Sunday, June 28, 2009

Day One

What a week. Who knew the jump from being a medical student to a resident could be so big? My first day was Wednesday. I donned my long white coat and headed out the door at 4:30am to begin my rotation on GYN Oncology. I started pre-rounding on my patients, collecting vitals, lab results, fluid ins and outs – nothing I hadn’t done before as a medical student. After rounds, when the attending physician, fellow, and resident headed down to the OR, is when the terror began. All of a sudden my pager goes into overdrive with calls from the nurses. “Patient A is complaining of pain – what do you want to write for her? Patient B is tachycardic, what do you want to do? Patient C has drainage from her incision site, can you come take a look at it?” And as I stand at the patient’s bedside, a nurse and two nurse assistants eagerly await my response. I look down at the patient. And yes, I see a stapled incision down her abdomen. Draining pinkish fluid. Crap. Now what?!? As their eyes burn holes into the back of my head, I think to myself, “Man, I wish my last surgery rotation wasn’t 10 months ago…” Trying to use my brain was like trying to pedal the wheels on a very rusty bicycle. It just didn’t…want…to…work…
“Would you like me to place a pressure dressing doctor?” The clouds parted and the light of heaven shone down on me that moment. “Why yes, nurse! Yes, I would!”

As a brand spanking new intern, that’s the moment you realize that:
1. You are no longer a med student.
2. You are calling the shots.
3. You have no idea what you are doing.

Can you say PANIC?!?

Many times, my non-medical friends ask me if life in the hospital is really like what they have seen on T.V. Their idea of practicing medicine is composed of the life-saving heroism on ER, the incestuous romance of Grey’s Anatomy, and the intellectual masturbation of House. I am here to say that it is all baloney. If you really want to know what residency is like, the show to watch is Scrubs. And my present life resembles Season 1. The intern that doesn’t know what she’s doing. The nurses who go through this every June and graciously fill me in on the many things I don’t know. (“Doctor, I think you want to write for Morphine 2mg every 4 hours for her breakthrough pain, right?”) The senior physicians who expect you to know it all already (or at least pretend to).

Somehow, I think all of us medical students have the idea that when we start residency, our brains will somehow already be filled with the basic information necessary to take care of patients. Ha! If only it was that easy, my friends.

Sunday, June 21, 2009

Signing My Life Away

This week marks the start of intern year, the first of my four year residency program. I’ve waited for this day my entire life and I am both excited and thrilled to begin a life of taking care of patients in the most intimate of ways. I also start this process, however, laden with fear and trepidation. Sure, my dream of being a physician is being realized. But so is four years of 80 hour work weeks, sleep deprivation, and little to no time for anything but medicine. As a medical student, I’ve experienced this life. On my surgery and OB/GYN rotations, I walked through life like a zombie. My schedule was simple: work-sleep-work-sleep-work-sleep. My fatigue and lack of exercise made me moody and irritable. My lack of food made me skinny. My lack of time with family and friends made me lonely. My lack of “me” time made me depressed. What brought me comfort during these times was the fact that in a few short weeks, my rotation would end and life would return to normal. Fast forward to today: I am about to start a four year long rotation. Shit.

We spend our adolescent and young adult lives trying to figure ourselves out. What makes us happy? Fulfilled? Balanced? Content with who we are? And when I hit 30, I felt like I finally did it. I had my best friends and a supportive family. I had my love of yoga and running. I had a burgeoning interest in cooking and wine tasting. I had my love and memories of international travel.

It seems like a cruel joke that now that I’ve figured out how to live my life to the fullest, I have to give it all up. It is difficult to think of my very full and complex life being reduced to one dimension.

I guess the new challenge, now, is to figure it out all over again: Happiness, the condensed version. Appropriate for an 80 hour work week.

* Check out the very appropriate article in New York Times this week by Dr. Pauline Chen: http://www.nytimes.com/2009/06/18/health/18chen.html?em

Sunday, June 7, 2009

The First Day of the Rest of My Life

The day has finally come… I am officially a doctor! A physician! An M.D.! And I have my beautifully crafted diploma sitting beside me to prove it! I will no longer be a mere medical student at the bottom rung of the hospital hierarchy. Today is the day when I am bestowed the honor and privilege to hold a person’s life in my hands. Wow… I better not mess it up.

I didn’t think I would feel different after my medical school graduation. After all, it’s just another day, right? But walking on that stage, being hooded in front of my family, friends, and mentors, was something else. It finally hit me. I have had this dream of becoming a doctor for the last 20 years (seriously, check out my fifth grade notes on becoming a “docter” when I grew up). I’ve studied. I’ve taken tests. I’ve worked all hours. And now that day is here. It’s a remarkable and powerful feeling to finally reach a goal that has been out of your grasp for so many years. While a thousand different thoughts and emotions are running through my head, one thing I know for sure. I am going to be the best physician that I can be. I have worked too hard to become anything less than that.

While I can’t deny I am on a graduation high right now, today is also bittersweet. It’s the day that I leave everyone who means anything to me for a life unknown on the Other Coast. I take with me only my fiancé and rainbow of emotions. Will I like my residency program? Will I like my co-workers? Will they like me? Will my suturing and knot-tying be up to par in the operating room? Will I remember how to deliver a baby? Will my patients have confidence in me? Do I have confidence in me?

Stay tuned to find out.