stay with those who did. My power came back on yesterday, and things are starting to get back to normal. Restaurants are open (as are bars, of course) and the grocery stores are crazy. The Saints are playing their opening game at the Dome tomorrow, as scheduled. We start back to school on Monday.
With everything that happened in the last week, I think I may love my class even more, if that's possible. The way everyone came together, and found the best in what could have been a horrible situation really showed how much of a family we've become in the last 2 years. Hopefully we'll all have an uneventful rest of the hurricane season, the city definitely needs it. We're all keeping a watchful eye on Ike, as it starts to head toward the gulf. As for now, though, we'll sit back, relax, and cheer for the Saints tomorrow!
Friday, August 29, 2008
Back to Normal?
So I've been back from Pineville since Tuesday and as of today have officially finished my first rotation! All in all, I had a really good experience, which was a pleasant surprise. I still don't think that OBGYN is the specialty for me, but I am really glad that I enjoyed it, and I feel like I learned a lot.
Everyone has really been looking forward to this weekend, its the first time in 2 months that our whole class has had free time at the same time. Unfortunately, mother nature has put a damper on our relaxing long weekend. Everyone is watching Hurricane Gustav as it approaches the Gulf. No one is really sure where its going to hit, except that New Orleans is currently in its projected path. If it hits, it would likely be Monday or Tuesday, so they haven't declared any mandatory evacuations for the city yet. School is closed until Thursday, so regardless of what happens we'll have some time off. As of right now, most people I know are in wait and see mode, although a lot of people have already left. The timing of this couldn't really be worse for the city, as today is the 3rd anniversary of Katrina, so everyone is already on edge. This is the first potential evacuation that we've had since I've moved here, so its a little overwhelming. I'm planning on staying for now until we have a clearer idea of what the course of the storm will be. Ideally, it will pass, and we'll get a nice weeklong break. I'll try and keep this updated as things change. Oh, and in true Tulane fashion, our block party for tonight has not been canceled. I love this school.
Everyone has really been looking forward to this weekend, its the first time in 2 months that our whole class has had free time at the same time. Unfortunately, mother nature has put a damper on our relaxing long weekend. Everyone is watching Hurricane Gustav as it approaches the Gulf. No one is really sure where its going to hit, except that New Orleans is currently in its projected path. If it hits, it would likely be Monday or Tuesday, so they haven't declared any mandatory evacuations for the city yet. School is closed until Thursday, so regardless of what happens we'll have some time off. As of right now, most people I know are in wait and see mode, although a lot of people have already left. The timing of this couldn't really be worse for the city, as today is the 3rd anniversary of Katrina, so everyone is already on edge. This is the first potential evacuation that we've had since I've moved here, so its a little overwhelming. I'm planning on staying for now until we have a clearer idea of what the course of the storm will be. Ideally, it will pass, and we'll get a nice weeklong break. I'll try and keep this updated as things change. Oh, and in true Tulane fashion, our block party for tonight has not been canceled. I love this school.
Monday, August 18, 2008
Laundry's done
So apparently over the weekend, we had a patient come in to the ER saying she was having contractions and was at her due date. They sent her upstairs to Labor and Delivery, where she was put in a room to be monitored. Our resident got paged, and the nurse set her up to be put on a fetal monitor. Before that could happen though, the nurse lifted her shirt to find not a 9 month pregnant belly, but a bundle of clothing stuffed under the patient's shirt. Her pregnancy test was negative. I can't make this stuff up.
In other news, we went on our now weekly fishing trip to the lake yesterday. We had just gotten there, and one of my classmates and I had gone down to the edge of the water to try and catch some minnows (we were unsuccessful). When we went back over to meet up with the rest of our group, there were 3 Fish and Wildlife trucks surrounding our fishing spot. Three old rednecks with guns were questioning the rest of our group on where they were from and where their fishing permits were. Since none of us have Louisiana or fishing licenses, the fine was supposed to be $200. However, since they were so "nice", the tickets were only written for fishing in state without a permit (only $50). So, 2 weeks in, and already a run-in with the law. Only in the South. Oh, we did catch several fish. We threw them all back.
Today was a major milestone in my medical career: I had my first drug-company sponsored free lunch. It consisted of take-out fajitas from Chili's, a handful of free pens, and listening to a stereotypical looking blond woman talking about Loestrin. Supposedly we should feel guilty for taking free food from companies that charge so much money for their drugs. I probably would, if I wasn't going to come out of this thing $250,000 in debt. That makes it a little easier to sell my soul for a few free lunches.
In other news, we went on our now weekly fishing trip to the lake yesterday. We had just gotten there, and one of my classmates and I had gone down to the edge of the water to try and catch some minnows (we were unsuccessful). When we went back over to meet up with the rest of our group, there were 3 Fish and Wildlife trucks surrounding our fishing spot. Three old rednecks with guns were questioning the rest of our group on where they were from and where their fishing permits were. Since none of us have Louisiana or fishing licenses, the fine was supposed to be $200. However, since they were so "nice", the tickets were only written for fishing in state without a permit (only $50). So, 2 weeks in, and already a run-in with the law. Only in the South. Oh, we did catch several fish. We threw them all back.
Today was a major milestone in my medical career: I had my first drug-company sponsored free lunch. It consisted of take-out fajitas from Chili's, a handful of free pens, and listening to a stereotypical looking blond woman talking about Loestrin. Supposedly we should feel guilty for taking free food from companies that charge so much money for their drugs. I probably would, if I wasn't going to come out of this thing $250,000 in debt. That makes it a little easier to sell my soul for a few free lunches.
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