Putting A Bow on Third Year

I'm on vacation this month.  It's pretty sweet.  I can tell it's been a proper vacation because I'm starting to miss work.  Seeing patients, having structure, using my brain... it will be nice to get back to it.  That said, I have almost two weeks left of time off, and I intend to enjoy them.

I was looking back over the posts I've made this last year and I realised, with a quick flash of guilt, that there are some key months I didn't write about.  In fact, there are some months I specifically said I'd write about that I then never wrote about.  Clearly, I am untrustworthy.  But to show you that I am capable of trying to make amends well after it matters, here is a quick rundown of The Months I Missed!

THE MONTHS I MISSED

September, family practice clinic: My attending worked like a dog.  And he had cancer.  Which meant I worked like a dog while he tried to work and often failed and sat in a chair with his head down, breathing deeply.  I was constantly worried about what would happen when he collapsed.   He gave a lot of steroid shots.  Pros: I got comfortable with autonomy and learned how to give knee injections.  Cons: none.  JUST KIDDING MY ATTENDING HAD CANCER.  You try watching a cancer patient work three jobs with a chemo pump on while he's almost too weak to stand and see what happens to your blood pressure.

(He's fine now.)

December, surgery: I know, I know.  How could I haven forgotten to write about surgery?  I don't really know, because it was a very post-worthy month, seeing as how I hate surgery and surgery hates me.  Not the people; they're just fine.  But the actual job.  Do you know how many times I almost collapsed during laparoscopic surgeries because I was falling asleep?  How many times people had to send me back to rescrub because I left my wedding ring on/ my hands were too high/ my hands were too low/ my elbows were touching my sides?  (Side note: my elbows were touching my sides.  Well, I promise not to rest my elbows on the surgical field, then - I mean, I was planning on it, but now that they're tainted and all.)

And then there's the wound care.  (Look up "chronic wound debridement" on an image search if you are brave and would like a visual.)  Keep in mind that I love abscesses and acute injuries.  I could lance infected wounds all day, go home smiling, and eat a casserole for dinner.  So.  When I tell you that cleaning/ debriding a chronic wound gives me uncontrollable full body shudders, it should give you an idea of how very much I should not do that job. I could go on, but hopefully I've already accomplished my mission and put you off your food and we can all stop thinking about this now.

Pros: I know without a doubt how to scrub in now, and they managed to beat the basics of sterile procedure into my brain.  Apparently that's important.  Cons: CHRONIC WOUNDS.  NEVER AGAIN.  Except probably again.  They're a difficult thing to avoid.  Also, I learned I am physically incapable of getting up before 0530.  I was late to work every day that month.  Every.  Day.


February, pulmonology: I got to see why people in internal medicine like to specialise.  It's because as a specialist you get time to stop and think while making boatloads of money, and you get to do procedures.  If I didn't think -oscopies were boring (from bronchi to bladders, if you have a tube or a space, we can stick a camera up/down/into it), and I didn't think 3 years of internal medicine residency would break me, I would consider specialising in something.  Seems like a nice life.  Pros: learning the basics of ventilator settings and a little ICU medicine.  Actually, learning period.  My attending this month wasn't the sweetest man, but he was a bloody good teacher, and that's more important.  He didn't load us down with scut work, so we could actually use our brains instead of tearing through paperwork as fast as possible to get it finished in time.  Cons: I'm really not built for a subspecialty.  If pulmonology is any indication, you learn about one small field in extremely thorough and technical detail, you use a lot of gadgets, and you avoid getting anywhere near chest compressions.  I'm a jack-of-all-trades, big-picture kind of lady.  Also a chest compressions kind of lady. I probably won't become an -ologist.

March, family practice: Family practice is nice.  We're all aware that I struggle with family medicine vs. emergency medicine, so the fact that I liked this month is no surprise.  I do know that clinic is a place where I struggle spiritually, because it's so easy to get lulled into the rhythm of paperwork, timed visits, and mild complaints.  I have trouble staying sensitive to what the Lord might ask His servant to do day-to-day.  I don't know.  It was a good month and a good way to cap off the year.

~~~

Overall, I loved third year.  I finally feel like I am being trained to be a doctor and it's thrilling.  That's probably a really naive-sounding thing to say, but guess what?  I'm not ashamed that my third year was awesome!  And I am deeply hopeful that fourth year will be similarly challenging and exasperating and bizarre and intense and fun.  Especially because my husband's back now.  Everything's better when he's home.

How I Learned To Stop Worrying And Love Kids For Short Periods Of Time, or, April: Pediatrics

I have a long and storied history of detesting children.  They are loud, messy, stubborn creatures whose apparent sole intent is to overwhelm you with snot, poop, and really loud screams.  For most of my life to date I have studiously avoided them and certainly have never understood why anyone would choose to spend time around them.  This year, the Lord decided to change that.

The first step was when my really good friends started having kids.  To be around my friends, I had to be around their (surely) loud, messy, poopy, screaming children.  And despite myself I realised... babies maybe are not always terrible to be around.  And they can be sort of cute.  At times.  And maybe they are cuddly when they're not crying.  And sometimes when you look into their big, trusting eyes, you see the future and blah blah blah they're nice, okay?

You can imagine how horrified I was to find out that I like babies.  But kids, I thought.  Certainly kids are still irritating and stressful and zero units of fun.  So it was with a certain amount of trepidation that I entered my last third year rotation.

My school gives students a mixture of outpatient and inpatient pediatrics, which is nice because it gives you greater exposure while still allowing you to get familiar with things like pediatric vital signs, lab values, most common diseases/ infections, etc.  And of course you see all ages.  So I had good opportunity to learn some things:

- Children get constipated a lot.  Like, a lot.  And they also get a lot of diarrhea.  Yet another similarity between elderly people and the very young: it's all about the poop.

- There is way too much asthma and obesity in our country.

- Pediatricians are vastly undercompensated given how hard they work and how valuable their services are.  And yet they're pretty cool people to be around.  Pediatricians like their jobs and like their patients, and now that I've seen both ends of that spectrum I know how much of a difference liking one's life makes to the kind of care patients receive.

- Sometimes, a toddler on sildenafil for his lungs is going to stare at you, slowly undo his diaper, and grab his penis. 

- FINE I ADMIT IT.  Kids are funny and fun.  And exhausting.  And they do scream and poop a lot, and sometimes cough RSV into your face.  Somehow this does not negate how fun they are.

The Lord showed me part of what all of this was for recently.  I have been praying about where to serve in my church, trying a few different areas and just feeling like God was closing doors in my face.  Youth?  No.  Bible study leader?  Not yet, at least.  Worship?  Surprisingly, no.  Finally I accepted what the Lord has been trying to tell me for a while but I didn't have the strength to acknowledge: for now at least, my way to help at church is with the little kids.  So I signed up.  And I love it, because kids are fun.

(And because their parents come and take them away at the end of the morning.)