ERs, clinics, exams, applications and nightmares

Another month of family medicine and I'm hooked. I really enjoyed my elective away. Office practice was interesting and well paced for my liking.

My month in emergency has been, as expected, a roller coaster. There were days that were boring, days I didn't have time to think, days I loved it and days I thought the time couldn't pass fast enough. I've had staff who I get along very well with and there have been staff who ask me two questions about a patient and order a test, sometimes without even seeing the patient.

Residency application time is quickly approaching. That constant nag of "did I remember to do that?" is going to make me lose sleep. So many documents and reference letters and forms and deadlines that I'm ready to explode. I feel like I gotta screw my head back on. My focus is all over the place. For example, I just realized that I completely forgot about a lecture yesterday. We get a grade based on attendance at four lectures, I missed one. Also, I just poured a tea and forgot about it. I can't get things done right now. I'm exhausted from a long, eventful month, and not in a good way. Between the GF's friend's death, my grandmother in the hospital, myself having a run-in with the ER as a patient, constantly changing shifts and nightmares for a good month I'm in need of a break.

A break. Guess what I'm doing next? ICU! By no means is this next month going to be a break. In fact, I have a heavy load in terms of rotations and work up ahead. Geriatrics at one of the busiest, craziest hospitals in the city, one that puts the most pressure on students to be assembly-line workers instead of students learning the craft. Up next, plastic surgery, where clinics that are WAY too overbooked and crazy surgeries, with anatomy that I desperately need to refresh on and a shelf-exam at the end of that month. Followed by: Internal Medicine consults! Where I'll be tested to remember the Zebras of medicine, the "Who'd have thought it would be that!" area.

And then finally, a month off. A month with no lectures, no clinics, no wards, no consults, no exams. Whatever shall I do with myself? Oh wait! I know! Interviews! I can only hope that by then I've figured out if I want Internal or Family Medicine. I'm sure it's Family. But the added stress of knowing that I really can't screw up because of the added thought of a Couples Match, where my interview isn't just MY interview, it's an interview for OUR application, TOGETHER to a residency.

But I want family medicine. A program where, usually, the programs are trying to get YOU to go to THEIR school. Instead of the usual, US trying to convince THEM to let US into THEIR school.

Have I enjoyed the hustle and bustle of the ER? Yeah. Was it what I thought it would be? No. Do I think I need to see what it's like in residency to make my decision about doing a fellowship in ER after I finish family medicine? Absolutely.

Ok, I know. I haven't blogged in ages. I could tell you all kinds of stories. I had a guy come in with the cops, another guy who avoided eye contact and would yell over my voice if I tried to interrupt him, one lady who had fibromyalgia and who cried hysterically when I examined her collarbone which had nothing wrong with it. I've had patients look at me like they would kill me, I've had others shake my hand and say "Thank you! You're going to make a great doctor" after I took the time to adequately explain things to them instead of barking orders at them like my attending did. I saw a lady with epiglottitis who became stridorous two hours after I first saw her and needed to be intubated in the OR with a tracheostomy kit ready. I saw a man with generalized fasciculating muscles, who probably is going to be told in the coming weeks that he has ALS or Lou Gherig's Disease. I had one man just recite numbers to me over and over and over and over and over and even when I told him "SHHHHH" so I could examine him he kept going and going and going and going and trying to blow out the fire on my stethoscope.

I love my job. I can't imagine doing anything else. Well I can imagine, but I can't imagine getting as much excitement out of it and feeling inspired to better myself every day, while doing something else.

I just need the nightmares to stop and my concentration, when I'm out of the hospital, to come back.

Time to remake my tea...