Medical Student Overload

Saturday evening I went out to dinner with a few friends. I'll save the details for the grand finale. After dinner, we made our way out and about and I amused myself by sliding around on a patch of ice. We then did some karaoke (at a place full of really bad singers, I can't see myself returning) and then about 1am I'd found my limit, and went home. 

Just after getting home I felt some discomfort in my abdomen. Discomfort quickly turned to pain. Somatic. PAIN. In my right lower quadrant. I freaked myself about thinking that I had appendicitis. Being almost 2am at this point I said, well I don't have a fever, no nausea, vomiting, or diarrhea, or fever, appendicitis is very unlikely. Given I had just eaten all-you-can-eat sushi, I also thought it could be a serious case of indigestion. I went to bed, actually got comfortable pretty quickly, and said if the pain hadn't resolved by morning I would have a friend take me to the hospital. Having done plenty of stints in the ER and night shifts on the floor, I knew I'd be lying in a bed either way for the next several hours. I then started organizing my thoughts and symptoms to be able to tell the doctor, and started thinking of how my mother was going to fly up to Chicago and cluck like a mother hen until her baby got better. 

Thankfully I woke up and felt much better, a little sore, but not painful. I'm convinced in my shenanigans on the sidewalk ice I pulled a muscle. 

Today's lesson

The first good snow of the year in Chicago came on Christmas Day. I awoke to find a clear sky, and could see Indiana with no problem. I did some work on my computer and twenty minutes later looked up to find that I couldn't even see the wall next to my window, much less the street below. It was snowing quite heavily. I became unnecessarily excited. Later that day, a few friends and I were walking along the lake enjoying the snow, and I was still excited. One of my friends is from Northern Ontario, and she's looking at me bemusedly saying "This is nothing. I'm still wearing my high heels!"

This afternoon, I was at a clinic and had to drive through downtown to get home, and it started to snow again, heavily. I have never driven in snow so I was a little nervous. My dad tried to teach me, but I've never had practice. So I did what I could, slow acceleration etc etc, and got through a slick spot with little muss. After I parked my car, I quickly observed that I'd rather walk in snow than slush.

And thus today's lesson: Slushy sidewalks and dress shoes do not a match make.

Eating...

After coming home yesterday morning and sleeping for a few hours after my overnight call (always the highlight of my medical school experience...), I went shopping with a friend of mine. Wanting a little bit of a scenery change and to catch a good deal we went to the outlets in Aurora, about 35 miles west of Chicago. We had a good time, did a little shopping.  I got what I was looking for for a good price (minus that ice scraper I just remembered I had forgotten). Then it came time to eat. We started to look around, and we quickly realized that, eh, we can wait until we get into the city to eat.  After all the amazing food that Chicago has to offer, Applebee's and On the Border just don't cut it anymore! We ended up at a fantastic Mexican restaurant in Logan Square. It was so good we had to speak Spanish to order. 

Bad Doctor! Bad Doctor!!

Sitting in a lecture about obesity. The presenting doctor provides a platter full of asorted Danish. This medical student also sucked down a bottle of Coca Cola with 65g of sugar.

Hi, I'm your hypocritical doctor. Please do as I say, not do as I do.

Back to overnight kvetching...

Tonight is the first of what promises to be many overnight calls over the next five weeks for OB. It feels quite strange to be at the hospital at night (or at all rather) without Awesome Partner. We were partners for six months, side by side throughout the day. Awesome Partner has finished her scheduled rotations for now at Chicago Hope Hospital, and I remain. I miss working with her, because we worked well together. I made my way to the call room to deposit my things--not to sound lazy but I am not staying awake overnight if I don't need to, so if I can catch a few hours of sleep to guanratee I'll function the next day, I'm going to make use of the facilities provided--and the smell of the hallway took me straight back to working overnights during Internal Medicine, and all those quiet hours walking the halls and doing admits with Awesome Partner.

...here's to you Awesome Partner. Stay tuned for more kvetching...

You know you're old when...

Yesterday afternoon I received a text message from a friend saying "I bought you a ticket for the 9pm show at Second City." Ok, looks like I'm going to Second City tonight. Good thing I didn't have any other plans, haha. So we went to Second City which was a lot of fun and really entertaining. Afterwards we met up with some friends at a bar in Wrigleyville. Yesterday was the TBoX, or Twelve Days of Christmas Bar Crawl. Nonstop drinking from 8am to 9pm, and the revelry continued well past that. My liver aches just thinking about how much alcohol some of these people consumed. Anyway, we get into this one place I've never been before, and now I know why, it's crowded with mostly college students. Oh goody!. If my friends hadn't been there I would've left. 

So I take in the scene--I swear half of these kids had to have a fake ID--and start to notice how they're dancing...

You know you're getting old when you see college students dancing and you ask yourself "What the hell is going on here???" 

...I feel old.

OB/GYN

Yesterday was my first day on OB/GYN, but all we did was sit through a day of orientation. As mind-numbing as that sounds it was preferable to the way I was introduced to surgery, when we basically had a twenty minute crash course and then were left to figure out what we were supposed to be doing, and then yelled at for not knowing what we should do.
One of the other students in the rotation has had the exact schedule as I, and we by far have done more rotations and knew the hospital whereas everybody else who came through had done at most one. It was an odd feeling, and we left the hospital feeling "like fourth years," and like we had actually accomplished something. It was a nice feeling because not too long ago I didn't know a thing.

Today was my first day on the floor, and quite frankly it was a bit boring. I got good practice filling out H&Ps, determining fetal heart rates, and gathering a whole new type of history. In twelve hours I saw two deliveries, ten minutes apart. The other OB student and I spent much of the rest of the time listening when we could to the attendings, trying to learn whatever we could, and basically just standing around. I spent a good hour pretending not to listen to the doctor and midwife talk about hospital politics and other such stuff trying to pick up a thing or two, and get a feel for who's who in the department. Afterward, just as it's time for another student to arrive and assume the evening call, the doctor turns to me:

Doctor: "So how many deliveries have you done?"
Me: "I've been in the two today. This is my second day.''
Doctor: "Oh well!!! Then it's time for you to do one! See one. Do one. Teach one!"
Me: "That sounds great."

So we talk about the patient that she was sticking around to watch, and I said I was waiting for the next student but that since I am post call tomorrow I'd be happy to stay for a while to assist in the delivery. We talked for a few minutes about fetal heart monitoring and accelerations and decelerations, and the doctor then said she was going to go check the patient. In one hour she went from 4cm to 8cm, and 90% effaced, with an IUGR, so the doctor said we're ready to push. She told me I could scrub in and I did. As the baby was coming out the doctor had me come finish the pushing. I held the head and caught the baby literally as it came out. Then, having seen previous deliveries, I went for the clamps for the umbilical cord, and ended up cutting the cord as well because the mom (who was alone!) didn't want to do it.

QOTD

First day of OB/GYN, and already I have the best quote of the entire rotation:
"Almost all of your patients are going to be women who are pregnant and healthy -- well, actually they will ALL be women, whoops!"

Le fin surgery

Yesterday marked the last day of surgery. Because God does have a sense of humor, there wasn't anything to do until 2pm. My rotation partners and I literally sat around and did nothing from 10am when we finished our exam and the pediatrics grand rounds we were invited to until almost 2pm. While we were sitting there (I actually fell asleep for a good half hour at one point) we were hearing rumblings about a small bowel obstruction that was put on the schedule. Grand. Just what I needed on the last day when all I wanted to do was get out of here on time.

Luckily the doctor showed up on time (Shock me!) and the surgery started on time (Please pick me up off the floor). I felt completely superfluous in the surgery. I had scrubbed with this same doctor the day prior and actually got to get my hands dirty. Not today. The first assistant wasn't really needed either. All the doctor did was run his hands along the entirety of the small intestine, lop off the obstructed segment, and sew it all back up. Mostly a one-man job. I just kind of stood there like a bored idiot, trying to think of questions, no matter how obvious the answer was, to remind the doctor that I was indeed there, and not just an ugly piece of art propping up the table. The only thing of real interest to me was the fact that this was the patient's sixth surgery for an obstructed bowel, and her abdomen was covered in flowery, vine-like tattoos. What a pleasure to close that back up.

So now surgery is done. I enjoyed the actual operations and procedures, but I can unequivocally say that I did not enjoy the very unpleasant lifestyle and environment that the high-stress OR fosters. I wasn't looking to go into surgery before I started this rotation but I did enjoy it more than I thought I would. I must say I grew tired very quickly all of the unnecessary and at times unprofessional drama and pot-stirring instigated by one individual in particular who seemed to have an unwavering need to make us feel as insignificant as possible. This same individual is also the type of person who when she feels is correct will say anything and shred you alive if you do not agree with her. I felt like I learned a great deal, not just about surgery, but about the associated clinical and physiological aspects of the cases that I had the opportunity to work.

After our last day, most of my rotation partners joined for an evening of celebration. I must say I enjoyed myself immensely from the conversation, to the food, to the company. It's not often I'm in a group of people with whom I feel so at ease and on the same page. We started our evening in Wicker Park, and (somehow) ended the evening at the Hancock Center's 96th floor lounge. This was a first for me, and I enjoyed it immensely.