That time of the year again?

Is there a terrible case of PMAD going around? Tons and tons of emails. I responded to 20 or so today. If I didn't make it to yours I'm sorry. It's me, not you ;-)

Don't let me dissuade you from writing, though. I DO read EVERY SINGLE email. And I like reading them. I just don't always get to respond.

Take care ~Ella

Well it's Father's Day...

And we had to tell a big family that their 90 year old rather healthy and lucid father only had a few months left to live because of untreatable cancer. That was sad. Especially because he was such a total doll. When we told him his prognosis he just smiled, shrugged, and said "Eh, Whaddya gonna do? I've had a good life." That's how I want to go down. It was sad, but oddly not terrible. Kind of just like farewell.

HUGE NEWS

Anesthesiology has moved into first place.

To my readers...

I know that so many of you have been writing to me recently and I have not responded. Please forgive me. I am so crazy busy right now that I just can't. I will try to get through my old emails eventually. If you don't hear from me, feel free to try again in a few weeks. I'm sorry. I know that's lame but it's the best I can do.

~Ella

This med school stuff

Can seriously make a person a little nuts. Today was a call day. Usually the way it works is that as we admit patients during the evening, the med students are assigned patients to see. After we see our patients, we round with the attending, and if we've picked up enough patients we can generally go home. Now, if we meet our requirement by 8:00pm, we can generally go home when we are done. Today, I got mine done at 6:00pm and we finished rounding soon thereafter. I was so stoked about getting done early. But we got a new resident today. And instead of letting each person leave as they finish their work, she wanted everybody to stay until each student was finished. And of course one student wasn't done... and she seemed to be taking her sweet time as well. So I literally had to stay 3 extra hours for no fucking reason whatsoever. Just standing around with my thumb up my ass.

Thats when the "nuts" part kicked in. My brain really started messing with me. Chastising myself for being so stupid as to go to med school at 32. Considering writing my letter of resignation. Wondering what would happen if I threw that large glass bottle of some unknown narcotic across the ED and just went totally AWOL. It was surreal. I seriously had to Buddha Zen my way out of it. It wasn't pretty, folks.

Oh my friggen' God

SOMEONE (not naming names) acted like I was the HUGEST idiot for mixing up two drugs.

Her: What's Solmeterol?

Me: It's a steriod.

Her: NO its NOT!

Me: Oh. I thought it was similar to Prednisone.

Her: No, Prednisone is Prednisone.

Me: I didn't say it WAS Prednisone. I just thought it was a similar steroid.

Her: No, you're wrong. You should know these things. Solmeterol is a long-acting beta agonist.

Me: Oh, ok. I guess I was confused. I don't know why I thought it was a steroid.

Her: Neither do I.

Later I look it up and realize I was thinking of Solumedrol. Which in my opinion, sounds damn effing close to Solmeterol. WOW. I'm SUCH an idiot first month, third year med student.... getting Solmeterol and Solumedrol mixed up. I should probably drop out of med school asap.

I want her to do it

I've been seeing the same patient on the wards for almost 4 weeks now... and today he finally got to go home. He seems to have gotten pretty attached to me... and I to him. He tells me things he won't admit to the other doctors, and he always asks me to "translate" what the attendings say after they leave. He says he "loves" me (in a "thank you for not letting me die" kind of way) everyday, and offers me lunch and brings me candy. So we have a bond. And... I forgot to mention... he has MASSIVE white coat anxiety. So he literally turns to a nervous wreck whenever any docs enter the room but me.

So on the day of his discharge... (finally!)... he needs to have his central line taken out. The whole team goes into the room and my attending tells him he's good to go as soon as we take out his line. Well, he freaks out and asks the attending who is going to take out his line... and the attending says he'll do it himself.

Well my patient throws a fit and says he only wants me to do it. I was certain my attending would respond with a "Oh no you don't! She doesn't know WHAT the hell she's doing" ... but instead he smiles and agrees. For god's sake I didn't want to tell him I'd never really pulled one before... since he was so nervous anyway. But alas, I pulled it without issue, and managed to act like I totally knew what I was doing. Not sure if I'm a better actress or physician... but overall it was all a success.

On nurses....

I'm sure this post is going to go over like a match on gasoline... but really... I need to vent. So let me preface this venting session with a couple things:

1) I am a HUGE advocate for treating everyone alike, getting along with everyone, and for doing my best to refute stereotypes in the workplace.

2) I have worked in many hospitals (a dozen in several different states) and dealt with 100's of nurses... so my "opinion" isn't based off of 3 nurses in my hospital.

So here's my question. WHAT'S UP WITH THE EFFIN' ATTITUDE?

Do nurses really get treated THAT badly by everyone that they cannot muster a clean slate when they meet new people? Let me throw out a few scenarios here. All different nurses, mind you.

Scenario #1

Me: Hi Nurse 1. I'm Ella, part of Dr. X's team. Are you patient Y's nurse?

Nurse: Maybe. Depends on why you want to know.

Me: (smile... trying to break the ice) Ok, well when you have a chance he'd like to get his nicotine patch.

Nurse: Don't know why you bother. He's just going to rip it off later.

Me: Well, maybe, but he asked me... so I'd like to get him one while he's in the mood for trying.

Nurse: (Very snotty) Well, YOU'RE just going to have to wait.

Me: No prob. Like I said, whenever you get a chance.

Nurse: Well IF I get a chance I will.

Scenario #2

Me: Hi nurse 2. Dr. X is worried about patient Y and he'd like to get a glucose check right now.... I don't mean to rush you... but I think it's pretty important.

Nurse: JESUS CHRIST! Like I don't have anything else to do.

Scenario #3

Me: Hey is that patient Y's chart? Do you mind if I just sneak this note in there real quick?

Nurse: Is this your patient? Why has he been here so long? He needs to go!

Me: Well, he's got (really bad disease X). And he needs daily treatment.

Nurse: Well, I don't feel sorry for him. He does cocaine, right?

Me: Well, his tox screen was positive... but that's not related to the disease.

Nurse: Well, still. We shouldn't be putting so much effort into him.

Me: Well, that's what we do here. Help sick people.

Nurse: Hmpppfh.

Scenario #4

Me: (trying to get some blank progress notes which have been placed near a nurses desk... and I'm not even in the way or near any of her personal space/ things)...

Nurse: What do you need (attitude 10/10 on the bitchy scale)??

Me: Oh, hey, sorry I didn't realize this was your desk. I am just looking for the progress notes.

Nurse: Well this is MY desk.

Me: Oh. Ok. Well Dr. X said this is where they are kept.... but maybe he was confused. Is there some other place I should get them from?

Nurse: Nope.

Me: Well.... ok...

Nurse: Sigh. Well, go ahead.

Me: Big smile on the outside. Dagger of death on the inside.

Scenario #5

Me: Hi Nurse 5 (who is in charge of LTAC placement). I'm Ella. Dr. X was wondering if you know of any LTAC facilities that will do IV meds for 10 days.

Nurse: No.

Me: Well the problem is XYZ. Can you think of any way that we can deal with that?

Nurse: No.

Me: What about Facility X?

Nurse: No

Me: Facility Y?

Nurse: No

Me: I heard they will make special accommodations as long as the patient is ambulatory. Would you be willing to check?

Nurse: No.

And I can give 100 more scenarios like these....

Hmmm... that's odd

So last week my attending (the rock star woman who is highly respected in the city, university, and medical community) told us that we were some of the best students she had worked with and she gave us (well at least me... can't say for the others, but I assume so) great evals. She even had gifts for us (books with personal notes in them) the following week at class as a thank-you/congrats. THIS week, we have a new attending... who also acts like (and actually said so) he likes us.

However, our new resident doesn't seem to like us. First off, we were supposed to meet her at 7am the first day in the conference room. Which we were all there. And she wasn't. So we waited. 45 minutes later she shows up. Ok, fine. So she's late. No biggie. However.... the first words out of her mouth were "Ok, so my expectations. First, don't be late.". We all kind of looked at her like she's nuts... but ok whatever. Now, onto the end of the week (yesterday).... she pulls the three of us aside and says she has problems with our professionalism. That we should be on time (to my knowledge I have never been even a minute late for anything), and that it is highly unprofessional to be writing anything on rounds (um, so I'm supposed to just memorize everything?)... and that we are so lucky to have her and a "nice" attending because we would get our asses chewed by anyone else... and that she's doing us a favor.

THEN during rounds... the attending asks her a question... something like "What part of the gut does iron get absorbed? I can't remember"... she shrugs her shoulders, doesn't know.... and neither do the interns. Then he asks us, and none of the three of us know either. Then she incredulously says (rather rudely) "Seriously? I mean, you guys JUST took step 1".

Needless to say, I'm a HUGE fan of hers.

My First Clinical Evaluation

Was awesome. From a "high on the food chain" attending who I deeply respect. She said she had nothing to discuss in regards to weak areas... basically she thought I was doing really well, presenting strongly, establishing rapport with patients, and demonstrating strong medical decision making. She gave me some good "life as a woman doctor" advice... and that was it. YAY!!! I was so happy I almost floated out of the office. And I totally thought she was going to ream me for constantly eating granola bars on rounds.

More Gastric Pornography

Homemade Strawberry Ice-Cream

Toasted Sesame Seed Asian Chicken Pasta

Spicy Creole Tomato Egg Salad Sandwich

Zucchini Bread

Blackberry Cobbler

Oh and...

I keep running into my ex's fiance at work. Which I thought was going to be weird or irritating or awkward. But actually, I think I like her better than I like him. Lol, Whatev. (kidding. sort of.)

Frustrations...

I'm frustrated. Irritated. And it's only the beginning, I am fully aware. But I figured this is the best venue to vent. But seriously? People that refuse to sign DNRs for vegetative family members just so they can continue to receive their government-issued checks? Wrong on 500 levels. Sickle cell patients that rotate through the hospital every week or two and act like they should be waited on hand and foot like it's the damn Four Seasons? Refusing to answer simple questions, or make eye contact, or refuting every attempt made by anyone in the hospital to make them happy? Patients that have to be readmitted to the hospital 3 times a week because they can't qualify for outpatient dialysis?

Pure insanity. And I have low tolerance for BS. My attending however, is amazing. I'm pretty sure she's next in line for canonization.

Ok so this sucks

It's finally kicked in. Call nights that suck. Worked 16 hours, slept 4, working another 12 now.... t...i....r....e...d.....zzzzzzz...zzz....zzzz.z...z

First Patient Died

Well, it happened. I knew it would sooner or later. My team saw a patient in the morning. She asked for chocolate Ensure. Two hours later in the middle of rounds we heard a "code blue". There were 50 doctors and 20 minutes of CPR. Then that was it. And we finished rounding on our last 3 patients.

It will work out if you don't give up....

Lately I've been getting a lot of "panicky" emails from pre-meds. If I haven't written you back, please don't be offended... I've just been inundated with "help me!" emails as of late. And I figured I'd kind of throw my answer out for everyone to read.

So the panicky emails go something like these...

- Help! I took pre-med class X in the spring of last year but didn't pass it so I need to take it again. The question is should I take the MCAT before or after I retake the class? Because if I wait, then it might be too late to apply this year... yada yada yada....

or

-What should I do?????? I haven't heard back from any schools, should I contact the Dean? Or should I not bother them? Because I know you are supposed to assert yourself but I don't want to be annoying...

or

I got into 2 med schools and I don't know which one to go to. One is near my parents house and I can live at home for free... but the other school is way more prestigious and six times the price....

Sigh. If I could go back in time... say oh, 10 years, and tell my young semi-pre-med self just ONE thing.... it would be that NONE of this matters. Seriously. It doesn't matter if you make a phone call or send an email. It doesn't matter if you take the MCAT in April or September or even 2 years from now. It doesn't matter which school you choose.

All that matters is that you

1) try your best to make reasonable decisions that minimize your stress level and are conducive to you being happy and an overall ethical person

2) don't give up.

Really. I swear. That's it. Things will work out the way they are supposed to, when they are supposed to. And it won't be because Thank GOD you took physics before O-chem, or because you wrote a thank-you note on paper instead of sending a thank-you email. That stuff doesn't matter at all.

Moving on up...

Yesterday we got called minions by our resident. Before that he just called us speed-bumps.... because apparently we slow him down. I think that means we're moving up on the totem poll.

Worst Day So Far...

I mean nothing TERRIBLE happened... but I worked 16 hours and 4 of it was class on acid/base. Talk about hell. And my dog is NOT a happy camper that both of his walks today were in the dark. Poor baby.

As much as I hate to admit it...

I kinda like internal medicine. I mean... maybe. Or maybe I just like that my attending is extraordinarily hot.

First Call Night

Well, I survived. It wasn't bad actually. I arrived at 6:00 am and I managed to be home before 7pm. I was tired of being on my feet, and not used to being so damn hungry, but other than that it was pretty fun. Have to say I'm learning a lot, and I really like my residents and my attending. So yay!