today was not much better in regards to my attendings. for the second time my attending put her hand up in front of my face.. yesterday she did it when i was following her into a room trying to ask a questions [she literally put her hand up in my face and then closed the door behind her] today it was in front of a patient [i was talking and she put her hand up to get me to stop talking so she could have the patient answer]. i dont know what kind of upbringing she had but i could not think of a more rude way to ask someone to be quiet. worst part about it is that being a medical student, you really are powerless. you cant say anything to them, you just gotta take it and shut your mouth so you dont get a bad evaluation. this whole situation makes me wonder why certain doctors work in teaching hospitals when they clearly have no interest in teaching and all they want to do is get through clinic days as fast as possible so they can go home?

if i ever become this rude, bitter or unkind when i am an attending i will know its time for a career change...


some humor from the day:

"man, the terrible twos really are the terrible twos" - Torey

"your japanese? so where did you get your eyes from " -attending referring to Torey's very light eyes
"lens crafters..."- Torey


"I saw Dr X in the hall and I could feel my adrenals pumping out the epinephrine"
-Ron [after seeing the attending that yelled/screamed at us last week]

"think costumer service. try to be like nordstroms" - one of the attendings to a nurse in the clinic [clearly trying to increase the amount of patients/money that comes in'

Peds Clinic

just got home from my first day in the peds clinic at the hospital. not too exciting but the day went by much faster than days in the inpatient ward. i will be working in the clinic for the next 2 weeks and luckily the doctor from friday [aka Judgement day] is on vacation for 2 weeks so i can start fresh with new attendings. clinic days are short- today we worked from 9 to 12, then 1:30 to 4:15. we basically do the same as other clinic, go in and do the initial history and physical, present to the attending and formulate your assessment and plan and then they go back in with you and do their own physical and ask more questions. today i saw a couple sick kids [ear infection, asthma, etc] and then did a couple well child exams. no wonder kids hate doctors, they have to get like 4 shots a visit every couple months for the first couple years of their lives!! that immunization schedule is no joke!

things i learned today:
1)if you take off your white coat before entering a room with a peds patient, you can delay crying for an extra 3 minutes than usual...though crying is inevitable by the middle of the physical exam
2) i had no idea kids could scream so loud
3) i think most children are bipolar. one second they are crying, the next they are laughing and smiling. if an adult were to do that, they would be in a psychiatric facility
4) little girls are like live dress up dolls for some moms... they can make their outfits as glamourous and girly as they want because they look damn cute and hey, they arent the ones that have to wear pigtails and huge bright pink puff scrunchies on their heads.
5) not so much what i have learned but what i predict: these same little girls that were dressed up as diva's by their moms when they were little are probably the same kids that grow up to be teenage diva's that demand things and wont listen to a word you say
6) thus, the last thing i learned today was that if i have kids, it will only be after i can genetically verify it will be a boy

Peds... lots of disney stuff around but not the happiest place on earth?

This has been a really rough week. I thought that peds would be filled with happy people and fun attendings but boy was i wrong...

On Tuesday, shit hit the fan when we got yelled at [more like screamed at] by the head honcho of the peds department. Reason being is that we are supposed to stay everyday until 5pm but since there isnt much to do in the afternoon, the interns AND the residents we have worked with have had one of us stay for the afternoon while the rest of us go home to use our time wisely. This worked all last week and then up until Tuesday when Dr. X [we will call him that for safety's sake] came in and found only Torey in the office. He told her to tell all of us to come back to the hospital by 2pm or else we will fail the rotation. SO we all came back and dr. X walked in at 2 and gave us a 5 minute speech that started with, " im gonnna make this short and to the point, you are all failing the rotation as of right now. you are going to have to work your way back up and bring your A game to pass this rotation. I have never be do disrespected in my life...blah blah blah." This went on for a while. he then just turned around and walked out the door. at first i really thought he was joking around because we rounded with him the week before and he asked a lot of questions but he still was fun to work with. i thought this lil rant was a joke and he was gonna stop in the middle and say, 'haha, just kidding' but he didnt. oh boy he didnt.

So this week we rounded with another doctor and boy was she a debby downer. this lady never smiled, made the meanest faces at you, and was not very fun to work with. She had her positive moments [telling me she was proud of me because i was 'teachable' because i went home and read about something she taught us the day before] but mostly, she was not very excited about anything. She was known to ask a ton of questions about your patients so we were warned to read everything about them and be able to answer her detailed questions. It was really hit or miss with her. Sometimes you would answer her question and she would be happy, other times you would answer and she wouldnt even look at you. Then of course, the times when you didnt know the answer she nailed us for it. Everytime i didnt know one of her questions she would tell us off about how 'you should know this and that' but she never gave you the opportunity to explain. She was ok at teaching but her accent kinda got in the way sometimes.

Anyways, on Wednesday I did a presentation [we have to do 1 every 2 weeks] and she gave me a good evaluation for it. But then Friday came about and she must have really changed her opinion on me. On rounds i guess i just didnt shine. She asked me what my plan was for a baby with a UTI and when i told her what antibiotics i wanted to put him on she said 'absolutely not, completely wrong' and went on to tell me why i was so wrong [even though my answer wasnt that off and i never got to explain why i chose them so really it just looked like i guessed an answer]. i mean, dont get my wrong, if i dont answer something correctly im not going to be upset at the attending for correction me because i am a medial student and i expect to be wrong most of the time, but the way she made me feel about being wrong was just really mean. then later during rounds i asked why she had decreased a dose of antibiotics and she said, 'no, i am not going to answer your question. we talked about that earlier in the week and you should know why.' So to prove i knew the basics of why and just that i was confused at why she was doing it that day instead of the next day, i ran through some of it with her but she still just looked at my like i was stupid. So, as we talked she told me how i shouldnt ask so many questions and that i should just look at the answers instead of asking people. That it makes me look stupid and when i get to other services people will pick on me for it. Yes, i am not shy and dont mind asking questions, but i have never been scolded for it. i guess i didnt formulate my questions right with her since she jut thought i was an idiot. but that doesnt make to much sense to me considering this is schooling and they are there to teach us. yes, i will look something up also but who is it hurting to ask a simple question during rounds to get the doctors opinion on the matter?

i wasnt too surprised when later that morning i asked her to do my 2 week evaluation and she pretty much just criticized me for about 3 minutes. She said i 'didnt know my patients at all' and that my knowledge was lacking. I need to read more and study more and that i have a lot of room for improvement [emphasis on the LOT]. I sat there just nodding and saying ok and trying to be as accepting as possible to her criticism. the part that made me the most angry is that she never gave me specific examples of what i did wrong and she never gave me any constructive criticism as how to improve. she just talked for a couple minutes, circled a bunch of low %s on my eval and then got up to leave. its like she just put me down, said [in not exact words] that i was stupid and that i needed to work harder. Oh, and then as she gets up and walks out the door she says have a good weekend, dont worry, you will be a good doctor you just have a lot of work to do. WHAT THE FUCK?

I may not have been a complete gunner on this rotation like that annoying girl [who at several times threw us under the bus and made herself look great on our expense] but i have still worked hard, gotten to the hospital early to read up on my patients and see them, and i worked hard to make the intern's lives easier. at this point i still dont know exactly what to do to make my grade go up because clearly my grade for this rotation is going to be at minimum passing level. on the bottom of the evalution she wrote 'student has much room for improvement over the rest of the 4 week rotation.' great...


i had to work this AM [saturday] and when working with one of the residents, we got to talking about that doctor and i told him what happened. he says she does that all the time and really does pick on certain medical students and residents and gives them really bad evals. so i guess i cant feel too bad if she does this to one person in the group everytime. but i cant stop wondering why me? i guess im just to talkative and normal...haha. this is the first time [of many i am sure] an attending has not liked me and i just need to get used to it and know that some people are gonna love me and some are gonna not love me and thats just life. i am able to kinda laugh it off today but honestly yesterday was a hard day. first time i have cried about rotations so far.

i worked all week, worked today and tomorrow [sunday] work all next week and then get saturday off. i will then work sunday- friday.

im really ready for vacation

I have officially become a germ-a-phobe. I find myself putting alcohol sanitizer on everything a child touches. I knew it has become more apparent when after doing a physical exam on a child with a viral infection and a rash, i washed my hands for at least 2 minutes and after drying them, used hand sanitizer [just in case]. Another strike against peds.


i miss OB/GYN a lot.... is this a sign? is there more meaning to this they i realize?

ok, time to go to bed. i need to get to the hospital tomorrow so i can write a progress note on [yet again] a child with a UTI that i admitted from the ER this afternoon. *sigh*

"Miss you, miss our group, miss ob/gyn. You off this weekend? P.S. I like PEDS but it is MUCH slower..."
-Nicole

Im not the only one that feels like peds is much slower than OB/GYN. i knew this was going to happen.

Today i got to the hospital at 7:15am to prepare for rounds at 8:30 because our attending this morning was the chair of pediatrics at the hospital [the 'man']. So i got there early to know my patient very well. I saw 2 patients, one of which was the 19 month old girl who i admitted from the clinic yesterday. She was doing much better and i have to admit, she really is adorable. I wouldnt mind seeing such cute faces everyday but as everyone says about peds, you spend way more time with the parents than with the cute kids. this is making me re-think peds a lot. its not that i dont like it, but its just something to consider. Oh, and another attending today told us she didnt recommend going into peds because she didnt want us to be poor knowing how high our school loans are, she said that we shouldnt go into it. So that was interesting....

Rounds too a long time today. The doctor came in around 9:30 and then we spent almost 5 hours covering our patients. It wasnt bad though, he asked us a ton of questions but also taught a lot. We all had fun also, talked about lots of things outside of medicine and made the whole morning very interactive. When we were in OB/GYN, rounds took about an hour and a half and it was just a small part of our day. On peds, rounding IS the day because after we can go home [one student will stay each afternoon until 5pm but since there are 5 people on our team thats only once a week!] Needless to say, the hours of this rotation are much less stressful.

Lastly, there are 2 medical students from other schools on our team, 1 of them is the most annoying girl i have ever met. Well, that may be an exaggeration, but shes pretty bad. She is very eager to demonstrate her 'abilities' and will cut off other people as they are trying to explain things. It is taking me a lot of effort to not say anything to her [knowing my personality]. It is a learning experience because for the rest of my career i am going to be working with people like this girl and i just have to learn how to keep my mouth shut. The problem is that everyone else feels the same way i do, i just express my feelings while other people remain quiet. I do have something positive to take away from working with her: it helps me to shape the medical student/resident/ physician i want to become by making sure to NOT be like her and others i have worked with in the hospital...

Things i have learned:
1- kids get a lot of fevers....and a lot of illnesses can cause fevers in children
2- it doesnt matter how many times i study antibiotics, they still get mixed up in my brain
3- reading a chest x ray is not easy

the nurses that dont know me call me doctor...

re-thinking my interest in going into pediatrics....

I have been on wards for 3 days now and though the kids are freaking adorable, its not much interaction with them so much as their parents. FOr the past 2 days we have come in around 7:30 in the morning, written progress notes and seen our patients (about 2 each) and then we round with the attending from 8:30 or 9 until almost noon! It is very different from my last rotation. Most kids are admitted for fevers of unknown origin and then stay a couple days to get antibiotics. Maybe its the fact that their arent many patients that make it hard for me to imagine going into the field. Also, its not a lot of procedures or excitement...

This afternoon i went down to the pediatric clinic to write an H&P on a 19 month old girl who was having fevers, one of which was 105.5! I went in and talked to her and her mom but as soon as i started doing my physical exam she started wailing. Imagine a 19month old crying refusing for me to look at her ears while i am trying to stick a pointy object with a light into her eye to see how her ear drum looks. It was not easy and dare i say it, it was not pleasant. No joke, in the 10 minutes i spent trying to figure out how the hell to look inside this little girls mouth, ears, and nose, i decided i didnt want to do this for the rest of my life....i think i was patient that at least understand me and sit still.

But then later in the day when i went up to the ward where she had been admitted, i went in to check on her and when i said bye she said bye back and waved at me with two hands that each had examination gloves on her [the nurse gave them to her to play with and they were about 30x to big for her]. It was the most adorable thing i had seen. She wasnt screaming and she looked very cute. Maybe peds isnt that bad?

I have another 5 and a half weeks to decide. For now, I am going to read up on the 50 million things that can give babies/children fevers...

Pediatrics

First day of Peds at arrowhead regional. My day was from 7:30am and was done by 1pm. I think im gonna like this rotation. I am going to be on the peds ward for 2 weeks and there are not many children there so the days are short. arrowhead is a great facility, im looking forward to working there for the next 6 weeks.

tomorrow im responsible for writing the progress note on a kid with a complicated ear infection. how appropriate for my first peds case.


got this text from nicole today, she's at a different site for ped's:
me "how was your day"
nicole "mine was good, all my pts spoke english!!!"