Friday, February 20, 2009

Nobody said it was easy...

Time is surely ticking down on surgery and I couldn't be more thrilled! I really wanted to post more on this rotation but when I take the time to write, it is like I have to relive it all over again. Usually when the day is over - it is the last thing I want to think about, unfortunately for you. Well, fortunately for you I am stuck here in Saginaw, as my attending as asked me to come in and round in the morning. Afterwards, I will have the rest of Saturday and Sunday off and plan on heading back home. So, here I am bored and realize what a perfect time to update people on my rotation ;)!

So this was the third week with my second attending and it was a better one. I don't know what it was but I have been getting most questions right, doing much better on my notes as far as my plans go and overall just getting along better with him. After last week, I really thought about how his work ethic affected me and how others (staff, students, residents, etc.) really had similar experiences as me. I know that it isn't just me. Being strict, unrelenting and at times condescending is just his way and maybe not even how he'd see it. I have felt like over this past week he has the military "break 'em down and build 'em up" style. I say that because my first two weeks were brutal. I mean to the point of crying most days and leaving the hospital feeling lower than dirt. Nothing I could do would please him and it was just a fight that I could not win. It is still somewhat to that point but he is seemingly more happy with my work, praising me more, joking with me more and generally a more pleasant man to be around.

I hate (really) to admit it and I am sure this happens with many students. When you are getting to the end of a rotation that you really did not like, you are sooooo happy but then have a sense of hindsight. I do not like the phrase "hindsight is 20/20", because well... duh. It's the same thing as finding something lost "in the last place you look". Anyway, I am slowly seeing how I have learned this month. While I am not learning ICU management or a plethora of information, I know I have become just that much tougher. Sure, I have gained some knowledge too, of course - but I think the majority of what I have learned is to work up a better plan, thinking to read up on patient's conditions while I have them and becoming more confident. My plans are improving, patient conditions I try to read on but when you never know where questions are coming from you just get sidetracked and completely are oblivious to thinking ahead to what the next day's questions might bring. Confidence is still something majorly in the works. It is coming along though.

Today, I had rounded and found out there was nothing else much to do for the day. Hoping I would get a break and allowed the weekend off, I was told to come in tomorrow morning to round and couldn't be happier about it (ahhemmm). Anyway, so tomorrow I will round and head home for a day or so. Next week? My last week of surgery baby! Well, there is still a month of ER to go in my rotation but it is completely different. No calls, no rounding, no lectures. Just 10 hour shifts. So next week marks a huge point for me in my medical education. As always, it hasn't and probably will not hit me for a while but I hope it does. There is a Hawaiian Ball next Friday that I cannot wait to attend for our local firefighters at home. It is dinner, dancing and... open bar! Also, it is on the same day that my surgery months end and I am sure I will be partying it up! I have really started to work on my diet (less junk and such) and began my workout regimen again that I have ignored for about 3 weeks. I am slowly getting back to my old self and can only hope that I see more of this. I know I will appreciate it as well as others who have heard me yabbering on about how stressed I have been.

Well, I am going to do some reading and relax a bit before heading to bed. I can't wait to head home in the morning!

Saturday, February 14, 2009

Oh surgery, how I love thee - let me count the ways (not).

As you all probably know, I am sorry for my lack of posts over the past couple of weeks. Surgery is ... well, surgery. Overall I am sure that I will be getting a positive overall experience but I truly feel that I learned much more out of my first month than this one.

To start off, my first month ended spectacular. I found a wonderful book on the ICU call "The ICU Book" (haha). I really haven't had much time to read it since I started my new month of surgery but I can't wait to get to it once it is over! I truly loved trauma surgery and mostly I guess it was for the ICU patients. I think that I have determined that IM is the way that I am going to go in residency. Not 100% sure yet, but pretty darn close to that! I am thinking of specializing as well and at the top of my list is oncology but we will have to see. Anyway, at the end of trauma, I have learned so much, done procedures (PEGs, art line, femoral triple lumen, pulling chest tubes, etc), closed in surgery, done countless H&Ps (which I think I am kinda getting the point of *wink*) on top of learning so much in rounds! I was never criticized for having the wrong answer, sometimes told to check up on some things but for the most part having my attendings take the time to teach me. I left that month, feeling like I worked as hard as I could have and got nothing but good reviews of my performance. Who knows if that will translate into an 'A' but if not it is ok. Truly I am just trying to get through it.

So... this month. Yeah. Much different. Let me tell you, I would rather be on the trauma service for another month of 80-90 hours a week than what I am doing now. While my attending gives off a nice vibe, it is the majority of these last two weeks with him that I have felt just as how I thought the "typical surgical student" would feel. I am criticized quite often, rarely praised and pretty much nothing can please the man. When I get things wrong, I am given a good talk about how I need to read more (if I am even reading in the first place to him). If I am right, just more questions come until I get something wrong most likely. If I try to ask a question to clarify after I do something wrong, it is taken as trying to justify myself. I have already been told to shut my mouth when he is trying to make a point and to speak when he asks questions. It goes on and on. I know he has so much to teach and is a smart guy but I haven't learned 25% of what I did last month. Everyday I go in thinking that I will get SOMETHING out of this month - even to be more thick-skinned or quicker in responding to questions with more definite answers - but it usually comes out as a flop at the end of the day. I really am trying hard but I must admit that the constant comments and criticism of my work - to the point where he thinks I go home and just watch tv, MAKES me want to just go home and do that. If he will not believe that I am actually studying no matter how hard I try - why should I? What's the point?

We were in surgery for a total thyroidectomy and I read up good on it. I will admit I get super nervous when questions come. This is diminishing because for the 1/2 of the questions I get wrong (if not more) I am just getting used to that "oh shit" feeling in the pit of my stomach. So I read up on the thyroid well and in the 2 hour procedure I get 4 questions - 4! Out of the whole thyroid. Of course in the book I am reading it breaks down anatomy, physiology, diseases, surgical points in preventing complications, etc. Notta one question on what I read. So automatically, I must not have read because I answered 1/2 of the questions wrong. This was not the first time this has happened. At the end of the surgery when I was getting lectured, I was tired of it and told him that I did in fact read and he didn't ask anything about what I covered. I don't know what he thought of that but he told me to go ahead and tell him what I studied. So I spend a couple minutes telling him of anatomy, things to watch out for in surgeries, etc. Who knows if he was satisfied or more upset but I was tired of it. Some of his questions are just too advanced it seems for me - but I take it in stride hoping that I will learn even more. When I was asked to what I would like the D5 0.9%NS maintanence fluid rate to be set at for the patient post-op, well thank goodness I was wearing my mask because I was like whaaaatttt... Positive note? I now know how to do that. When I didn't know however it was shocking to him. His favorite line of this month is, "You have had a month of trauma surgery and you don't know how to do this/know this?"... sigh. What can I say, I am trying and furthermore... Only 2 more weeks! Less than that actually, as he is on vacation until Tuesday (so I am with his partners) and of course I have lectures to attend, conferences, meetings and still one more call. Only one more on-call in surgery!

I truly cannot wait until this month is over. Again, I will be in the ER next month for what is now 10 shifts of 10 hours thoughout the month. Umm, sweet!??? Plently of time to study for my shelf exam and Step 2 CS! Oy, but surgery just needs to end and I don't see why Ross has such a long surgical rotation. I was with a MSU student yesterday and he just had 4 weeks. Lucky duck. Anyway, I have made it this far and am currently finishing up the part of medical school I have been dreading for 3 years. It is almost over and to me, everything will be downhill from here. I have no idea what my grade will be in this rotation and as long as I pass... whatever!

Whew, felt good to get that off my chest. I still have a bunch more to talk about with other things but I will save it for another day soon to come. I am sure once this month ends (last day is February 27th) I will have so much more time to post! :)

Well, I am post-call and it is time to get ready to see my sweetie who is coming up to see me for Valentines Day! We are thinking of maybe going out to a comedy club which would be great. I could really use some comedy in my life at the moment ;)!

HAPPY VALENTINE'S DAY (or Happy Hallmark Holiday - whichever you prefer!)