More than faithful
My last month on my program's rotation was last month (we have 4 during intern year) and it was one of the more demanding rotations. I was supposed to have my last month in January but due to babies being born mine was moved back to accommodate.
Hands down it was the month were I got the most procedures. I treated my most severe cases of hyper and hypothyroidism with TSH of <0.008 and 218 respectively (reference range is 0.5-5). I had some very interesting, complicated and sad cases throughout the month. And unusually I only had 3 patients with chest pain (usually 30% of my patients present with this).
I was able to take a week vacation as decided through a massive switch and was covered by another colleague. That meant I got my longest vacation of the year at 9 beautiful days off and 8 of which I could spend in California (because I had 2 golden weekends on either side of my 5 days of vacation). I have labelled it the best vacation of intern year.
I did however come down with a cold during that week of vacation. Subsequently my voice was hoarse and frequently gave out on me the week I returned to work. I have never had so many blank spaces in my dictations as I did during that week (even many more than when I first started dictating this year). One of my attendings as I gave them check out on a patient over the phone said the phone kept cutting out. I didn't tell them that my voice was giving out and it may not have been the phones fault.
During the 3 weeks I worked last month I got to do a bunch of procedures which is awesome. I am going to list them for my sake more than yours 2 intubations, 2 thoracenteses, an unsuccessful lp, a punch biopsy, a tick removal, a paracentesis, an i&d, a delivery and a c section. The first one I hadn't done as an intern or in a non-controlled (read: non-operative) setting. The next 4 I had never done before.
So I started pediatrics this month and I can already sense that it is going to be a crazy month without a doubt. However, yesterday I was given my second opportunity to do a lumbar puncture (lp). The first one having been unsuccessful because the patient called the procedure off after the needle was half way in her back. So under conscious sedation (read: propofol), I attempted my second lp yesterday. This kid had had many in the past so I suspect I went through a fair bit of scar tissue. At the end of the insertion of the needle, clear fluid rushed out. I was excited and calmly measured the opening pressure and drained 22cc of spinal fluid off this child. After the procedure, I told my attending that I had never successfully done one and she was stunned. I texted my friend that I had gotten a champagne tap and went on my merry way.
Little did I know that a champagne tap is more than just clear fluid. Apparently it means a completely bloodless specimen. That means 0 RBC found on the microscopy. The significance is that it is such a rare and difficult thing that the supervising physician is supposed to buy the apprentice champagne. So this morning on rounds my attending actually hit me because she was so excited that I had 0 RBC on my specimen. Now that I know the back history I wonder if she realizes that she's supposed to get champagne! lol
These days it seems the epiphanies I have are one that I have had before. It seems that so much insight has been provided me in the past. I just need to be reminded of my utter dependence on grace. How easy it is to let pride creep up into our lives. Intern year is a battle in that respect because as doctors we are taught to have confidence and authority but on the other hand there is so much I've never done and never seen. Zebras are more abundant in that respect than one would think. Also how easy it is to think of what I deserve since I've worked however many hours in a week and slept however few hours. But I guess in that regard it's a good furnace for revealing our imperfections.
And when I say how much I need grace every day let me put it in perspective. One of my friend's has developed a tremor so even though they love procedures they are limited in what they can do. Another one of my friend's has developed an allergic reaction to a chemical she uses on a daily basis. But what this shows me is that can can't stop either of those things from happening to myself and that my life is really very good and I shouldn't ever let complaints fall from my lips or consent to others complaints.
Ask me about my propranolol story, if I forget to write it here.
Hands down it was the month were I got the most procedures. I treated my most severe cases of hyper and hypothyroidism with TSH of <0.008 and 218 respectively (reference range is 0.5-5). I had some very interesting, complicated and sad cases throughout the month. And unusually I only had 3 patients with chest pain (usually 30% of my patients present with this).
I was able to take a week vacation as decided through a massive switch and was covered by another colleague. That meant I got my longest vacation of the year at 9 beautiful days off and 8 of which I could spend in California (because I had 2 golden weekends on either side of my 5 days of vacation). I have labelled it the best vacation of intern year.
I did however come down with a cold during that week of vacation. Subsequently my voice was hoarse and frequently gave out on me the week I returned to work. I have never had so many blank spaces in my dictations as I did during that week (even many more than when I first started dictating this year). One of my attendings as I gave them check out on a patient over the phone said the phone kept cutting out. I didn't tell them that my voice was giving out and it may not have been the phones fault.
During the 3 weeks I worked last month I got to do a bunch of procedures which is awesome. I am going to list them for my sake more than yours 2 intubations, 2 thoracenteses, an unsuccessful lp, a punch biopsy, a tick removal, a paracentesis, an i&d, a delivery and a c section. The first one I hadn't done as an intern or in a non-controlled (read: non-operative) setting. The next 4 I had never done before.
So I started pediatrics this month and I can already sense that it is going to be a crazy month without a doubt. However, yesterday I was given my second opportunity to do a lumbar puncture (lp). The first one having been unsuccessful because the patient called the procedure off after the needle was half way in her back. So under conscious sedation (read: propofol), I attempted my second lp yesterday. This kid had had many in the past so I suspect I went through a fair bit of scar tissue. At the end of the insertion of the needle, clear fluid rushed out. I was excited and calmly measured the opening pressure and drained 22cc of spinal fluid off this child. After the procedure, I told my attending that I had never successfully done one and she was stunned. I texted my friend that I had gotten a champagne tap and went on my merry way.
Little did I know that a champagne tap is more than just clear fluid. Apparently it means a completely bloodless specimen. That means 0 RBC found on the microscopy. The significance is that it is such a rare and difficult thing that the supervising physician is supposed to buy the apprentice champagne. So this morning on rounds my attending actually hit me because she was so excited that I had 0 RBC on my specimen. Now that I know the back history I wonder if she realizes that she's supposed to get champagne! lol
These days it seems the epiphanies I have are one that I have had before. It seems that so much insight has been provided me in the past. I just need to be reminded of my utter dependence on grace. How easy it is to let pride creep up into our lives. Intern year is a battle in that respect because as doctors we are taught to have confidence and authority but on the other hand there is so much I've never done and never seen. Zebras are more abundant in that respect than one would think. Also how easy it is to think of what I deserve since I've worked however many hours in a week and slept however few hours. But I guess in that regard it's a good furnace for revealing our imperfections.
And when I say how much I need grace every day let me put it in perspective. One of my friend's has developed a tremor so even though they love procedures they are limited in what they can do. Another one of my friend's has developed an allergic reaction to a chemical she uses on a daily basis. But what this shows me is that can can't stop either of those things from happening to myself and that my life is really very good and I shouldn't ever let complaints fall from my lips or consent to others complaints.
Ask me about my propranolol story, if I forget to write it here.