Quick Update

I know I promised more uplifting posts, but it's just not going to happen. Not anytime soon, anyway.

After being spoiled by starting my EM year by actually doing a month of emergency medicine (astonishing, I know), I am now in hell. I have been shuttled down to Large Teaching Hospital in major Canadian city also known as the Centre of the Universe (or COTU, semi-affectionately). So in my fragile emotional state (for more illustration of this, see last post) I have been sent to a sterile little apartment far from my home, my husband, my fur-babies and everything familiar to me to be overworked, belittled, abused, demoted and generally made miserable. Why is this happening to me? Because I'm reliving some of the darkest days of my medical education... my days as a junior surgical resident.

This is allegedly my 'Trauma' rotation. Bullshit. If this was a true trauma rotation, I'd be working with the TTL (trauma team leader) running the trauma from start to finish. Instead, I respond with the trauma team to all incoming traumas and traumettes (little traumas, or minor injuries that might require a chest tube or something), do a quick primary and secondary survey and then sit around and pick my ass until the patient has been scanned. Then after all of the injuries have been identified, I define which ones are directly relevant to the general surgery team and report back to the staff. Not too bad, right? Particularly since I get first dibs on some of the more invasive stuff (chest tubes, femoral pokes, art lines, etc.). So why am I miserable?

You'll be sorry you asked. My day starts at the hospital at about 6:15am. I am expected to pre-round on patient results and conditions for all of the team's patients (both trauma and regular general surgery patients) before the senior comes in. To add to the fun, the ward is often locked that early in the morning and I have to buzz the intercom for a good 10 minutes before someone will let me in. Which then makes me behind, and I get yelled at for not knowing everyone's Tmax (maximum temperature, indicating fevers and such) over the past 24 hours. My days last about 12 hours long. That's an average. On my feet. Spent running around from one corner of the hospital to the other, mostly completing scut while my senior is in the OR. I rarely have time to eat, and I don't really have the urge to anyway. I am nauseous most of the time, whether it's from being exhausted or stressed I don't know. Thanks to pregnancy hormones, I am quick to cry-- and considering the number of times a day I'm frustrated or overwhelmed, I have had to choke back humiliating displays of emotion more times than I can count. I save it for the 2-3 hours between the time I get home and the time I go to bed to have a hope in hell of waking with my 5:15am alarm.

Doing this pregnant was the stupidest idea ever. My feet are swollen by 8am, thanks to a combination of being on my feet constantly and the 40 degree heat. My back and abdomen cramp constantly, again probably thanks to the time spent on my feet. I've started having those lovely pre-syncopal episodes again, probably in part due to my ongoing blood pressure issues and part due to the fact that I'm back to minimal food intake.

Pregnant or not, this rotation sucks. I am the whole team... just me and the chief resident, who just stays in the OR. I'm trying to do everything, but no one will tell me what 'everything' is or how I'm supposed to get it done in a hospital system that is completely foreign to me. There is no one to answer my questions, and the only time I find out that I was supposed to have done something is the next day, when I'm being yelled at for not doing it.

And to add to the fun, my 'protected educational half days' (teleconferenced lectures from my home school) are anything BUT protected. Today for half day I had to beg someone to take the trauma pager, and he wouldn't cover my call for the afternoon. So I barely even heard any of today's lecture because I was too busy answering pages every 5-10 minutes. Then I got yelled at by my senior for sending a med student to do a consult-- she was placated when I explained that I had already seen all of the urgent consults and assessed them for the OR, and that this consult was VERY non-emergent and the staff requesting the consult admitted on the phone that the patient wasn't likely a 'surgical candidate'... but still.

I've done this already. I've put in my time as a surgical scut monkey. I'm not here to be anyone's lackey, I'm here to learn to run trauma. And I'm getting very little of it. It would have been MUCH more useful to do this as an EM/Trauma rotation. I'd still see the same stuff, but from a perspective that is pertinent to my role as an emergency physician.

Now any other time in my life I probably would have sucked this up and just counted down the days until I was done. But my coping skills have already been recently taxed to their maximum. I'm doing my call tonight, working a full day tomorrow (going home at noon post-call is not an option here on this service... particularly not when your staff surgeon has booked a clinic with 42 patients on your post-call day), back on Friday, then I'm going home. Home to my husband, my dogs, and my crazy sister who is visiting for the weekend with her significant other. There I will carefully construct a letter to my program director explaining my case, my issues, and how difficult this has been. I will emphasize how little I am getting out of it. I will offer to do extra Trauma call during my easier rotations, or even over my maternity leave. But I want to come home.

I just can't do this anymore.

I'm not even reading this post over. Excuse the disjointedness. I might regret posting this later, but what the hell-- you want an insider's look at medical education, here it is. Often, it sucks. And I am too tired to keep sucking it up right now.