Charlie goes to Medical School

I mean, working all weekend. Man.

So my new philosophy for the blog is that I am not going to worry so much about posting my personal information and people figuring out who I am, but I still will never discuss patient stuff here obviously. Any medical stuff that I discuss here will be in a general since, and will never be related to patient care…in fact I will probably be time shifting all that stuff (no “Hey, today I saw a PICC line get placed.” …. more like “PICC lines which I have previously seen) as a little additional safety. Patient privacy is obviously a huge issue because a) we do care about patients and b) violations cost a lot of money.

So anyway, here goes with the personal stuff. I’m on Trauma Surgery right now as part of my surgical sub-specialty training. I’m working days this weekend (surgical core students handle call). Next weekend I have off before switching to Ortho.

I have previously ruled out surgery as a career choice because generally surgeons wind up retiring early because of the precision needed during procedures. I’m not middle aged yet, but I will be close by the time I really do get to practice on my own. I really want the opportunity to work as long as possible in case I don’t feel like retiring in my mid-60s.

However, surgery rotation can have a way of making you change your mind. Everyone I work with is great, they have a great attitude about the patients, and they emphasize the education experience on the floor. Trauma surgery is great cause it seems like we deal with every system in the body meaning we also get to work with teams from all over the hospital.

More stories later…I just need to get to sleep.

• There is a special sheet in our charts that is for billing.  If an attending is touching this sheet.  Never talk to the attending.
• Sub-point: This also applies to new computer systems.
• Sub-point 2: This also applies to pretty much any other time, but the above can affect your grade significantly more.
• A great time for your hardest rotation is right after studying for boards…because those out-of-left-field basic science questions might just pop in your head.
• Nurses are like the cool kids in school.  Always try to impress them.  Never disrespect them.  Give them anything they want.  Do whatever they say.  Dance if you hear a ring tone on the off chance that it belongs to a nurse and they then think you like their music.  Do not disrespect them.  Do not disrespect them.  This is not based on anything that has happened to me, but apparently there are still medical students who have not figured this out.
• Speaking of cell phone music, never let a soul hear yours.  Set your phone to silent and your pager to vibrate.  I thought that I would get to turn my phone on during 3rd year…that has been revised to residency.  Oh well, I guess nyan cat will just sing to himself every time I get a call.
• Apparently, at some point during 3rd year, people turn into true gunners and will screw others over…do not be that guy.  Be competitive, but not cutthroat.  Just be excited about learning and doing your best.  No one will fault you for that.  Also keep in mind that after “inspection” and “management” comes “education”.  Knowledge is like love.  Yours won’t diminish if you share it.  It will only grow if you spread it around.
• Don’t tell any jokes.  Don’t use any nicknames for any of your seniors.
• Eat when they tell you to.  Bring healthy snacks (Clif bars?).  Do not leave them in your backpack.
• Don’t stand when you can sit.  Don’t sit when you can lie down.
• Don’t upgrade the template to your blog if you have made any modifications to it or you will lose your background images.
• And do not ever, ever fuck with the pancreas.

Working on getting back up and running.

Yes, I didn’t post all of second year. It was tough and Step 1 is a … to quote the vice president … a BFD.

Year 3 started today. We had a very brief orientation followed by me reporting to Trauma Surgery and feeling like a nobody.

I’ve been handed a pager so I can report to different areas of the hospital which directly conflicts with my “nobody” feeling. I had to deal with that conflict right away.

Third year is where you start moving from “reporting” to “investigating”. As soon as I get a patient, the key to looking more like a third year and less like a second year is digging for all the information I can get on each and every patient…all the information that time will allow. We’ve also been handed 4-6 outside sources for information along with a required textbook and all the review books that word of mouth seems to think are a good idea.

Also, I played some golf. Good stuff. More later.

What US Health Care Needs (via Slashdot)

I’m not going to add too much to this.  I’m not exactly a non-partisan guy, but both sides are eventually going to have to buy in to make health care reform work.

Other than that, I’m trying to keep this blog pretty non-political, so everyone enjoy their morning coffee.

[Time Shifted Post: This post was a quick one that I wrote before going to visit my parents. It was basically a recap of that first week or so of summer vacation. Nothing really super about this post, but I didn't have time to proof it when I wrote it. Hope everyone out there is doing well.]

Summer research has already started getting underway, but I don’t start it full time until next week. I wish I had come up with a little more organized plan to enjoy these couple of weeks out of school, but I had spent the previous few weeks trying not to think about summer in order to get my studying done.

Last week, I worked on the apartment for a little bit getting some spring cleaning done. The mess that was my desk is now completely under control, and desk II is back to being our dining room table. Admin cat has been enjoying watching my toils.

We had a spot of bad news with our previous living space which we have had on the market for sale for a while now. Wife and I had a pretty good offer come in, and unfortunately it fell through. If anyone out there is thinking about medical school, start getting rid of responsibilities like this. I have been trying to avoid renting because it is one more thing to worry about, but in this market it is the best option. Hopefully, we can rent it for now and then get it back on the market and sold by the time I am in residency and be done with the whole mess.

I have had a few meetings about my summer research since school got out of school. It was useful as it has taken me a while to get into the right frame of mind. My mentors have been guiding me along for a little bit, but it wound up taking some time and going through their old literature review materials before the right frame of mind sank in. Now that I understand our approach a little more clearly, I am going to update their literature review to look for anything recent and get things under way. I’ll be ready to hit the ground running.

I am trying to branch out a bit with my research. I have met one person who works in a different hospital as a statistician. I want to take an afternoon and meet with her to discuss our methods and get another take on how we are examining our results. I also will be getting some shadowing opportunities which is required of everyone in the program whether their research is in the clinically-based or not.

You don’t get to do everything during a break, so you try to find the stuff you most want to do, but don’t sweat what you can’t. You are supposed to be on a break after all.

You don’t want to return to school or work more tired than you left it.

• It’s official. I don’t have time to post this summer. Well, it’s going to get better. After taking a couple of weeks to travel and do nothing, Wife and I got me into the new work routine and we tried to get onto a diet. After the first week on this diet, I gained weight. My response to this was to freak out and go completely strict on the diet. In the ensuing weeks, I’ve manage to lose 8 or so pounds. The diet involves a lot of clif bars (blueberry crisp and crunchy peanut butter) with a fairly restricted dinner and a popcorn snack at around 10-11. I’ve been using an app on my phone to keep track of calories and trying to stay around 1500. The exercise routine is running about 25 minutes during the week and about 30 minutes on the weekends (the time limit on the machines at school) and hitting the bikes afterwards. Wife has been joining me at the gym, and we’ve gotten good at keeping each other on track. My goal is to lose enough weight to make staying on the diet significantly easier during the school year when I will be needing all of my energy for studying.
• Research has been a little crazy. I was hoping to have a little more time for literature review and preparation for my data collection in the next couple of weeks, but there was a pretty big snafu with my IRB approval involving some misplaced paperwork. This big issue aside, everyone has been very cooperative and quick on the turnaround (which isn’t normally the case, but it is nice to know you can easily get things escalated). The IRB and the people managing summer research have been great. I was actually in the IRB office and was trying to express my appreciation for their help. I said something like to the effect that they were being very fastidious, but that was great because I also appreciate them looking out for my research subjects. However, they were also very quick on the turnaround to me when they could which helped make my approval possible. I should point out that my situation is a little unique because I am doing data collection with actual people which most people don’t try to squeeze into a summer research project. I’m also doing my collection off-site which most people aren’t stupid enough to try to get through for a short summer research project. I am also doing a pediatric study, and people under 18 automatically get the extra special scrutiny for any research project at any IRB. That all being said, I got my IRB approval on Friday!
• Wife and I have friends from my class, one of whom is moving. Not much to say here except I’m glad we did the move at night instead of during the day, and my entire body is sore two days later. I’m having a time even getting up off the couch, but I do want to workout today.
• I still have some posts that I need to finish and publish. However, I’ve lost my eye for proofing lately, so I’m going to have to wait for Wife to get home today to look over them.

I have two or three posts written, but haven’t had time to clean them up. Will try to sit down and clean them up before the weekend is through.

Happy Memorial Day Weekend!

Just quick post. There are a couple of tools out there to help you identify pills. Chances are if you are a doctor, you have some form of Epocrates or the like which you refer to. PillBox offers one feature that I’ve seen before in reference software which is pill identification. Color, shape, and the numbers etched in the side can help you identify that pill that for some reason you have pulled out of its container (this can be helpful if a patient shows up with one of those pill-a-day boxes, but can’t remember the names of those pills). The difference here is that PillBox is by the NIH as opposed to some random company that might be more likely to think about charging you. They do caution that you double check any result, but it might help fill in some of those gaps when taking a history.

PillBox via Lifehacker

Another year has passed, in more ways than one.

Three years ago, I was ready to start out on my new career. A change that I was not completely ready to make, but wound up having to make a quick choice. Luckily at that point, I had thought about medicine for a long while. The choice that I had to make was an easy one. Wife was by my side. For my birthday that year, she took me to one of those themed restaurants where the knights joust and sword fight each other. I entered school unprepared mentally and struggled a bit under the stress. However, thanks to some hard work and the well-stuck lessons taught to me by my high school science teachers, I succeeded at transitioning into my post-bacc work.

Two years ago, I had finished my first year of my post-bacc work. I was excelling at my classes, and was starting to prepare to take one more class over the summer before studying for the MCAT. When that did happen, it was me, a card table and several very thick books. I was strung out and playing video games every 4-6 hours just to maintain my sanity. One evening, I cooked Wife a meal and sliced through my left index finger. Wife was not there, so I had to drive myself to the quick care where Wife met me. Wife nearly passed out because she was so concerned for me. I did well on the MCAT. In the fall, I started to take some of the more recommended courses. And I applied to many, many medical schools.

One year ago, I got accepted to one of those medical schools. Wife found a new job and followed me here. We moved here over the summer and I matriculated. I ran headlong into a wall of knowledge. I tried to absorb everything. I drank from the fire hose. I did well in class. I did well in group discussion. I did well in lab.

Today, Wife and I have been married for three years. I have finished my first year of medical school. We are struggling to get our old place sold on a soft market. She drives longer than she should for a job that is not quite what she wants to do. She definitely could have found an easier life for herself. She has stuck by me as I picked myself up from a career that I hated and stumbled into a new career that I love.

Happy anniversary, Wife.

Gonna kick back and relax for a minute.