A Day in the Life

I feel that whenever I have a story to share from the chronicles of residency or life it is typically an outlandish outlier from the day to day events of normal life. These patient stories and tales of inpatient medical adventurism are of course entertaining to share with other residents, and useful in doing so to blow off steam. These stories are also typically the traumatic or heart wrenching memories that have a profound shaping effect on our careers and insights as physicians. But, what often gets missed I feel is the mundane days that fill the void between the outrageous tales of crazy and noteworthy patients. I also think we as health care providers get so used to this monotony that we sometimes fail to see just how amazing and equally outlandish our typical normal days have become for better or for worse.
      So I feel justice should be paid to an average day in the life of a resident. One random day while on inpatient medicine I decided to chronicle the entire day. The following is the story of that day. If not for taking note of it, this day would have likely been lost from all memory and would have passed as just another drip of water on my forehead in the endless water torture that is general medical education.

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My Return…

It’s been almost a year since my last blog. Much has happened and in some ways its been a little overwhelming to absorb all the transitions that have unfolded. Although, I suppose that in itself is not special. We all live our own important lives with transitions and adventures in our own way. So in some sense that is no excuse for not finding the time and mental space to keep writing. This blog helps me make sense of the world, the brilliance, and idiocy that surrounds me. Ultimately writing helps me to figure out which one is which. Perhaps I’m shy to write more again as I’m pretty sure I’ll just wind up finding idiocy in my own self perceived brilliance.

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In summary over the last twelve months: Read more

The Interview Trail

We walk many lines in life. Sometimes these lines are well structured with clear and concise paths laid out in simple steps. Sometimes they are serendipitous. Most of the time we don’t see the lines for what they are. They are simply lines. Lines that we’ve created by our free will and choice. These lines cut and shape the seemingly gelatinous space that we call our lives to give us an idea of purpose, direction, and ultimately the identity of what we see ourselves to be.  Sometimes in rare glimpses we are allowed the fluke chance of circling back and re-emerging  on a line after a tangential circumnavigation through the life jelly, and in these strange moments we see can see a little more clearly, and we see that defining ourselves solely by the line we walk in life is a bit of a joke. If there are an infinite amount of possibilities in how we cut through the jelly than one singular path cannot possibly be our definition. Our identity that is immutable is the substrate between the lines. How we shape that substrate with these lines and paths through higher education and the carnival of the modern business world is just a byproduct of living in the modern world, and not as meaningful to our real identity as we are trained to think. Read more

The white coat turns black

If you think about it there is a high probability that you will someday die in the ICU. Unfortunately my month, notably my last two weeks became well known for the record setting 14 patients we celestially discharged. For the majority of these people death was inevitable, their last few breaths before a massive heart attack just happened to be on the ramp of the hospital after leaving some clinic appointment resulting in them being intubated just in time to buy a few more hours on the unit. But even in the face of futility there is still a feeling of guilt and sometimes overwhelming hurt when this news must be broken to a family sitting calmly in the waiting room. Read more

Settling In

 

Once the initial shock of foreign dials and tubes wore off I was starting to fall into the rhythm of how the unit works. In reality a lot of it is pretty cookbook, and I was getting better at baking. There are only so many paths to walk down when someone comes in with respiratory failure, or septic shock. As I caught on I really started to enjoy it. The MICU is just as busy as the CCU, but far more enjoyable because in my mind its real medicine and not a bunch of referencing to some obscure cardiology study to guide treatment. I started making decisions about treatment by just using common sense and wasn’t chastised for it, sounds like that would be simple enough to understand, but on the CCU I felt like I needed to be well versed in the “I went to third grade” trial before I could confidently tie my shoes without fear of punishment. Settling In

Intensive Confusion

 

The difference between the ICU and the medicine wards is sort of like the difference between making a microwave dinner and preparing a five course meal from scratch. What became painfully obvious to me the first day on the ICU is that I’ve gotten really good and pushing the buttons on the microwave, yet I’ve never had a cooking class a day in my life. Read more

Not a Cardiologist

Is the answer to the question what I will be when I grow up! Besides last month the last few months haven’t been all that bad. I was on Neuro for a month and then GI, my role was somewhere along the lines of a med student with the ability to write prescriptions. I got weekends off, and for the most part was home well before 5pm. Nothing to complain about at all, in fact I was starting to slip away from the reality that intern year is supposed to be hard. Read more