The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Monday, July 17, 2006

I Love my Job

And not just because the hospital is air conditioned while the rest of the world (including my house) is sweltering in the second straight week of temperatures in the mid-thirties coupled with smog and Humidex advisories. But that helps.

And as an aside, what is up with the freaking Humidex? If the Humidex makes it FEEL like it's 43 degrees, don't tell us that it's 34 degrees with a Humidex of 43... just tell us the bottom line. It's not like anyone walks around in a humidity-free bubble. It's like the windchill in the winter-- there's no point in reporting the temperature as -10 if the second you step outside a blast of icy wind makes it "feel like -20". If it FEELS like -20, it's -20! No?

Okay, I'm over it. But working 10 hour shifts nearly every day last week (they nicely gave me Wednesday off to attend my academic half day... and yes, I'm rolling my eyes as I say this) was much more tolerable when it was viewed as an escape from the heat. I need air conditioning in a big bad way.

Oddly enough, we haven't seen that many people come in with heat-related illness. In the past week, though, I've seen some interesting stuff. Although I have to admit, I feel somewhat sheepish posting about the 'interesting' stuff I've seen when I read Fingers and Tubes in Every Orifice, a kick-ass blog written by an emerg doc in the US. A regular shift for him sees more action than two weeks in this mid-sized Canadian town. On one hand, I'm envious-- I may go through an entire career without seeing a gunshot wound. But on the other hand, the constant adrenaline rush that comes from dealing with trauma must grow tiresome at best... lead to early burnout at worst. I don't know if I'd be able to cope.

So yes, I've managed one or two 'life or death' type situations. A woman came in with a ruptured thoracic aneurysm last week, just a few minutes before the end of my shift... I got to tube her, start her central line (my first one unassisted!) and more or less run the code under the watchful eye of the emerg attending. She died, but not before a daring vascular surgeon attempted an emergency thoracotomy in the middle of the ER, unwilling to wait the 10 minutes it would take to open up and staff another operating theater. She coded three times in the process before someone finally conceded defeat.

Most of the docs let me work pretty independently. Which is cool, because I'm gaining so much more confidence in my skills.With the exception of peds and neurology, both of which make me feel like a useless tit, I rarely feel like I'm in over my head. I've diagnosed a first-outbreak genital herpes in a middle-aged woman who had been treated (unsuccessfully) for a UTI and a yeast infection before she landed on our doorstep. I've seen an anterior uveitis in a young guy with ankylosing spondylitis, although it took quite a bit of fumbling with the slit lamp to do so. I've caught both a peritonsillar abscess and mono on nothing more than a hunch, and managed to catch a fractured shoulder that my staff missed on first pass. I'm not exactly saving lives, but I'm starting to feel like I might be able to eventually.

And on that note, the match website for the emergency medicine third year for family practice residents is up. Here we go again. My new match day is November 2nd. Wish me luck.



Blogger M. Dyspnea said...

That was a great post. I'll admit to liking you over Finges and Tubes, if only becuase your not 35 years down the road in your career and I can still identify in a small way with your troubles.

Keep writing.

12:04 PM

Blogger VitaminKMD said...

Good Luck? Pah! Not necessary, because you rock, and will be the bestest emerg doc asset to the program that is lucky enough to get you!

But then, I'm biased! :)

8:16 PM

Blogger Kungfukitten said...

I thought that eye looked familiar! That gross milky red eye. I had a really awful case of uveitis last year which cinched the diagnosis of sarcoidosis for me. I guess my eyes were really messed up but at my last ophthalmologist visit they looked good, just really dry, I guess I have some scarring in the tear ducts, but at least I can see. Good luck on matching. Where do you want to go?

3:32 AM

Blogger ArizonaDB said...

Don't sell yourself short. You may not be "saving lives" (quote-unquote), but you're significantly improving your patients' qualities of life, which is often overlooked in medicine today. Keeping someone alive until they're 105 looks great on paper until you realize that for the last 20 some years of that they haven't been able to get out of bed. People overlook quality for simple quantity, a problem in most aspects of modern Western culture.

But I digress.

What you do is very important and although the doc at Fingers and Tubes deals with life and death on a daily basis, your job is no less important. You are providing a much needed service to society, and society thanks you. :-)

4:14 PM

Blogger Ms.Teacher said...

As someone who has an iritis attack every 6 months, you ARE saving lives. That is the most painful thing I have ever gone through, and thankfully you diagnosed it and sent him away with the proper meds. I'm sure he feels 200% with the first eye drop!

10:41 PM

Anonymous Kim said...

You don't need luck, you've got it down solid.

And with Pediatrics? Immerse yourself in it and you will have it down in no time. At least, as an ER nurse, that is how I conquered my fear.....

7:58 AM

Blogger wintemp said...

I have recurring iritis and have gone through all the regimens posted on various med sites (blood & urine tests, xrays chest & back, and steroid injections in the eye). As you're aware, they only treat the symptom, they do not cure. By accident I found a cure for myself where outbreaks end after a day or two instead of 6-8 wks with relief of pain in 2-4 hours.
Try the antihistamine Hydroxyz HCL 25mg. It is a presription drug. When an outbreak occurs take a pill. If after 2 hours pain is still present or increasing, take another pill. Once pain is under control, take pill about every 4 hours based on pain level. Pain is usually gone in 2-8 hours. Outbreak gone after a day or two. I only take a pill if the pain is obviously returning/intensifying. Once the eye is on the mend, I stop taking the pills. So far I've only had to take 2-10 pills during an outbreak depending on intensity of pain.
Side affects of the pill is drowsiness. You can still function, but you're definitely in a haze. I shake the effects after 12-24 hrs.
This may help other sufferers.

12:13 PM


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