100-hour work week

I worked 100 hours this week. I'm not even kidding. I was on call 3 times. Two of those call nights I didn't sleep AT ALL. I have never felt so tired in my life. On Friday I had about five cups of coffee and I was still struggling to stay awake. This is nuts!

But somehow I'm still enjoying it. I love the kiddies. I respect my colleagues, and feel privileged to be a part of Pediatrics. And I still get excited about interesting diseases and cool procedures. So I guess that's a good sign. Intern year hasn't completely jaded me. :)

Well this tired little intern is going to veg on the couch tonight. More later!

Protest

My body is protesting. It's over the long hours. This weekend I slept about 24 hours. I slept Friday night, almost all day Saturday, and had a little cat nap today. I'm not sick. I haven't been going out partying. So the only explanation is that my body is in protest about residency. I have to agree with it. I'm tired of this. What was I thinking when I decided I wanted to be a doctor? And what was I smoking when I decided to join the military? I am so not military. I don't like wearing boots. I don't starch my uniform. I can't remember ranks. I don't like guns. I believe in love, not war.

How in the world did I get here? I suppose God led me down this path. I just hope He knows what He's doing. :)

Now it's back to... you guessed it, BED!

Back to the grind

I am back from my one glorious week of vacation. I flew to southern Virginia, where my parents live. I enjoyed 7 full days of sleeping in, eating home-cooked food, and vegging on the couch. It was fantastic. I was so sad to fly back on Sunday night. I have never dreaded going back to work so much. Not that work is BAD... it's just the hours were wiping me out, and so the thought of returning for another 6 months of intern year was depressing. But I suppose that's a glass-half-empty attitude. A glass-half-full person would say, "Wow, I'm halfway done with intern year!" I am trying to be more optimistic. Affirmative thinking, right? I can do it!! 6 more months!

Last night I worked on the ward. We had a 3 month old baby come in that seriously looked like a little Michelin man (hence the picture above). It was hilarious. I walked in and almost started laughing (thankfully my social tact kicked in and I laughed on the inside). Then I wondered to myself if that's what doctors thought when they saw me as a baby. I was also a really fat baby. My mom says my Korean grandmother thought babies should eat as much as possible so every time I cried she stuck a bottle in my mouth. There are pictures and home movies of me looking almost like the little Michelin baby I saw last night. So I guess I shouldn't poke too much fun at this kid. It just cracked me up, though.

Happy New Year! :)

Dry spell?

Today was so frustrating. I woke up late, as usual. Got to work late, as usual. My senior resident said, "You're gonna be one of THOSE residents, aren't you?" He was just teasing, but I didn't laugh. It was 6:00 in the morning and I hadn't had my coffee yet. I was slow rounding on patients. Physically slow, mentally slow. I didn't even get all of their information before rounds, so I sounded like an idiot when I presented to my attending. Then we were called to a scheduled C-section. The baby was 37 weeks gestational age, a bit premature. He appeared to be doing fine at first, but had some increased work of breathing. We watched him for awhile and decided to take him to the NICU for observation and diagnostic work-up. He needed some interventions, including an IV line, arterial stick, and intubation to give surfactant (a medicine we give to premature babies with immature lungs). As the intern, I was permitted to try all of these procedures first.

IV - tried three times, missed it. The nurses and techs made fun of me. "Have you put IV's in many patients? Maybe you should practice on an adult." I tried to laugh along, and replied "Yes I've put lots of IV's in adults AND babies, and I've gotten many of them. I'm just not having much luck lately."

Arterial stick - tried two times, missed it. At this point I can feel my blood pressure rising and my frustration increasing. But decided to get back on the horse and keep trying procedures.

Intubation - tried three times, missed it. Are you kidding??? I've gotten the last several intubations I've tried. This kid is KILLING my self-esteem!!

A little background info - I've been missing IV after IV, blood-draw after blood-draw... for the last 3 weeks. So today was just the icing on the cake. I felt so completely incompetent. The teasing got old. I was hungry and cranky. I snapped. My senior resident tried to make me feel better. He told me I'm probably just in a "dry spell" and that I need to keep trying until I start getting successful procedures again. I'm not so convinced that this is a dry spell. I think I'm getting tired of intern year. It's wearing me down. I've been working 12-14 hours a day for the last 3 months and I'm exhausted. I need a break. Thank goodness Christmas is just around the corner. I can't wait!!

Circumcision gone bad

Don't be fooled by the title of this blog. I didn't cut off a little boy's penis. He is still a boy, thank goodness. I'm on my nursery month right now so I've been doing lots of circumcisions. And if I say so myself, I've gotten pretty good at them. I think I'm down to about 10-15 minutes per circ, and I have had very good results. HOWEVER, yesterday I had a small complication. Not for the baby, but for ME. I was injecting lidocaine to numb up the baby's penis - something I've done many many times before. I was feeling confident, chatting with my resident and working quickly. I withdrew the needle in order to inject more lidocaine on the other side... and whaddya know, I stuck myself. A small poke in my finger, but I saw a little drop of blood. Nobody saw it happen, and for a millisecond I thought about not saying anything. But I knew I had to. So I told my resident, and I had to stop the procedure and go through the whole needlestick protocol. It can be quite painful. They took 5 tubes of blood from me (it was a lab tech who I was rude to once, so I think maybe he took more blood than he needed as revenge). They checked the baby's mom for diseases. Everything is negative so far. But I felt like such an idiot. I guess that's what I get for being too confident, and being careless with my needle. Lesson learned. And intern year continues...

Kids and their stupid germs...

So I've discovered one of the sucky things about working in Pediatrics - getting sick from the little disease vectors! Oh yes, they're cute. But they are loaded with all kinds of nasty viruses. I got to experience one myself this weekend. Late Friday night I woke up feeling nauseous. I thought maybe it was just something I had eaten, so I rolled over and tried to sleep it off. A couple hours later I was making a mad dash for the bathroom... and just barely made it. I ended up spending all day Saturday either in bed moaning or hanging over the toilet wretching. I managed to keep a few saltine crackers down, but otherwise didn't eat all day. I felt so weak I could barely walk to the kitchen to get water.

The thing that sucked the most about getting sick was that this was my last full weekend off for awhile. And it was Kimberly's last weekend here in San Antonio. We had big plans to go to Austin Saturday night, to enjoy one last night out together. Oh well. I guess I should be thankful that Kimberly WAS still here when I got sick. It would've sucked being all by myself and sick.

So that was my weekend. Tomorrow it's back to work. My month on the ward is over. I start Nursery next. Should be fun. I'll be sure to share interesting stories.

My 33-hour day

Yesterday (which really started the day before yesterday) was one of the longest days I've had yet. I'm working in the NICU this month and I'm extremely sleep-deprived, so I'm going to be brief. In fact, I think bullet format will suffice.

- Monday, 0530: Woke up late, threw on my clothes, packed my lunch, and grabbed the trash to place on the curb. Halfway to the hospital, realized I had accidentally left my lunch with the trash. Not a great start to the day.
- 0615: Arrived fashionably late for sign-out (that's when residents change shifts). Apologized profusely and sank in my shoes, feeling like the worst intern ever.
- 0700-1230: Rounded on patients, hurriedly wrote notes, ran to the call room to change into my uniform for continuity clinic.
- 1245: Left late for continuity clinic, which is across town at a different hospital. Drove my little Civic Si like a race car and STILL got to clinic late. Had enough time to grab a corndog for lunch. It was disgusting.
- 1300-1600: Had continuity clinic. One no-show, one left without being seen because as always I was running late. Again felt like the worst intern ever.
- 1615: Headed back to Wilford Hall for call. Grabbed snacks and Red Bull from the BX. Ran to the call room and changed out of uniform back into scrubs (now on clothing change #3 of the day). Got to sign-out JUST in time.
- 1700: Began my wonderful night of call. Attempted to work on discharge stuff for one of my babies, but kept being interrupted by my pager.
- 1800-midnight: Don't even remember what I did, but I was busy.
- Now Tuesday, 0200: Decided to try to get a quick nap; went to the call room and fell into the bed. Set my alarm for 0400 thinking that would be plenty of time to gather numbers, write notes, etc.
- 0400: Stumbled back to the NICU and starting writing down vital signs.
- 0430: Paged for twin delivery. Headed to the delivery room, felt like absolute crap. Head was hurting, mind was still asleep, stomach writhing a little from all the candy I ate on call.
- 0530: Finished writing notes and orders for new twin babies; returned to NICU to collect data. Started putting data into computer for day team.
- 0600: Day team arrived; NOT done with my work. Gave a crappy sign-out, and ran off to see my patients before rounds. Again, worst intern ever.
- 0715: Informed that we had the ferret lab. Went to the call room to change out of scrubs and into PT gear (you can't walk to the lab in scrubs). Note: this is clothing change #4. Walked to the lab with coffee in hand... running on adrenaline and Seattle's Best at this point. Changed out of PT gear and into another set of scrubs (change #5). Lab was pretty cool, despite the fact that I had now been awake for almost 24 hours straight. I got to intubate two ferrets, and I was succesful on my first attempt on each. Not bad, if I say so myself. Hehe. Changed back into PT gear (change #6) and walked briskly back to the hospital.
- 0900: Changed back into original set of scrubs (change #7) and headed to the NICU to finish seeing patients/writing notes.
-0930-1200: Rounded on patients, finished work. Drank more coffee. Tried to finish up work, but was told to leave (after 30 hours we "turn into pumpkins" - we have to leave in order to avoid breaking work hour regulations).
- 1215: Changed back into PT gear (change #8) and headed to the library to kill time before my dental appointment. Almost fell asleep at the keyboard.
- 1330: Went to dental clinic. Had probably the most painful filling placed EVER. Almost gagged on my saliva as the dental assistant sat there with the suction device stuck to the inside of my cheek instead of suctioning the back of my throat. Tried to say "I'm gagging" but it came out "I hahheen".
- 1430: Left the dental clinic wanting to cry from the pain. Called my sister and complained. Went home and sat on the couch moaning. Spent the rest of the day feeling sorry for myself.

And that was my 33-hour day. I didn't eat breakfast or lunch (unless you can count a nasty corndog). I changed 8 times. I resuscitated 2 babies, intubated 2 ferrets, and had a cavity filled. Did I mention I feel like the worst intern ever?

Now I gotta get to bed so the craziness can continue tomorrow.