Being the chick's again

Monday 2:00pm
We got to the hospital for orientation at 8am. there was around 20 of us medical students starting either internal med, family med or surgery. we listened to more lectures about professionalism and proper handwashing, then took a tour of the hospital. while looking at the ORs and surgery lounge, a surgeon that has obviously been a surgeon for a very long time [imagine grey hair and long white coat] needed to walk through the group and he just laughed and said to the tour guide, "are these all the new chicks? hello chickens," and walked right through the sea of short white coats with 'deer in headlights' faces. it was very appropriate for, lets be honest, we were all starting new rotations in a new hospital and were all pretty nervous. he just chuckled along, obviously having cracked himself up.

after that we got split into 2 groups and we met our attending around 11. Nicole is in the same team as me and word on the street is that we got the cool laid back attending. When he came in for rounds I found out why people say so. He was wearing jeans and our rounds took place in the resident lounge while we occasionally chatted with people that would stop by (compare this to the other group that does rounds starting at 9am on the wards and has to be on their feet walking around until 1ish). I was concerned at first that I wouldnt learn a lot from him since it's so casual but i think the decreased anxiety in the situation will really help us stop worrying about looking bad and just focus on learning medicine. It's always nice to have an attending who's goal is to make you feel smarter not dumber. Though, I'm sure making us feel stupid makes us study harder...

I admitted one patient in the morning. She spoke only Spanish. I think this is gonna be a trend...




Monday, 8pm [having finally sat down to relax]

First day down... I forgot how much the first few days of rotations suck. Its pretty difficult to get familiarized with a new hospital, new paperwork, new residents, and new attendings all while remembering that you are here to do a job and use the stuff we learned in school. I swear the first day always reminds me of how far away I am from being a competent and independent physician. How people remember everything amazes me. Only thing that makes me feel better is knowing everyone else feels the same way.

 The first week of every rotation is a steep learning curve. Trying to remember all the common medicine you should know but forgot. Then trying to not look as bad when you dont remember stuff by spouting random facts about the disease process or treatment plan.
For example, I admitted a patient today who came in from the ER with chest pain and back pain. She had a history of a ton of heart problems [CAD, atrial fib, valve replacement-- she basically had a plastic valve in her heart, a re-plumbing surgery for her heart and a pacemaker to make sure it doesnt ever stop because sometimes, it just decides to stop]. After seeing her labs I decided the patient was hyponatremic and that we needed to give her IV fluids. Next logical question from the intern was "ok, how much?" in my head went a few thoughts like "shit i dont remember, shit why cant i remember, shit what should i say, oh god now i am turning red, uh oh now ive paused for too long and he knows i dont know, shit he knows im incompetent." so after a long pause i say, "we should give her normal saline but im not sure how much because i know the pediatric equation not the adult one." next logical question from the inter was, "thats fine, its similar, what is the peds one and we can talk about how its different." well, again, lots of thoughts ran through my mind and i was already a lil tachycardic at this point and i couldn't figure it out so i just smiled and said "im gonna need to look that up but one we do that we should...." i rambled off some information so we didnt end the discussion on my obvious lack of knowledge.

i make this sound bad but it really wasnt. the intern we are working with is a really sweet guy who is really enthusiastic about helping us learn. i think its more the need to show you belong there that makes us all anxious when asked questions. its like "i studied a lot these last two years, please think i am worth teaching!"

we finished up the day at 5:30 and it took me an hour to drive home in traffic. tomorrow, and every other day after that we have to be at morning report at 6am. its still dark at 6am.