why do i have to be mr pink?

my, my, how time slips away. i was just looking back at my last post, which detailed the close of my intern year, and now here i am nearly 25% through my 2nd year. yikes. i'd like not to skip any of the wonderful experiences i've had, but it seems as though i just can't keep up. so now i will quickly summarize the end of my first year and the first few months of this year.

end of the year as an intern, orthopedics and back-up:

basically, during this month we are supposed to go to work from about noon until 8pm with the ED ortho consult resident. i think the goal is to learn basic management principles of orthopedic injuries and how to apply splints and casts. i say "think" because i'm only guessing what they want us to learn because i never actually went. not once. it was the end of a tough year and i needed some time to decompress. you only work with other residents so no one really knows if you are there or not--the ortho resident is usually very busy and my guess is that they don't really care if you are there or not. there was a little scare for me after the fact--apparently, part of this month was supposed to include a few afternoons in an outpatient ortho clinic. i actually didn't know this, so of course i didn't go (nor did 11 of 13 residents in my class, since they didn't know about it either). essentially, my program director asked me if i went and i told the truth, stating that i had not attended because i didn't know about it. i got scolded a little, was told to pay closer attention to the rotation requirements, and sent on my way. phew.

i also got called-in to work 3 shifts in the ED for back-up, meaning someone else called-in sick so they needed someone. that someone was me. not too bad to have to work 3 out of 28 days; plus, the residency now "owes" me 3 shifts, meaning that i get to work 3 fewer shifts this year in return for the 3 i worked this month.

what did i do with all my free time? i did a lot of pleasure reading, i got back in shape, lost 15 lbs, drank a lot of wine, and did lots of bike riding (i even won a race and brought home $200 dollars). all much more rewarding than splinting some broken bones (i should mention that i have done a good deal of splinting in my time as a resident, and am fairly adept at it, so i don't think i really missed any great opportunity).

exit intern year.
HOORAY!

2nd year, block 1: pediatric intensive care (PICU)


not such a bad month. it was pretty slow when i was there, so i generally had only 2-3 patients at a time. kids don't generally get that sick, so often (not always) kids get admitted to the PICU for higher-level nursing needs rather than because they are really sick (eg, frequent vital sign monitoring). this month also required being on-call every 4th night, which as an ED physician, i naturally eschew. i think that i slept at least 5 hours on each call night except 1, so on the whole, not so bad.

i learned a fair amount--largely due to the amount of reading i did during the slow call nights--including the fact that it is somewhat more sad when a child dies than when an adult dies. i also saw a good number of children with rare genetic disorders and bizarre deformations. there was a lot of stuff i had read about in medical school but never actually seen first-hand: rocker-bottom feet, dandy-walker syndrome, poly-dactyly, and cri-du-chat (yes, they really make a cat-like sound). this was both interesting and depressing.

the disappointing portion of this month was that there are no interns in the PICU, so i was left to do all the degrading intern-level work: pre-rounding, writing notes, making pointless phone calls, etc. wasn't this kind of thing supposed to have been completed last year? fortunately, given the low patient volume, there was not enough of this work to make it truly ignominous.


2nd year, block 2-4: ems, pediatric ED, surgical intensive care.

i'm in the SICU right now, and am on-call tomorrow, and every third night thereafter. egad. thus, there is not much time for ranting these days. but my goal is to churn out at least 1-2 malevolent soliloquies each week going forward. i'm cautiously optimistic about this goal, but we shall see.

to close, an interesting fact: a study published in the new england journal of medicine in the late 1990s found that on TV shows, the success rate for the immediate success of CPR was 67% and survival to discharge was 93%.**

**the above quoted numbers are incorrect; for the corrected data, please see the posting dated 3, october, 2009.