Its been a long, stressful and unusually uncertain time. But though it is not completely passed, at least I am past one of the most important decisions I had to make, wether to do the AOA or ACGME match. Though I choose, I still chickened out and didnt completely pick one. I only ranked 2 programs and if I do not get into one of those then I am going to try the ACGME match. So really, im a wuss. I ranked Arrowhead number 1 and Lakeland number 2. Ive had email exchanges with both and though Arrowhead doesnt seem very promising at this point im still hopeful that it will work out. If not, I am pretty certain I will get into Lakeland. I have been emailing with the PD and showed lots of interest during the interview, when I went back to shadow for the day and through emails.
Making decisions in life is not usually this hard for me. But this was. I spoke with so many people about this decision including 2 PDs that were advising me and my new awesome mentor Dr. V. 1 PD said go AOA, the other PD said go ACGME. That didn’t help much. So I emailed Dr. V telling him Res was my number 1 and he called me and we had a very realistic chat.
He looked up my interview file and the rank list and was very upfront with me. “Dorothy, I don’t want to mislead you. Right now its unlikely that you will match into our program. If it were up to me, you’d be here. I think you will be a great ER doc and I would love to train you. But its not just up to me.” I went on to find out that since I interviewed while I was there and not during the ‘rotators’ interview time, I didnt interview with anyone from St. Francis that knew me so I didnt get enough support during my interview. Basically, I shot myself in the foot by asking to interview while I was there. If I had stuck with my origional interview in January I would have been interviewed by St. Francis faculty and they could have put me higher on the rank list.
That was a rough pill to swallow.
So, after this conversation, it was clear to me that I have to do AOA. If a program that I got a glowing LOR from and rotated at doesnt rank me, what are my changes of getting into even more competitive ACGME programs that barely know me!?
So now I will wait to see where I will end up for the next 4 years...or not end up. And then I will have to make another list and wait another month to determine my future.
Im just gonna try to keep taking it one day at a time.
Friday, January 25, 2013
Thursday, January 24, 2013
LA County Coroners Office
Welp, that was the weirdst month of my life. Not only did I re-learn my anatomy, I got very very familiar with the human body. and with death. I learned that I have a stronger stomach than I give myself credit for. I also learned I am more emotionally attached than i pretend not to be. Here are a list of autopsies and situations I was involved with. I believe it will take my a very long time to adequatlly process what I saw during this month. Honestly, I have no idea how some students leave this rotation with smiles saying it was so cool "blah, blah." Yes, its great. But I think the scenerios we encounter really make it a high price to pay for education. Life is so very delicate.
Week 1
-A gentleman who was found in a burning apartment. We were there to establish if he died before or during the fire. Sadly, he died during the fire as seen by a huge amount of sut and ash in his airway meaning he had to still be breathing in order to get them into his airway/lungs.
-A skeleton discovered by a hiker who stumbled into a homeless man’s encampment...that then stumbled upon some scattered bones including a human skull
-a man who committed suicide by putting a shotgun into his mouth
“you may be wondering why we are doing an autopsy on him considering we know the cause of death. Well, apparently this man’s wife had an ex-husband who did the exact same thing when they were married....” -coroner
-a young man that was stabbed 77 times. Every single stab wound had to be probed, measured, documented and drawn onto a model
-a women who died of pyelonephritis. we knew this because there was frank puss all over her kidneys and ureters...a totally preventable death if she had gotten antibiotics
-a 26 year old baby that was found dead in her crib. we found no cause of death
-a body that was murdered then dumped in concrete
Lastly, the most troubling case I saw was a young college kid that died on New Years Eve. The police report stated it was 3am and he was known to be drinking at a restaurant. For some reason, he was alone trying to cross a very busy street/ highway and was struck by a vehicle going 45mph. He was hit and flew 120 feet forward. He died instantly on impact.
As I read this story and looked at this handsome young man, it was very disturbing. This guy could easily be me or any of my friends. Who hasnt gotten drunk and separated from their friends? I know I definetly have.
What made this case even worse was when I looked at the next of kin and it stated that it was his father who lived in a city on the East coast. I imagined his parents laying in bed sleeping at 6am new years day getting a phone call that their son in college had died. I imagined this couple mourning the loss of their son from the other side of the country and having to take a plane to LA to take their son home to barry him. I will never forget standing next to this mans naked body as he was being cut open feeling so helpless.
Week 2
-a young black man who was shot once and died. He was shot, was able to run from the scene into his friends car and they took him to the ER where he died at the doorstep. This was a very educational case for my ER standpoint. This one tiny bullet did more damage than one could ever imagine. When we opened him up, we saw the trajectory of the bullet and it basically hit every major thing that could kill him. It entered his left flank and went through his left lung [lower than uper], then through his esophagus, then aorta, then through his right lung, then his right subclavian artery. This guy had no chance.
-A baby with what appeared to be DiGeorge syndrome
-a 22 week old fetus who died in utero when his mother was in a MVA on the freeway. the impact was large enough to break the femur of the fetus. This was an incredible autopsy to see as it was literally on an unborn child
-This week we met with the forensic odontologist. Who I found out went to high school with my dad.... small world
-A older chinese man who was completely emaciated but yet had a huuuuge abdomen that looked like cirrhosis. He was found dead in his jail cell. When we opened him up it was pretty clear what he died from, his abdomen was filled with cancer. He had the worst case of carcinomatosis I will ever see in my career
-A man who died of a subdural hematoma
-A young man who died of sudden cardiac arrest at the gym. He was here on vacation from Spain. He was found to have a large subarachnoid hemorrhage. spontaneous unavoidable death.
Week 3
-A young lady who went into sudden cardiac arrest at home and was 28 weeks pregnant. She was brought to the ED where a peri- mortem C section was performed and then pronounced dead. We did the autopsy which included taking out her uterus that had the placenta still attached. A rare experience.
-A young man who was s/p GSW to the head with subsequent craniotomy. He was pronounced to be brain dead at the hospital and life support was withdrawn. He was an organ donor.
-A older gentleman who was changing his tire on the side of the freeway and was hit by a car. He was killed on impact from a T spine fracture. The driver fled the scene
-A man with a massive PE
-a spinal cord dissection. That was pretty cool
-A young man who was hit by a car and brought to the ED where he was intubated, had bilateral chest tubes placed, several central lines but ultimately was pronounced. We did the autopsty and double checked that everything was in place. This was when I learned where a chest tube should correctly be.
Week 4
This was a short week because we had Monday off for holiday and then I went to my Cook County interview. This week I got to work with Sarah for a day which rocked. I got to watch her be handed a spleen by the autopsy tech and then drop it on the floor. It was a great experience to watch her face as the spleen slid across the floor. Complete horror.
-One of the last autopsys i saw was a murder victim who had major blunt force trauma to his head, wrapped in a blanket and barried.
Some great lectures we attended:
Dismemberment [this was just as gross as it sounds]
Animal activity on the dead. In case you were wondering, Yes, your cat will eat your face off when you die.
A random fact to know: a group of crows is called a murder. A group of turkey vultures is a wake.
And on those notes, I am done with this rotation. and i think i am very very happy about that.
Week 1
-A gentleman who was found in a burning apartment. We were there to establish if he died before or during the fire. Sadly, he died during the fire as seen by a huge amount of sut and ash in his airway meaning he had to still be breathing in order to get them into his airway/lungs.
-A skeleton discovered by a hiker who stumbled into a homeless man’s encampment...that then stumbled upon some scattered bones including a human skull
-a man who committed suicide by putting a shotgun into his mouth
“you may be wondering why we are doing an autopsy on him considering we know the cause of death. Well, apparently this man’s wife had an ex-husband who did the exact same thing when they were married....” -coroner
-a young man that was stabbed 77 times. Every single stab wound had to be probed, measured, documented and drawn onto a model
-a women who died of pyelonephritis. we knew this because there was frank puss all over her kidneys and ureters...a totally preventable death if she had gotten antibiotics
-a 26 year old baby that was found dead in her crib. we found no cause of death
-a body that was murdered then dumped in concrete
Lastly, the most troubling case I saw was a young college kid that died on New Years Eve. The police report stated it was 3am and he was known to be drinking at a restaurant. For some reason, he was alone trying to cross a very busy street/ highway and was struck by a vehicle going 45mph. He was hit and flew 120 feet forward. He died instantly on impact.
As I read this story and looked at this handsome young man, it was very disturbing. This guy could easily be me or any of my friends. Who hasnt gotten drunk and separated from their friends? I know I definetly have.
What made this case even worse was when I looked at the next of kin and it stated that it was his father who lived in a city on the East coast. I imagined his parents laying in bed sleeping at 6am new years day getting a phone call that their son in college had died. I imagined this couple mourning the loss of their son from the other side of the country and having to take a plane to LA to take their son home to barry him. I will never forget standing next to this mans naked body as he was being cut open feeling so helpless.
Week 2
-a young black man who was shot once and died. He was shot, was able to run from the scene into his friends car and they took him to the ER where he died at the doorstep. This was a very educational case for my ER standpoint. This one tiny bullet did more damage than one could ever imagine. When we opened him up, we saw the trajectory of the bullet and it basically hit every major thing that could kill him. It entered his left flank and went through his left lung [lower than uper], then through his esophagus, then aorta, then through his right lung, then his right subclavian artery. This guy had no chance.
-A baby with what appeared to be DiGeorge syndrome
-a 22 week old fetus who died in utero when his mother was in a MVA on the freeway. the impact was large enough to break the femur of the fetus. This was an incredible autopsy to see as it was literally on an unborn child
-This week we met with the forensic odontologist. Who I found out went to high school with my dad.... small world
-A older chinese man who was completely emaciated but yet had a huuuuge abdomen that looked like cirrhosis. He was found dead in his jail cell. When we opened him up it was pretty clear what he died from, his abdomen was filled with cancer. He had the worst case of carcinomatosis I will ever see in my career
-A man who died of a subdural hematoma
-A young man who died of sudden cardiac arrest at the gym. He was here on vacation from Spain. He was found to have a large subarachnoid hemorrhage. spontaneous unavoidable death.
Week 3
-A young lady who went into sudden cardiac arrest at home and was 28 weeks pregnant. She was brought to the ED where a peri- mortem C section was performed and then pronounced dead. We did the autopsy which included taking out her uterus that had the placenta still attached. A rare experience.
-A young man who was s/p GSW to the head with subsequent craniotomy. He was pronounced to be brain dead at the hospital and life support was withdrawn. He was an organ donor.
-A older gentleman who was changing his tire on the side of the freeway and was hit by a car. He was killed on impact from a T spine fracture. The driver fled the scene
-A man with a massive PE
-a spinal cord dissection. That was pretty cool
-A young man who was hit by a car and brought to the ED where he was intubated, had bilateral chest tubes placed, several central lines but ultimately was pronounced. We did the autopsty and double checked that everything was in place. This was when I learned where a chest tube should correctly be.
Week 4
This was a short week because we had Monday off for holiday and then I went to my Cook County interview. This week I got to work with Sarah for a day which rocked. I got to watch her be handed a spleen by the autopsy tech and then drop it on the floor. It was a great experience to watch her face as the spleen slid across the floor. Complete horror.
-One of the last autopsys i saw was a murder victim who had major blunt force trauma to his head, wrapped in a blanket and barried.
Some great lectures we attended:
Dismemberment [this was just as gross as it sounds]
Animal activity on the dead. In case you were wondering, Yes, your cat will eat your face off when you die.
A random fact to know: a group of crows is called a murder. A group of turkey vultures is a wake.
And on those notes, I am done with this rotation. and i think i am very very happy about that.
Wednesday, January 23, 2013
Cook County!!!!!
Last minute Cook County Interview. I am interview at Cook County. That is all. EEEEEEEk.
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