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!

Because I like lemonade....

I am an optimist. I may be accused of being a Pollyanna and sure I most often have on rose-colored glasses (literally, I have rose-red glasses!) but I like that about myself. I don't enjoy being depressed or anxious and I really do want the best out of life, for myself and for everyone else.

And while I like being positive I also have huge expectations. I expect the most and best out of others (and myself) and thus am quite often disappointed. Rarely can a person measure up to my ridiculous expectations and for sure I am the worst culprit of falling short. But the thing is, I can often empathize with the person and see the good in the situation and move on. Being optimistic means I forgive and forget and yet still expect better next time.

What am I trying to say? I'm not sure I even know... this post may be a bit of a ramble but I suppose I just want to say that I realize how lucky I am. I do not take my life and the opportunities I've been given for granted. Sure I've worked hard and going to medical school was not the easy path for me. I sacrificed much for this life/career but I've never felt entitled to it. I realize that a certain amount of luck and genes and a ton of support from my parents, husband, friends has made where I am today possible. Yet I have to say that the struggles, the work, the time invested has been worth it. And for the most part I've enjoyed it and I think know I will love being a doctor! So that is good...

I am so grateful that in just a few weeks (okay 2 and 3/7 weeks, aka 17 days) I will find out where I matched (granted that I do, but the optimist in me doesn't actually believe that not matching is a possibility). And in 17 days we will find out where we will be moving and living and working for the next five years and that is oh so exciting!

Also, I was also going to share some big news with my family and friends on Match Day. You see I am 8+ weeks pregnant and had planned to announce both at the same time. However the pregnancy is not viable and so I'm going to be medically induced this weekend and that kind of sucks. Because I was excited to be pregnant and it was mostly good. The polyuria, constipation, sore boobs, insomnia and fatigue not so much... But the knowing I was pregnant and the minimal morning sickness. The possibility of a brand new baby was inspiring and exciting and good. Of course it was also a bit scary and the timing was less than ideal. It won't be so horrible to NOT be 6 months pregnant when I start residency. There is something to be said for establishing oneself as a person/resident and making an impression before being the "pregnant resident" so for that reason I can say there is a silver lining. Oh and I am very happy to be drinking my two favorite beverages again (coffee and wine). I didn't miss them as much as I feared but I welcome them both back with welcome arms. Being caffeinated on 3 hours of sleep is a definite positive and I do love me some Pinot Noir so I can't say I'm sad that I no longer have to abstain with dinner....

So yeah, lemonade really is okay.

I guess that's all I've got for now. Happy Hump Day!

Up in the air I go...

One more interview, one last trans-America trip, one concluding night in a strange hotel, one final trip exploring a new city.

I am at the airport ridiculously early because I opted for one of those group Shuttle van services to the airport and I guess I'm flying at a not very busy time because I got my own personal town car ride to the airport for fraction of the cost of a cab... and I'm more than two hours early, which is after I cleared security! Less anxiety provoking than leaving my house at this time and taking a cab, two trains and a shuttle bus to arrive in the same spot when boarding is already in process. And I even managed to score one of those comfy SW lounge chairs/charging stations at my gate, so I really cannot complain.

It will be nice to be done with interviews and finished with traveling. Of course the ranking and waiting part is going to be torture but still, it will be nice to have this part behind me. And then I can actually stay in Miami and enjoy it for almost two whole weeks before I am headed back to Cali for the remainder of fourth year.

My Genetics rotation continues to be awesome. If you are at all interested in Medical Genetics or Pediatrics then I recommend this rotation. Miami Children's is wonderful and it is a great place to spend a month. I had to apply for the rotation over 6 months in advance and follow up via emails and phone calls ad-nauseum to ensure I got the elective but it was more than worth it.

I have lots of thinking and ranking and pondering to do, but I'm waiting until this interview is over to really start.... stay tuned!

Insomnia- take 2

I'm not sure that this post has a point. I'm wide awake, SUPER wide awake and have been since 4:30am this morning, which considering I didn't fall asleep until after 1am is kind of odd.  I feel strangely hypomanic, this is my third night/day of not needing very much sleep: 3 hours, 5 hours, 4 hours. And this from a girl who is normally vary happy to sleep 8 or 9 or more. So yeah, insomnia is weird.

If I didn't have my exam in 8 days and I wasn't busy with a super B-day surprise for Dr. Boyfriend*** I'd be more concerned. But I think this is my way of displaying stress, or something like that. Not that I feel stressed, I fell strangely calm and ready but at the same time like my heart is pounding and my fingers are trembling and I just don't need to sleep. Or eat. It is all very odd. If this is what bipolar or hyperthyroidism feels like than I totally have new respect and sympathy. Not fun. Or maybe this is like ADHD. My attention span has been whack the last few days as well. Which makes studying and doing a block of 44 questions rather cumbersome. Oh well. Hopefully the exhaustion kicks in and I go back to normal for a day or two before I have to sit for Step 2. I don't feel very confident to sit in a chair for 8 hours at this point. I can't even sleep in my bed for 8 hours right now. Something has got to give!


**** We are adopting a dog! Dr. Boyfriend has been asking me for some time and I kept saying no, well anyhow I decided that it was time. I'll be away at rotations for most of next year and if a dog would make him happy and keep him company than who am I to deny him that? He let his wife move to Grenada and has put up with marriage via Skype for three and half years now. It is my time to do something for him.

Future Fido- I know you are out there... we are looking for you....

(We have an appointment to see some American Staffordshire Terrier puppies at a local dog rescue today and I'm feeling confident.)

This I Know...

I DO want to be physician.  I chose this career, or it chose me?  Either way, I'm doing it.

But sometimes, just sometimes the path is long and wandering and so I start to wonder... not is it worth it exactly, because I believe it is, or I wouldn't be doing this, but sometimes I pause. I guess what I'm trying to say is that I see friends who have families already (kids, careers, homes) and I wonder if what I'm sacrificing is what I truly want. I see young athletes at the height of their careers and can't help but think that they are going to retire before I even get to "practice" my profession. The path is long and the sacrifices great. I think they are worth it, I know they are worth it. But sometimes, just sometimes I wonder what if I had taken a job teaching first grade or actually traveled around the world after college instead of getting on the MCAT/pre-med train if I wouldn't be just a happy as I am today.

I have no regrets. I don't. I fully understand that I chose this life, I CHOOSE this life and in the end it will be worth it for me. And don't feel bad for me in the day-to-day. Sure medical school is "hard" but really what in life isn't hard? And what I get to do and the people I get to meet, those are things that I do not take lightly. I love my life and I love medical school (well now, maybe not so much in Terms 1-3) but overall medical school is an amazing time. I got to live in Grenada and meet some really good friends. I get to see illness and pathology and health up close every day. I have to travel a bit but that just means I get to see a variety of hospitals and different patient populations. I am away from Dr. Boyfriend but I am lucky I have a husband that is so supportive and that we have a strong marriage so that this is possible. So I don't ever regret going to medical school or choosing this life. But still I wonder what might have been....

And yes, I'm know residency will be fine. It will be hard and long and I'll sacrifice some more along the way but that is what being a doctor entails and I signed up well aware of these facts.

I suppose some of my "pause" comes from the fact that Dr. Boyfriend is about to start the last year of his fellowship thus his journey is almost over. I've experienced residency and two years of fellowship vicariously so I almost feel like I should be done too. But I haven't even started. And I don't even have a residency yet. Or a personal statement written to apply. Or all my letters of recommendation completed. So here I am, about to start fourth year and I have a LOT to do.

And right now I'm in the middle of studying for Step 2 (test date is just 10 days away) and Dr. Boyfriend is out of town at a conference so I'm alone with my books and so maybe that is making me morose. Reflective. Pondering. Whatever.

But this I know....

I am lucky. I do want to be a physician. It is/will be worth it. This I know! (along with lots of random medical knowledge, some actually important and plenty of arcane facts that I'm sure I will promptly forget as soon as I take Step 2.)

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I am feeling as if I need to write but I'm not sure if I have anything to say, profound or otherwise... Third year is officially over. I'm in limbo land as I study/take Step 2 and then move back to New York to start fourth year electives. Most of my schedule is figured out but I'm still waiting on out of network Peds stuff. (Note to fellow SGU students that are contemplating out of network rotations: allow the school at least 8 weeks 3 months to get your paperwork together and signed off on and submitted, it does take that much time!)

It is kind of nice to be back to studying again. Of course I studied while in my core rotations but it is different to wake up and have the entire day to study whatever you want (or need) to in any order or place you desire. And of course I love being back at "home" with Dr. Boyfriend and have been not 100% focused on studying as I had jury duty for two days and then dentist appt, etc. All the stuff you don't have time to take care of when you are flying around the USA for a year kind of adds up. But home is good. Schedule, or lack there of is good. Life is good.

In any case... I have to get back to studying. Happy Wednesday!

P.S. Here's a nice neuro article for any of you thinking of going into neurology. I thought it was an interesting read. Of course child neurology is a bit different but the sentiments are the same.