Attempt Number 2

So, it is now 3:30PMish, and I am sitting in the resident work room in the NICU (neonatal intensive care unit). It is (unusually, eerily) quiet this afternoon here - I only have 7 patients that I am responsible for today and they are all being well-behaved babies for now. I actually have all my work done already, so now I just get to chill until my shift is over at 6. (Hopefully noting catastophic happens between now and then.)

For some reason, I feel that NOW is a good time to retry this blog - I have made it through most of my intern year, and I haven't written a post since the first month, whoops! I really had NO idea how busy I was going to be, and how little free time I would possess.

Some things I've learned that has helped me survive thus far:
1. Be nice to everyone.
2. Be fully present where ever you are - at home, at work, driving.
3. Ask questions. If you don't understand it, don't pretend that you do. (Don't just ask your MD counterparts. Pharmacists, lab techs, nurses, respiratory therapists have made me much less of an idiot.)
4. Do laundry during nap time. Pray nap time lasts through at least 2 loads of laundry.
5. Plan your dinners out. Better yet, have your husband plan your dinners out.
6. Act calmly, even if you're not feeling calm on the inside.
7. Getting to work 15 minutes early on inpatient months saves an hour of time later. (I prefer to get in a few minutes early and leave early so I can see my family ... some may value sleep more.)
8. Assume everyone is smarter than you, cause they most likely are. Including your 1 1/2 year old son.
9. Admit to your mistakes. You will make them, and some will be bad. Learn from them and get over them. On the same note, you will get yelled at, don't take it too personally.
10. Don't gossip about anyone.
11. Tell your family you love them as much as possible, and be grateful that they put up with you.
12. Go outside as much as possible.

Addedum: This post was actually written two days ago ... I just got around to posting it now.

Things I Love/Loathe Right Now

What I'm loving right now:
- baby kisses (monsi [current nickname for our son] just learned to give kisses this week!)
- baby steps (he just took his first steps too)
- chai lattes (always a fave, but currently on a run with them)
- bookstores (I already miss borders)
- jogging with monsi (I love passing other joggers while pushing the jogging stroller)
- coupons (We save 100's of dollars a year, easily. Today I bought a brand new outfit for the baby for under 3 dollars. We've also been saving on chai concentrate, which is good since I've been drinking so much.)
- being silly with kids while at work
- being silly with son while at home (It's nice that someone thinks I'm funny)
- talking to first time moms in the clinic (I feel so connected to them!)
- seeing dads bring their kids to the doctor (It makes me feel so warm inside!)
- cooking at home (we've added a whole bunch of new recipes lately)
- my job, on the whole
- my husband taking care of me (I haven't done a load of dishes in days, he's awesome with our son AND he bought me flowers! Though he does lose a few points for repeatedly splashing me while I gave the baby a bath tonight.)
- yoga (stretching feels so good)
- snuggling (who doesn't love a good snuggle?)
- our church (we really feel like a part of our parish now)

What I'm loathing right now:
- working in the ER (I had to cover a night ER shift last week - I quickly figured out that it's not my calling, 3 hours into my first ever shift. I helped with some awful, awful tragic stuff. It was heartbreaking.)
- July heat
- construction zones (I go through 5 unique construction zones everyday)
- not having enough energy/time left to spend with my husband (after work, baby, and everything else, it's after 10 pm and I am just exhausted. Things are slowly getting better though.)
- our computer breaking
- unexpected car repairs (when it rains, it pours)
- our tomato plant growing 6 feet tall and not producing any tomotoes
- waking up at 5:45 on my days off (Thank-you, son.)
- not having enough time for my family & friends (I've been pretty anti-social since I've started working again. I haven't figured out how to balance everything yet. I still owe one of my best friends a return call from two weeks ago.)
- not having time to write in this blog (Saying I would have time to write 2x a week was a pipe dream)
- The Safety Dance (I've been listening to it daily for months because it puts my son to sleep. I just cannot listen to it any more.)

Dr. Dolittle

In clinic this week …

Patient (reading a book): “Mom, what type of duck is this?”

Mom: “Child, I ain’t no Dr. Dolittle.”

I’m a full week into residency, and still alive. (My husband reminds me that if I make it and if my patients make it through the day, then it’s been a good day.)

It’s been a big transition into residency.  In med school, I had no responsibility and was very limited in what I could do patient-care wise. Now, I can do everything and am expected to do everything. Patients think you know what you’re talking about when you have on the white coat. People take you more seriously on the phone when you introduce yourself as doctor.

Still, when my patients say “What do I do doc?” I look around the room for a doctor. A real doctor. But then I realize I’m the doctor. A real doctor in a long white coat. I have to reply to them.

I’m so green. And also so rusty. I’ve lost my rhythm in the past year. I frequently feel like Dr. Dolittle. Actually, it’s more like Dr. DoThingsInefficently.  With that said, I have learned a ton of information in the past week. It’s amazing how much better I am at doctoring now, and it’s only been a week. By the end of the day, my brain is total mush. And I’m just doing an outpatient (clinic/office-based) month. The hard months are yet to come.

While it’s been challenging, I’ve really been enjoying work. I love talking to parents and playing with kids. I like calling patients and being able to get handled things somewhat autonomously. I like being able to actually sign a script. My coworkers and attending have been nothing but wonderful, which makes work much more enjoyable.

Coming home to my monsies (my son) has been wonderful. He runs for me and squeals when I walk in the door. It is the best thing ever. I have been missing my son terribly, but he’s been doing great with my husband. I am able to give him 100% attention in the evenings . He fortunately is a night owl by nature, so we get a lot of quality time together. But then he goes to bed and my energy disappears, and I fall asleep on the couch after reading for 5 minutes. I’m just exhausted by the end of the day.

It’s been hard so far, but I knew it would be a difficult transition. I keep reminding myself that I am in the midst of a huge adjustment. I’ve gone from one extreme to the other – stay-at-home-mom to work-a-lot-mom.  (My goal someday is somewhere in between.) Things have been working out as smoothly as possible thus far. I am very thankful to have such great support from my husband. He’s amazing. He is really the one making this all go so well.

The July Effect

July First is Friday. That means I will be responsible for the health of children other than my own in two days. Good thing I've had eight months of practice with my own son.

There is always a lot of talk about how it is most dangerous to go into the hospital in July. You can find a lot of articles like this one from USA Today or this one from Newsweek that talk about patient deaths attributed to new residents in July. The basic idea is that July 1st is the start of a new academic year. All of the medical students are new, all the interns are new, the second year residents are really just interns +1 additional day, the attendings just graduated from their own programs, etc etc. [The attending doctor is the fully trained, supervising physician/professor in charge of the residents & students.] When you're new (and nervous) you make more mistakes, and theoretically that translates into worse medical care.

Should you really be scared to go to a training hospital in July?

One thing to remember is that the supervision is assuredly stricter in teaching hospitals in July. From what I hear from those that have trained before me, supervision in medicine, in general, is more strict now than it was years ago. There are more regulations - like duty hour regulations, and documentation regulations - than ever before. I have had attendings and preceptors tell me that they moonlighted [were paid to be work overnight] in their training ... as medical students! Interns are just not thrown in the way they once were.

The nurses are also not new in July. Some nurses have been working the same unit for many years, and frequently know more than the doctors that are taking care of the same patients.

If you go to a teaching hospital, you have multiple health care professionals evaluating you. If you go to a private hospital, you have the nurse calling your doctor, who comes in to see you at some point. (Or a hospitalist sees you instead.) That's about it.

I also looked up the study that the above mentioned USA Today article cites. There are multiple flaws with the study. The study only can show correlation of patient deaths in July, not causation by residents; the data is based on previous years where reporting may not have been as strict; only one type of error is evaluated, etc etc.

I don't think that overall medical care is worse in July, but I am going to guess it's slower. A lot slower.

Bottom line: all of the new pediatricians are going to be awesome. But you may want to avoid all those new surgeons ...

Sad News ...

My calculation of days left until the end of residency is off by a hundred. So much for triple digits - we're still well into the quads. Oh well ... I need everyday of practice that I can get!

I also found a more accurate countdown ticker (posted on the right side of my blog) - but it only goes into the triple digits, so just add 1,000 to the number.

Today's a Great Day!

Why? Two reasons:

1. My husband and I celebrated our two year anniversary today! We had a nice dinner out, followed by a nice jog together. (Had to burn off all those calories we consumed.) Baby came along too. He was exceptionally well behaved.

2. 999 days until July 1st, 2014 - the end of residency! Triple digits!

I hope everyone else had a great day today too.

Also, if you read my husband's blog, you will find that it is amusingly ironic that I had a suturing review course today.

The Name Game

Yawn, it’s late. The baby hasn’t been sleeping well this week, and I’ve been trying to do EMR (electronic medical record) training modules and study neonatal resuscitation after he goes to bed. It’s been quite challenging so far to find time at home to study. I’m hoping that the amount of things I need to do at home lessens, or that I get better at it. It must be very difficult to be a work-from-home parent!

Time is going to be hard to come by. My goal is to write a post twice a week on lighter rotations, and once a week on more difficult rotations. Writing is a valuable activity, and it’s definitely a good outlet for me.

This week was exhausting, but I think it went well overall. The husband and baby had a cold, but we all made it happily through the week. Going back to work is a difficult transition, but I knew that it would be long before it was here. Though challenging, it’s going as smoothly as possible. I’m very thankful for that!

I feel like writing about something light-hearted tonight.

Today I was thinking about how ridiculous I sound when I communicate with my son. Why do adults speak baby talk when communicating with infants? I don’t even realize that I’m doing it half of the time; I’ll catch myself (or a stranger will stare at me) talking nonsense and jumping up and down in the aisles of Target while shopping with my son.

Even the nicknames we have for our son are embarrassing. Our boy has acquired a disproportionate amount of nicknames in his short life, including (but not limited to)

babymon (it started as babyman - I frequently call my husband “dadmon”) the mons (also used to talk to my husband and son collectively), monsies (currently our fave), babes, bug, bean, bear, dude, the dude-ist, munch-munch, munchies, chubs, chubski;

There are also some nicknames we use only in certain situations: snoozy McSnoozerson (snoozy for short), crab crab, crab cakes, sneezy McGee, nude dude, splashy … the list goes on.   

Most of the inanimate objects in our house have names too, but I’ve already over shared enough for today.



Edit: I thought of some more nicknames we frequently use, based on the baby's hairdo: spikey, flatty, flat-head. I'm sure I'll think of more later.