total apathy and mid-night realizations

I have the worst case of senioritis. I am so unmotivated to go to work and once there I really have to try to care because right now I just don't. I am doing a month of cardiology as my final elective and while it should be interesting and good review on reading ECGs I simply find it torturous to be tied to a pager waiting for the next consult to come in. I really don't have much love for CHF or the intricacies of transesophageal echocardiograms. I am going to be a Child Neurologist and I am SO excited to see kids and think about the brain, however adults and their hearts, not so much.

I wrote these words a day or so ago and while they were true at the time and remain so there is a small caveat. I think that 90% of why I am "checked-out" other than the about to graduate thing is that I am bored to death. I actually had a real-bonafied, my patient is having an STEMI consult and the ER really did need a cardiologist and I woke up from a dream thinking about my patient. And the fact that I was at work almost three hours beyond the normal pager time didn't even bother me. Because I do like medicine and learning and when I feel important/needed/useful and even more so feel that the patient is benefiting from my time then I am more than happy to be at the hospital. It is just that up until yesterday most of the consults were a waste of time.

Seriously, I've had consults such as: patient with new onset V-tach, non-symptomatic, unsustained for 8 beats in the middle of the night. Please evaluate. Guess what? Motion artifact. You wasted an hour of my time and 10 minutes of my attending's time so that we could tell you that your consult was BS. I guess this was due diligence and now I will hopefully never make the same mistake so I did learn something but this happens all the time!

Surgical clearance consults. Yes, they have to be done but please don't ask Family Medicine to do the consult and Cardiology to do the same consult. We both show up and then feel obligated to do the consult because you asked but we are just duplicating each other's work, wasting time and using resources that could better be used for say that patient that is having an MI or the new admit. And this is all so that maybe you will get your surgical clearance a bit earlier from one of the services. Not cool.

Consults for medical management help. Unless you have actually tried all of the evidence based medicine guidelines for managing said problem and are actually asking for help because the patient is especially complicated please don't consult cardiology for every CHF patient on hospital day 1 that may need more medication. The attending cardiologist will not give you firm medication recs. if you haven't at least tried for 24-48 hours, so why bother to ask?

And in other news... I am thinking of changing blog names and sites. My island days are behind me and residency is around the corner. But if anyone has particular SGU questions or would like a final post or two before I do so, let me know.

I'm off to Houston tonight to hopefully secure an apartment and tour my new city. So that is exciting.

Only 10 more days of medical school left!
Happy Friday!

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