Another Audition Month Down

I can sum up this month in some key phrases: sleep deprivation, long hours, lots of beers, lots of Jewish people, chronic fatigue, spending a lot of time on the subway, and NYC Manhattan living with great music and delicious food

There are some things I wont forget about Maimonides. Mostly, the diversity of the patient population was incredible. One minute I would be using a Russian translator, the next I would be using Cantonese. I saw pediatric patients since they had their own ED and I saw lots of very old and sick patients. I also tended to a lot of middle-aged, high strung, high maintenance patients with no real problems and left walking away thinking “why the hell are they here?” before I would go to present to my attending/resident. Either way, I learned a lot. Most importantly, I learned and began to understand why people say emergency medicine physicians “burn out.” There are people that use the emergency room for just that, emergencies. But there are also those that abuse it for so many other reasons and its frustrating and down right difficult to distinguish between the two. With America being the way it is, medical-legal issues come second to mind [first being, is this patient dying right now or not]. Because if they are trying to die on you, the answer if easy, make sure they live. and that is what we are trained for. But, if they are not dying, it is our job to make sure they are not silently and secretly trying to die on us. And to distinguish them from someome who is a hypochondriac, someone who wants a note off work to take a vacation, or someone who has psychiatric issues, is why this job will take a toll on people. I havent even graduated med school yet and I can see the “jadedness” shinning through my sometimes fake smile. “OK sir, let me just make sure I have the story right, Your 32 and you’ve had nasal congestion and vomiting for 1 day...Im so sorry to hear that, we are gonna do our best to make you feel better” [these words are forced through a fake smile and a simultaneous suppression of the words “why didnt you go to your primary care doc??”].
Granted, most people in the US do not have primary doctors so yes, i am going to be one for them. But at Maimo, most [not all] of these people had established PCPs whom they see often.... Thats when it gets frustrating.
I also learned that people will always surprise you. You may think and believe one thing but the truth is usually very different.

This job is exactly what i wanted in life, a challenge. At least i will always have interesting days!

Some Patients to Never Forget

the pregnant young teenager texting on her iPhone during a trans-vaginal ultrasound to confirm the pregnancy, then actually picking up her phone and talking to someone when it rang...and the trans-vaginal ultrasound probe is still inside her

the 89yo Russian man with a huge picture of Lennon tattooed over his chest, over his heart actually

the 19 year old Male with chest pain that I helped diagnose with pericarditis and then ended up having Troponins of 35 [myocarditis!]

the young lady who was having a miscarriage and brought in the contents in her maxi-pad. then showing us and actually seeing the fetus [with eyes!]. A white/clear piece of tissue about the size of my thumb nail and clearly resembling an alien. I held a fetus in my hand that day. incredible.

a young teenage girl being wheeled into the resuscitation room in the pediatric emergency room for an overdose after having found out she was pregnant. she posted a goodbye note to her friends on facebook, so they went over to her home and found her passed out in the bathroom. [she ended up being just fine, physically at least. this was her 2nd suicide attempt]

Working Hard

Through the rotation, I had 3 residents on 3 separate occasions tell me they were going to write an email to the clerkship director about how great I was doing. Actually, one of the residents stopped me one day to tell me she wrote a 3 paragraph email to him about me. She told me "I only write emails to him about people I think will add to the program and I think your gonna be a great doctor."

Talk about good impressions!!