The next hurdle

During residency, we are constantly moving from one training environment to the next. We have month-long rotations through the different departments in Pediatrics: clinic, ward, nursery, intensive care units, specialties like Cardiology or Heme-Onc, and so forth. My first three rotations this year were pretty easy, despite all my whining about being tired and working hard. I've actually had it kinda nice. But starting next Monday, I will be entering a tougher phase of my intern year. I have three inpatient rotations in a row. First I have my NICU rotation (Neonatal Intensive Care Unit), then the pediatric ward, and then nursery. All of these rotations require long hours, sometimes working 2 weeks straight before having a day off. I will be pulling regular call, most likely every three to five nights. I'll be responsible for some very sick kids. I'm a bit nervous about it.

And the thing about these month-long rotations is that by the time you've kinda figured out what you're doing and feel comfortable, that's when it's time to move on to the next rotation. Today was the first day in my clinic month where I felt almost like a doctor. I was relatively on time for all my patients, I made some good management decisions, and I even had time to call some patients at home and follow up on stuff. It was a much-needed ego boost.

Oh, and I found out I passed my boards! So, one hurdle cleared... many more to go. (And yes, that's a picture of me jumping a hurdle - many, many years ago in high school. Ah, my days of track glory. Hahaha.)

It's all about the benjamins

I had my 26th birthday this weekend, woohoo!! I know 26 isn't really a landmark birthday, but I wanted to have a big celebration anyway because 1) It's my intern year and there are rarely occasions to go out and let loose, and 2) It's the one time of year when you can act like a kid and demand that the world revolve around you. Just kidding about that last part. Well, not really. But anyway, Friday night I had a birthday dinner at a really nice restaurant downtown. A few residents were there, as well as my good friends Kimberly and Jenn (Kimberly's my old roomie and a medical student, here on a rotation; Jenn's a friend from Maryland who had flown in to visit for a few days). After our fantastic dinner, we headed to a club across the street called Suede. I had never been there before, but one of my friends said it was supposed to be a great place to go dancing. So we walked into this place and headed to the bar for some birthday drinks. I had a buttery nipple, one of my favorite shots (despite the naughty name, haha). We stood and chatted for awhile, then the ladies started gettin our groove on. We were probably the only people dancing in the room, but I didn't care because - it was my birthday! Then, in the middle of a Justin Timberlake song, something really strange and random happened. I heard some noise from the balcony above and I looked over at Jenn and saw that she had stopped dancing and was staring up at the balcony with a confused look. There was a blonde guy standing there smiling, and it might have been construed as harmless flirtation had it not been for his entourage of beautiful young women with implants and low-cut dresses. Then he dropped a small paper object, and I watched as Jenn reached out for it. It slipped through her fingers and fell to the floor and everybody seemed to freeze as she reached down and picked it up. Then I saw it - Benjamin Franklin's face. "Jenn, is that a hundred dollar bill???" She looked up, dazed, and said, "Yeah, I think it is." I was stunned. "Did that really just happen??" I asked. She nodded and we both looked back up to the balcony. The blonde man and his entourage were smiling at us and giving us the thumbs up. I looked around and everyone was staring at the hundred dollar bill, mouths wide open. Jenn stuffed the bill in her pocket and said, "I'm going to the bathroom." So we ran off to the bathroom and once inside, we inspected the bill more closely. It looked genuine. We continued to be amazed for the remainder of the night, and the bill stayed in Jenn's pocket until we got home. Then I took the picture of Jenn that's posted here, just to prove that it really happened. Who was that guy? And why did he throw a hundred bucks at us? I'll never know. But for one night, it was all about the benjamins baby. Hahahah.

Ear day -- a.k.a. Kill-Linda's-self-esteem-day

Today started out as a normal day in clinic. I had a well-baby visit, which went smoothly. I was actually ON TIME for once, so I was feeling pretty good about myself. Then the ear visits started. First it was a little boy with fever and congestion - sounded like a viral respiratory infection to me. I strolled off to my preceptor's office feeling confident, presented the case, and said "He looks great. Tympanic membranes are clear, so I don't think there's an ear infection causing his fever. This is probably viral - we'll treat him symptomatically". My preceptor walks with me to the office, takes one look in the baby's ears and says, "He's got an ear infection." Great. Moving on. Next patient has similar complaints: fever, congestion, cough, loose stools... so again I'm thinking viral infection. But this time I wanted to be sure, so I attempted to get a good look at the kid's ears. FULL of wax. I tried cleaning it out with my little ear pick, and I guess I was too aggressive because the kid started screaming and I noticed blood coming out. CRAP. I ran to my preceptor's office in a panic, thinking I perforated this patient's eardrum... but he assured me that it's not uncommon for ears to sometimes bleed when being probed. So I sent the baby to get his ears flushed (I figured I had tortured him enough with my little instrument of death). When I was finally able to see his ears, they were bright red - as expected, since he had been screaming his head off. So I couldn't figure out if he had an ear infection or not. Turns out he didn't. (Again, my preceptor took one look and said, "No ear infection. Just red from crying." Of course, his ears didn't look any different to me than the previous kid's ears, but apparently it was obvious).

And then there was the finale of ear drama. My last kid of the day, chief complaint of hearing loss. Mom seemed friendly enough; she didn't even seem to mind that I was an hour behind. We chatted for a little while, I got the medical history, and then it was time for the exam. I looked in his ears and whadya know... full of wax. Perfect. It's the end of the day, I just want to go home. So I decided to try to get the wax out so I can see his eardrums. After my previous experience just hours earlier, making a kid's ear bleed, I decided to be extra gentle. So I got my little probe, pulled my patient's ear slightly to open up the canal, and started moving the wax out of the way. He seemed to be doing really well. Then all of a sudden I heard a sniffle. I looked at his face and he looked like he was ready to burst into tears. And a second later he did. Of course that made his mom get all upset, and so whatever rapport I had established with her went out the window. She went off on me. Big time. She said, "I want someone to look in his ears to see if you damaged anything. He never cries, and you stuck that thing in his ear and made him cry." I said, "I apologize, ma'am, but sometimes kids do cry when we try to get wax out." "NO, my son never cries. I want a REAL doctor to look at him. I'm just not comfortable with some intern sticking stuff in his ears." "Again, ma'am, I'm sorry. I AM a real doctor, but if you'd like to see my staff, that's fine." I maintained my composure long enough to leave the room and go to my preceptor's office. Then I lost it. I don't know why, but I started crying. And when my preceptor asked what was wrong, it was like when you're little and you've hurt yourself and you're totally fine until you hear your mom's voice, then you break down. I just felt so frustrated and incompetent. It's so hard being an intern. You've worked four hard years in medical school and you have an M.D. after your name, but you still feel so inexperienced. The nurses seem to know more, even the techs seem more capable. I've tried so many procedures and failed... I can't seem to remember any of the basic skills I should've learned as a med student... I'm tired and defenseless... and now a patient's mother has questioned my competency. It was enough to send me over the edge. But just for today. I won't let her shake my confidence for good. Tomorrow is another day. Fresh, with no mistakes in it yet. :)

And now I'm gonna go take my frustration out on my weeds. Later!

New hobby

I've discovered a new way to release my stress: gardening! My mom has always been into gardening, and she used to try to share her hobby with me when I was younger, but at the time I had no interest. Now that I have my own house, it's a little more appealing. Also because I spend so much time inside the hospital, it's nice to be outside and enjoy some fresh air and sunlight. But man, it's hard work! I spent two hours weeding today and barely made a dent in my backyard. It's FULL of weeds. My back is hurting, my neck is sore, and I have itchy red marks all over my legs. But it was rewarding. I have a vision for my yard. It will be my oasis.

Meanwhile work goes on. I'm now fully immersed in internship. No longer can I say, "Well it's only my first week!" I'm working in the clinic this month, which is fairly low stress. Next month I'll be in the NICU... which scares me. I did a rotation in the NICU last year as a med student, but it's going to be a very different experience as an intern. But I suppose I will get through it, just as everyone before me has. I cleared another obstacle last week - Step 3! It's over, yay!! Now I have to play the waiting game. It will be 3 or 4 weeks before I find out if I passed. PRAY!

Now it's time for well-deserved sleep. Goodnight! :)