Out of the abyss
I consider myself an "advanced 3rd year" now that the 2nd years are starting their clinical rotations now. Do we still consider them 2nd years even though they're on clinical rotations, which routinely start at 3rd year? The 4th years have another month left; the incoming class doesn't start until August. I'll stick with MS3.8 for now, I guess.
Peds was...all right. I had a good resident on wards, my interns were so-so. I was so scared to pick up sick babies at first. I couldn't look in their ears for the life of me. Nephro was very educational but tough nonetheless with constant, non-malignant pimping. Newborn nursery was fun; I can handle a baby comfortably now, and interact with kids well enough to get the information I need, which was my modest goal for the rotation. I got the flu from seeing many kids on my outpatient block - my first being really sick in school. It sucked, spiking fevers to 103, myalgias up the wazoo, and feeling generally crummy. My doctoring facilitator kicked me out of class to protect everyone else, and Christian forced me to take a day off, after which I submitted to the illness and slept most of the weekend. It was interesting that I've noticed for the 3rd rotation in a row that around week 6 or 7, I get really burnt out, apathetic, lazy, and +/- depressed about things. At those points I don't care about doing well enough to honor, I just want to veg and be "normal." Being sick didn't help on Peds. I'm glad it's over. My friends didn't have the best time on peds, either. Let's all try to repress it together now.
Having outpatient peds was a nice transition to my Primary Care clerkship, since I had normal clinic hours and weekends off the entire rotation. It was great. I was on IMPACT clinic the first month, working with great attendings and having the opportunity to spend lots of time with patients. It is not a real-life clinic setting with the traditional 15-30 minute appointments, but that was the appeal. (Plus, I'm slow.)
My second month was with a private practice doc in Elk Grove, who was also a good teacher. However, her practice was strict about the 15-30 minute appointment, and I'd make things really late while I was there. It's such a bind - we learn in med school to talk about all the patient's problems, spending lots of time with them, but in the real world, you have to stick to their chief complaint and smoothly divert their other questions to future appointments. It's weird; I have subscribed to the "hold all your problems for one visit" because I'm poor and don't want to pay multiple co-pays for each visit, and I always thought it's good to get all things dealt with at once (kill multiple birds with one stone). However, this is not compatible with the current health care system model. I had many experiences my 2nd month where a patient would come with their laundry list of problems *after* we discuss their chief complaint, as I'm opening the door to leave (and after I'd consulted with the attending so she is in the mindset that I will move on to the next patient, not re-consult her). It was really frustrating. I'm going to have to keep that in mind when I'm a patient seeing my PCP.
And now, I don't have to worry about shelf exams until August. I start a month of outpatient psychiatry (along with students on their 3rd year psychiatry clerkship). Looking forward to it; my last patient on FP was someone with panic disorder who was experiencing intolerable side effects to Paxil. I was fascinated through the entire encounter, talking about behavioral changes and how to taper off the medicine before starting a new one. It gave me a good vibe that going into psychiatry is a good decision for me over Medicine. Hopefully outpatient psych turns out well, as I think it is one aspect of psychiatry I would like to have as part of my future practice. Inpatient care was really emotionally draining. Consult was fun. I'm a bit irritated that my AI will be at SCMHTC again instead of the jail; the description said it can be done at county (SCMHTC) or forensic (jail) sites, and since I'd done SCMHTC, I was hoping to go to the jail. Alas, no. So at this point, since I didn't like SCMHTC so much, I'm gonna try to schedule an away AI somewhere. U Washington sounds like a possibility; it'd be cool to be in Seattle and maybe I can stay with some family friends and save on housing. Or I could try UCLA and commute from home???? (that doesn't sound as appealing even if it is UCLA).
In other news, Christian and I have been at this house for about a year now. I don't know if I mentioned this before, but the day I took my USMLE step 1, I'd noticed that on the way out, I saw a bunch of police cars lined on the street next to ours. Thinking "oh, wow, I wonder what's going on," I went on to go and take my test. A few days later, Christian was talking with my neighbor and they said that the morning of my test, minutes after I'd passed them, there were multiple police lined up on the front of the house looking like they were ready to raid the place. An officer showed a picture of a woman to my neighbor and she said that that person didn't live there, that an Asian girl and her white boyfriend live there, that we're graduate students. The police left after that, after saying they would have broken the doors and windows if they didn't have that information! What the hell?!. Good thing my parents put those security doors in the front. Anyway, Christian tried to call the police and tell them to get their act together (helloo, did you not see the "for sale" that was out on there for months, do you not know it was sold and there are new owners?!?!) but it was after hours. We subsequently forgot about that incident (and forgot to follow up on the call). Christian ran into another neighbor at the grocery store the other day and they chatted, and Christian brought the topic of the police coming by to him. Our neighbor mentioned that the previous tenants were kind of shady, and the house had been raided previously because it was suspected that it was a meth lab! AND, he said, late one night in the past week or so, there were police that had put up a freakin' SPOTLIGHT on the house. WTF?!?! They must be stupid and not updating their files. I need to call them ASAP to update them and tell them to back the hell off, no meth in this house! Geez! why was this not mentioned when discussions of the house were going on? I vaguely recall someone mentioning that the previous tenants may have had underage drinking going on, which is one issue, but meth is a whole other bag of worms. What irritates me the most is that the police STILL think the previous tenant still lives here, 6-7 months after it had been vacated and been up for sale, AND the house had been subssequently sold. Don't they talk to the city and wouldn't they know that the house is under new ownership? Bureaucracy sucks with this lack of communication. And i'll have to spend hours on the phone explaining this (and they might not even accept it because I'm not the actual owner) And then I'd have to explain this to my parents and have them deal with the police. UGH. Well, it would be out of my hands at that point.
Peds was...all right. I had a good resident on wards, my interns were so-so. I was so scared to pick up sick babies at first. I couldn't look in their ears for the life of me. Nephro was very educational but tough nonetheless with constant, non-malignant pimping. Newborn nursery was fun; I can handle a baby comfortably now, and interact with kids well enough to get the information I need, which was my modest goal for the rotation. I got the flu from seeing many kids on my outpatient block - my first being really sick in school. It sucked, spiking fevers to 103, myalgias up the wazoo, and feeling generally crummy. My doctoring facilitator kicked me out of class to protect everyone else, and Christian forced me to take a day off, after which I submitted to the illness and slept most of the weekend. It was interesting that I've noticed for the 3rd rotation in a row that around week 6 or 7, I get really burnt out, apathetic, lazy, and +/- depressed about things. At those points I don't care about doing well enough to honor, I just want to veg and be "normal." Being sick didn't help on Peds. I'm glad it's over. My friends didn't have the best time on peds, either. Let's all try to repress it together now.
Having outpatient peds was a nice transition to my Primary Care clerkship, since I had normal clinic hours and weekends off the entire rotation. It was great. I was on IMPACT clinic the first month, working with great attendings and having the opportunity to spend lots of time with patients. It is not a real-life clinic setting with the traditional 15-30 minute appointments, but that was the appeal. (Plus, I'm slow.)
My second month was with a private practice doc in Elk Grove, who was also a good teacher. However, her practice was strict about the 15-30 minute appointment, and I'd make things really late while I was there. It's such a bind - we learn in med school to talk about all the patient's problems, spending lots of time with them, but in the real world, you have to stick to their chief complaint and smoothly divert their other questions to future appointments. It's weird; I have subscribed to the "hold all your problems for one visit" because I'm poor and don't want to pay multiple co-pays for each visit, and I always thought it's good to get all things dealt with at once (kill multiple birds with one stone). However, this is not compatible with the current health care system model. I had many experiences my 2nd month where a patient would come with their laundry list of problems *after* we discuss their chief complaint, as I'm opening the door to leave (and after I'd consulted with the attending so she is in the mindset that I will move on to the next patient, not re-consult her). It was really frustrating. I'm going to have to keep that in mind when I'm a patient seeing my PCP.
And now, I don't have to worry about shelf exams until August. I start a month of outpatient psychiatry (along with students on their 3rd year psychiatry clerkship). Looking forward to it; my last patient on FP was someone with panic disorder who was experiencing intolerable side effects to Paxil. I was fascinated through the entire encounter, talking about behavioral changes and how to taper off the medicine before starting a new one. It gave me a good vibe that going into psychiatry is a good decision for me over Medicine. Hopefully outpatient psych turns out well, as I think it is one aspect of psychiatry I would like to have as part of my future practice. Inpatient care was really emotionally draining. Consult was fun. I'm a bit irritated that my AI will be at SCMHTC again instead of the jail; the description said it can be done at county (SCMHTC) or forensic (jail) sites, and since I'd done SCMHTC, I was hoping to go to the jail. Alas, no. So at this point, since I didn't like SCMHTC so much, I'm gonna try to schedule an away AI somewhere. U Washington sounds like a possibility; it'd be cool to be in Seattle and maybe I can stay with some family friends and save on housing. Or I could try UCLA and commute from home???? (that doesn't sound as appealing even if it is UCLA).
In other news, Christian and I have been at this house for about a year now. I don't know if I mentioned this before, but the day I took my USMLE step 1, I'd noticed that on the way out, I saw a bunch of police cars lined on the street next to ours. Thinking "oh, wow, I wonder what's going on," I went on to go and take my test. A few days later, Christian was talking with my neighbor and they said that the morning of my test, minutes after I'd passed them, there were multiple police lined up on the front of the house looking like they were ready to raid the place. An officer showed a picture of a woman to my neighbor and she said that that person didn't live there, that an Asian girl and her white boyfriend live there, that we're graduate students. The police left after that, after saying they would have broken the doors and windows if they didn't have that information! What the hell?!. Good thing my parents put those security doors in the front. Anyway, Christian tried to call the police and tell them to get their act together (helloo, did you not see the "for sale" that was out on there for months, do you not know it was sold and there are new owners?!?!) but it was after hours. We subsequently forgot about that incident (and forgot to follow up on the call). Christian ran into another neighbor at the grocery store the other day and they chatted, and Christian brought the topic of the police coming by to him. Our neighbor mentioned that the previous tenants were kind of shady, and the house had been raided previously because it was suspected that it was a meth lab! AND, he said, late one night in the past week or so, there were police that had put up a freakin' SPOTLIGHT on the house. WTF?!?! They must be stupid and not updating their files. I need to call them ASAP to update them and tell them to back the hell off, no meth in this house! Geez! why was this not mentioned when discussions of the house were going on? I vaguely recall someone mentioning that the previous tenants may have had underage drinking going on, which is one issue, but meth is a whole other bag of worms. What irritates me the most is that the police STILL think the previous tenant still lives here, 6-7 months after it had been vacated and been up for sale, AND the house had been subssequently sold. Don't they talk to the city and wouldn't they know that the house is under new ownership? Bureaucracy sucks with this lack of communication. And i'll have to spend hours on the phone explaining this (and they might not even accept it because I'm not the actual owner) And then I'd have to explain this to my parents and have them deal with the police. UGH. Well, it would be out of my hands at that point.
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