Surgery

I think the reason why I haven't written much is because I experience so many different things every single day that I just cannot find the words to articulate these experiences. It's also hard to express the excitement and befuddlement (is that a word?) at the FACT that I will be graduating soon.

Really soon.

I just finished my first week in Surgery at a hospital in Queens. I have to report to "Sign In" at 6:30am every morning. From 6:30- 7:45am 20 surgeons, residents, interns, and med students meet in a conference room to discuss every patient that has been admitted to the surgery department. From 7:45 to 9:00 we do rounds. The entire team (20 of us) walk to every patient's room and check in on them. From 9-noon we work in a clinic...either surgery, orthopedics, or wound clinic. And from noon to whenever...we can go in and assist in surgeries.

In the surgery clinic, my job is to examine a patient that had surgery within that last few weeks. I examine them and then present the patient to the head attending. In the othopedics clinic, I examine the patient and determine whether or not they are a candidate for surgery. Then I present the patient to the attending. In the wound clinic, I remove bandages and inspect patient's wounds. Most are diabetic ulcers and the smell is unbearable. One of the other students started gagging the hallway. Some of the docs put Vics under their noses for certain cases. I've seen some nasty wounds...

I participated in my first surgery on Friday. I was second assist on an inguinal hernia. Turns out the guy had a direct AND indirect hernia. I really had no idea what was expected of me and I left the surgery completely surprised by the amount of responsibility I had during the surgery.

There were three of us working on the patient. The surgeon, the resident, and me....the student. The surgeon made the first cut and pointed out all of the landmarks. He handed one retractor to the resident and the other retractor to me. I stood to the right of the surgeon. The resident was on the other side of the patient. I held the retractor with my left hand and was surprised when the nurse handed me a pair of scissors. I grabbed them and when the surgeon said, "Cut"....I cut! I would cut the internal stitches that the resident made under the instruction of the surgeon.

After the surgeon repaired the hernia, he closed the deepest layers of the wound and left the resident and myself to close the wound. The resident did the second layer and I closed the superficial layer under his close supervision. I'm glad I had my ER rotation otherwise I wouldn't have known what to do. There was a medical student in the room with us and she had never sutured before.

The curious thing about this rotation is that I am treated EXACTLY the same as the medical students. There are 4 medical students and 2 PA students. The interns and residents really don't know the difference. The majority of the interns and residents are from overseas and are male. Out of the 20 surgical staff...only 4 are female (including me!). I am asked the same questions as the med students. I've had doctors, nurses and patients address me as Doctor. I explain I am a PA student. So then I'm called "student doctor".

Once a week I am required to do 24-hour call. I work a normal day: 6:30am to 5pm...and then I stay in the hospital with a pager and wait to get paged until 8am the next morning! So technically that's 25.5 hours...but who's counting? Either way, I still don't get paid!

I can sleep in between pages. I do have a call room. It's a small room with a desk and a bed. I don't think the room has been cleaned since the 70's...but there is a door and I get to close it and have some "alone" time. I slept about 3 hours during my first call. I could have slept more but since I was in a new environment and was paranoid that I'd sleep through the pager beeping...I woke up frequently. It is the student's responsibility to update a list of patients. We have to update their conditions and treatment plans and make sure they haven't changed rooms. So, at 5am, I have to run around to the different floors and check up on the patients and their status. Then I have to type up the new list and make copies for everyone at the 6:30am meeting.

So, these days, I wake up at 5am...leave my house by 5:15am. I arrive at the hospital at 6:15am and change into scrubs before the 6:30am (sign-in) meeting. The sign-out meeting is usually between 3-4pm and can last up to two hours. I'm usually home by 7pm. I try to get to sleep before 10pm.

I have to say that I do like surgery. As demanding as this rotation is....I like the challenge and the responsibility. I also like the team approach and the dynamics involved. I would like it even more if I were actually getting paid to work all of these crazy hours!

Less than 4 months to go...

Holy Crap!

Where Have I Been?

I start my surgery rotation tomorrow morning!

I will try to write more...ob/gyn was not my thing. Although I did delivery 2 placentas! I just was not fond of doing pap smears everyday.

More on that later...

6 rotations down...ONLY 3 to go! August 17th is the last day...I can take the Board Exam anytime after August 24th. I have to work on my resume...people have been asking for it.

It's really happening now...still unbelievable!

t*rex

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OB/GYN

My OB/GYN rotation started last week in a major NYC hospital in Queens.

I travel 4 hours in traffic each day to perform pelvic exams, pap smears, and listen to fetal heart sounds. I couldn't help but smile when I heard my first fetal heartbeat or when I felt the baby's head during a vaginal exam for the first time.

I may have the chance to go into the Labor and Delivery Room this week.

I've never seen a baby born in real life.

I'll have to remember to bring my Kleenex.

Bump

I've learned that I do NOT like working overnights in the ER. I did two back-to-back, 8pm-8am shifts and then slept the following 20 hours...STRAIGHT. That lifestyle is not for me. I was scheduled to work 3 more overnights that same week...for a total of 60 hours. I realized after my second overnight shift that working overnights wasn't in my best interest. So, I spoke with my preceptor and asked to change my hours. We settled on 2pm to 2am. This worked out much better because after 2am...NOBODY wants to teach medicine.

The hospital that I did my ER rotation at was messed up. That's the best way I could put it. By the time I made it to the fifth week of any other rotation, I always felt more comfortable than the day that I began. Not at this place. I felt like I was walking on eggshells everyday. I did meet a few good souls. The nursing staff was very supportive and there were a handful of PAs that were helpful, but there was only ONE doc that really took me under his wing. The same doc that had me aspirate the knee and suture the forehead. This doc saw my potential and encouraged me. He told me to "keep in touch" after I graduate.

The greatest lesson I learned in the ER...I've got a VERY STRONG STOMACH!

Buzz Kill

I reported for duty at 8pm and couldn't find the PA that I was supposed to work with. He is the head PA of the ER and, more importantly, I have a great rapport with him. He told me last week that we would be working together in the Main ER for two nights. It gave me such a sense of relief because this PA teaches me and knows my capabilities. I wouldn't have to try to prove myself.

Wel, he was nowhere to be found tonight. I found his girlfriend (nurse) and she told me he wasn't working until Friday. My mouth dropped open. So, I asked her who was working in his place and she pointed to a woman (approx. 60 y/o) sitting across the desk from us. She was a nurse practitioner.

So, I went over and introduced myself as the PA student that would be working with her tonight. I could tell she was irritated by the simple fact that she had a student...and then doubly irritated when I told her it was my first day in the Main ER. Her lack of enthusiasm for my presence hit a nerve. I wanted to flee.

I stood in the corner for 20 minutes before she fully acknowledged me. Standing in the corner waiting to be acknowledged is a horrible feeling. Then she told me that I could ask the nurses to teach me how to draw blood and put in IV's. So, I told her that wouldn't be necessary since I already knew how to do that. I could see the disappointment in her eyes, I wasn't going to let her pawn me off to the nurses to do scut work all night. I was there to learn medicine...emergency medicine.

So she handed me the chart of her next patient. I took the history and performed the physical. The patient needed an IV and blood cultures. So, I offered to do it. But, the male nurse ignored my offer and went ahead and did the procedure while telling me how much he hated doing bloodwork. So, I told him I would have done it and that I would do the next patient. He ignored me. So, I had to laugh and walk out of the room.

I left the Main ER and went back to fast track. The doc that was a jerk to me on my first day...who became my new best friend last week...was there. He was happy to see me and I told him I was in the Main ER. He laughed and told me that the staff tonight was miserable. I just looked at him and told him that I felt like I was wasting my time. I told him how I was supposed to work with the other PA and he agreed that it would be better if I did work with him. When I told the doc that I was working from 8pm to 8am, he ruffled through some papers in his desk and pulled out the PA's phone number.

He handed me the number and told me to give him a call. I didn't hesitate. I knew I wouldn't make it through til 8am without losing my mind. I knew it would stress me out too much. I didn't feel comfortable in my surroundings and the people I was supposed to work with. I didn't feel safe in my surroundings. I was disoriented and nobody was going to be looking out for me. I was a nuisance. If it had been a day shift, I would have had more energy for the situation. But, it was my very first overnight and I knew it would do more harm than good. And although I'm willing to do what it takes, working an overnight under those circumstances would cause me more harm than good.

And I'm not into harming myself.

I tried to reach the PA a few times and finally reached him at 11pm. I introduced myself as his favorite PA student and he laughed. I explained the situation and how I felt about it and he apologized for mix up. He thought he told me about the schedule change. He told me I could finish out the night and then come in on Friday to work with him. I told him I'd rather leave at that moment and come back to work with him on Friday and Saturday! I was a bit surprised at my gutsy request. But, he took it in stride and gave me permission to leave.

I went back to the Main ER and told the NP that I was leaving. She looked surprised. I explained the scenario and thanked her for her help.

I had some anxiety once I left the hospital. I wasn't sure if my behavior was appropriate or not. I started to doubt my actions. I started to worry about what the NP thought about me. But, I stifled those self-defeating thoughts by reminding myself that I am a teamplayer and have gotten along with every tech, nurse, PA, and doc that I've worked with over the last 6 months!

It's my own responsibility to look out for myself. And for whatever reasons...I wasn't comfortable in that environment and it was my gut feeling that told me to get out.

So, I left. I came home and read my horoscope:

Personalities may clash when no one is willing to take the lead. Be aggressive without being manipulative. Whatever you do, keep it light. Give other people the freedom they want. Unexpected events may change the course of the day dramatically, so don't get upset if things don't go exactly as planned.

I guess the day was supposed to go down like this!

What a buzz kill!

Here We Go...Again!

I'm working my first overnight shift...EVER. I'm really not sure what to expect, mostly because I'm working in the Main ER and not fast track tonight.

Nothing like starting your first Main ER experience in the middle of the night.

I couldn't make this stuff up...even if I tried.

8pm to 8am...here I come.

I hope my brain doesn't fall asleep!

52 hours

I've worked 52 hours in the last 4 days! And of those 52 hours, I can honestly say that 51 of them were spent working. Yup, that's 15 minutes a day...just enough time to shovel a sandwich into my mouth and get back on the floor. I worked two 12 hour days and two 14 hour days.

AND I LOVED EVERY MINUTE OF IT!

What a difference one week makes! Last week was really tough. It's not easy being the newbie and some of the characters I worked with last week treated me pretty poorly. But, I grinned and beared it (although I cursed some of them out under my breathe) and I've gained some "street credibility" this week. I learned how the system works, and it's a terribly disorganized system. Now, the docs, PAs, and nurses smile when they see me coming. I've learned what "not" to do and who to ask when I need help!

Today was the most interesting day of the week. There was a wintery mix of ice and snow yesterday. Today the main ER and the fast track exceeded capacity. There were people waiting in the hallways to be seen.

My shift started at noon. I walked in around 11:45 and it was chaotic. I had a lecture to attend at noon and I had to give a presentation at 1pm. I didn't even take off my coat before a nurse came up to me and told me that one of the docs wanted me to meet him in the main ER. I worked with this doc twice last week and he appreciated my "willingness to learn".

So, I rushed over to the main ER and found him. He told me that he needed to aspirate a knee joint due to a gout attack and wanted to teach me how to do it! I took his request in stride, but inside my head there was a little voice screaming, "YES! He likes me...he really, really, likes me!" I told him about the lecture that was starting in ten minutes and he said he had waited an hour for me to get in and didn't want to wait more than another 30 minutes.

So, I ran over to the lecture center and talked to the chief PA...he excused me from the lecture, but reminded me that I had to present a case at 1pm. So, I ran back over to the main ER and learned how to aspirate the joint. We took out 100cc's worth of gooey, sticky, yellow pus from his knee! It was gross...and pretty difficult to get out with the syringe. The doc let me do everything. He just stood behind my shoulder and coached me.

We finished around 12:45pm and as I was getting ready to leave he told me that he had a patient with a laceration that needed suturing. I really wanted to do it, but I reminded him of my presentation. Again, he told me that he'd wait 30 minutes. So, I ran back down to the lecture center and presented my case. Unfortunately, I had to sit around listen to the other students present their cases (5 in total). It took about 45 minutes. The rest of the students were going to the cafeteria, but I ran back to the ER to see if the doc waited.

And the doc did wait for me.

I was psyched. He told what supplies to get and where the patient was located. So, I got all the stuff and went in to meet the patient. Now, I expected that the laceration was going to be on the patient's leg or arm. I expected it to be in a place where the patient wouldn't really be concerned about a scar...they wouldn't be concerned if I accidentally botched it up.

When I walked into the room, I noticed a 55 year old male sleeping on his bed with a laceration to his FOREHEAD! He was hooked up to all kind of monitors (that kept beeping!). I had to laugh. This was insane. I had thrown a couple of sutures a couple of days ago on a finger. The PA started the suturing and he let me throw in a couple next to his.

I set up the materials at his bedside and went back to see the doc. He looked at me and said, "You're done already?" I looked at him like he was nuts! But, he was serious! He told me that I didn't have to wait for him and that's when I told him that I would be more comfortable if he came in and coached me in the beginning. I knew I would be able to get through it alone, but at this stage, I want all the coaching I can get.

So, he watched me prep the patient, set up the sterile field and throw the first suture. He shared some of his suturing "secrets" with me and left me to do the rest on my own. The patient needed 8 stitches and it took me about 45 minutes. It only would have taken the doc 15 minutes (max) to get it all done!

The patient knew I was a student and was fully aware that the doc was coaching me. The patient was really nice and had a great sense of humor about the experience. I was the one that was concerned by the fact that I was stitching his face...but the patient didn't seem to mind. Usually people want plastic surgeons for their faces!

I chatted with the patient during the procedure and built up a good rapport with him. When I finished suturing, I went to get the doc to show him my work. He asked me how it went and I told him, "I did the best I could." He smiled.

As we walked over to the patient I started to wonder if I should be nervous about the doc's assessment of my work. But, I really felt deep down that I did the absolute best job I could. Considering I had no idea what I was doing last week and the fact that I practiced on pig's feet this weekend...and I threw 2 stiches on a finger under intense supervision two days ago.

Did I think I was ready to sew up a face laceration?

Absolutely not! But, I felt comfortable after he coached me through the first suture and that's why I went ahead with it.

The doc got up real close to the wound. As he was inspecting it, the patient remarked, "She did a great job, doc!" All three of us started laughing...of course the patient had no idea what his head looked like. There were no mirrors anywhere near him!

The doc looked at the wound, looked at me, then looked at the wound again. That's when I started to get nervous! But, then he gave me a wink and said, "Good job...dress the wound and meet me at the nurse's station."

I was still a bit nervous about what he really thought. But when I met him at the nurse's station he smiled, thanked me and said, "I knew you were out of your comfort zone, but I also knew you could handle it."

I smiled and let out a big sigh of relief.

I thanked him for the opportunity and headed back to Fast Track.

I still had 10 hours to go.

"I get it, doc!"

I worked with the same Doc and PA as I did on my first day. The same guys that got me so frustrated that I broke out in a blotchy rash over my chest and neck. The same guys that spoke to me like I was intellectually challenged. The same guys that rolled their eyes at me and made faces behind my back.

Yeah, those guys.

One week later and I find myself sitting down and eating dinner with "those" guys. A dinner that the Doc paid for, no less. A dinner that allowed me the opportunity to realize that these guys are human and aren't so bad afterall.

The Doc was the guy that really irritated me last week. And he knew it. He remembered it. And, as I suspected, he seemed to enjoy it.

He reminded me of some of my bloopers on my first day and I started to laugh. I had to remind him that it was my first day...and he genuinely seemed surprise. We both kind of looked at each other like, "Are you kidding me?"

So, he didn't know that my first day meeting him was my actual first day in emergency medicine. He's the Chief Attending at a different hospital and comes in to "moonlight". He then began to reminisce about his days as a resident. Turns out he was cursed at and belittled on a regular basis for 3 years.

I couldn't help but blurt out, "Oh, so that explains the way you treated me last week!"

Luckily, he laughed.

But there was a lesson to be learned. And here it is: "Although it was horrible to be humiliated like that during my residency, I know that there isn't anything that anybody can say to me that will get me upset. Unless someone threatens me with bodily harm, there isn't anything that will make me lose my temper, my focus, or my control. Looking back now, I realize that all of that was part of the training. And that's why I'm an ER doctor. I can handle it."

I made eye contact with him, nodded and said, "I get it, doc."

I get it.

Lesson learned.

Miss Piggy

Today was better...much, much, better.

The 12 hours flew by and I only sat down for "maybe" ten minutes to eat a sandwich. It was busy. There were some interesting cases and I did a lot of procedures.

I'm glad I spent my Saturday night suturing piggy feet because I sutured an arm and a finger today! I did the digital nerve block. Splinted a couple of hands and I also inserted my very first IV...all by myself. Doesn't sound like much...but it's thrilling! I'm a bit more independent today than I was a few days ago and I'm embracing the transformation.

I'm also more comfortable in my surroundings. It's a disorganized and chaotic place and severely understaffed. We worked without a nurse today. But today's staff took it in stride. Nobody stood around pointing fingers, everybody just worked. And the day went by smoothly.

I'm actually looking forward to tomorrow.

Tomorrow I'm working with the same two guys I worked with my first day.

Let the fun begin!

Saturday Night

We spent one day learning how to suture last June. I watched docs and PAs suture last week and I want to get in on the action this week. So, I went to my local grocery store and bought pig's feet.

Yup, pig's feet.

You know your social life has hit an all-time new low when you spend your Saturday night suturing a pig's foot!

But, I feel I'm ready for the next stab wound that comes my way! So, it was worth it!

EMED

Despite my previous entries, I do enjoy Emergency Medicine. I just don't enjoy the hours. It's kind of strange to me. We sit around waiting for something bad to happen to people! Isn't that strange?

I'm working in the Fast Track area for the next 2 weeks and then I go down to the Main ER. I see a lot of things that I saw in primary care. Flu, strep throat, gastroenteritis, pink eye, and there are a ton of motor vehicle accidents (MVA). Again, it's not the main ER so people aren't convulsing on stretchers like on the TV show. It's not that exciting.

There's also a lot of drama at this place. They're understaffed and overworked. Most of the docs, PAs and nurses are cranky. I listen to a lot of whining. That's when I go into the corner and take out a textbook and read. Most of the time I'm tired, so I just look like I'm reading. I like having a schedule. I like having "me" time. I don't have that at this place. There is NO lunch time. Everyone eats their lunch right there in the room.

This is my fifth rotation and I'm ready for more independence. I'm ready for more responsibility. Every five weeks I start over at square one. I've had someone take me under their wing the last 3 rotations. That hasn't happened yet. I'm constantly working with a new doc or PA. I'm constantly in the spotlight. I'm constantly being watched and critiqued. I'm always the new girl. And my colleagues know that in 5 weeks I'm out of there and a new student will replace me.

I imagine its tiring to train students month after month.

Just as it's tiring for a student to train month after month.

6 months, 6 days until the last day of rotations!

Days 2 &3

My second and third day in the ER were much better than my first. Mostly because I'm working with a different doc and PA. I'm working in the Fast Track area for the first two weeks and then I move on to the Main ER. When I showed up at noon, only the doc was there. I introduced myself and hoped for the best.

He immediately began to pimp me. He threw several different scenarios at me and wanted me to come up with differential diagnoses (ddx) for each scenario. He told me that at my level of education, I should be able to come up with 5 ddx for each scenario. I struggled on the first few and he kept telling me to THINK, THINK, THINK. For some reason, when he said that to me, things started to click.

If anything, I know that I can T-H-I-N-K! In fact, I think too much most of the time. The more he pimped me, the more in tune I became to his thought process. When I didn't know an answer, I told him, "I don't know." The first time I said that I didn't know the answer, he had a look of surprise on his face. I immediately thought to myself that the answer must be easy and that I must be stupid for not knowing it. Why else would the doc have that look of surprise on his face?

Well, he was surprised by my "honesty and ability to admit that I didn't know an answer." I kind of gave him a half-smile, because I honestly don't understand how or why a student would try to outsmart an experienced doc or PA. It just doesn't make sense to me.

Within a few hours, the doc began to ask me questions about my past education and work experience. He seemed impressed by the paths that I chose. When the PA came in a few hours later, the doc said, "we finally have a student that knows how to THINK!"

12 hours later, at midnight, the doc came over and thanked me for my help. He told me that it was "refreshing" working with me and that he looked forward to working with me the next day.

When I walked in at noon today, he greeted me with a big smile and seemed genuinely happy to see me. This doc gave me a chance to prove myself whereas the other doc, from my first day, did not.

I've gained some confidence. I've learned some procedures. And I'm ready to prove to the original doc that T-rex has a brain...and knows how to THINK!

Unfortunately, I'm working with a different doc and PA tomorrow.

It's a never ending cycle...no wonder I'm exhausted!

ER

My hours?

This week: noon to midnight x 4days.
Next week: 8 PM to 8 AM x 4 days.

My first patient yesterday?

17 year old male with two stab wounds. He went to school and got stabbed in the arm and the leg by a random kid.

I wonder why I don't want to go back today?!?!

Perhaps the nursing home wasn't such a bad gig?

;)

EMED

My first day in the emergency room lasted 14 hours.

I didn't like the way I was treated by the PA or the Dr.

Both of whom were MALES and underestimated my abilities.

Both of whom tried their best to make me look like a fool.

I know they smirked when my back was turned.

They got off on the power trip.

Now that I know what to expect, tomorrow will be a better day.

T-rex will show up and I'll be the one smirking.

Bring it on, boys.

Game on.

Boundaries

As I pulled into the parking lot of the nursing home I tried to become optimistic about the day. I told myself that today was going to be a good day and nothing will bother me. That it's all part of the job.

Well, as soon as I got into the lobby, I encountered a family that was crying. I hadn't even had a chance to take my coat off and I was hit in the face with the reality of working in a nursing home. My stomach sank.

And so the day began.

I'm lucky in that the PA that I'm working with is brilliant. He's been working as a PA for 12 years and before that he worked in a nursing home as an aide for 7 years. I'm lucky that he has a very sarcastic, witty sense of humor and a compassionate heart. He's amazing when it comes to dealing with the patients and their families. When a patient tells him that they want to die, he takes it in stride and finds a way to make them realize that it's not their time. The patients love him. The old ladies flirt with him and he loves what he does.

He takes the time to teach me as well. We basically move from floor to floor and round on our patients. We do a mini-physical on each patient and then we go back to the nurse's station to write in their charts, check labs, and write orders. He's spent a lot of time teaching me how to interpret labs. It's an absolute blessing to have him do this with me. I've learned so much from him and he helps me "connect the dots". There is so much to learn, so much to know, and he takes the time to make sure that I know it. He appreciates all of my questions and my suggestions. And he encourages me and reminds me that there is a light at the end of the tunnel. He reminds me that one year from now...I'll be getting a paycheck!

I've learned from this rotation that I need to work on my "boundaries". When I worked for the AIDS organization, I went to a lot of boundary workshops. I learned how to create distance between my work and my own life. Although I dealt with a very serious and horrific virus, I was able to leave it at work at the end of the day.

I'm finding the nursing home to be a completely different challenge. When I leave the facility, I do indeed leave it behind me. I do not think about the patients once I leave. But, the day does take an emotional toll on me. I'm surrounded by a population that is sick and dying and the overwhelming majority of them do not want to be in a nursing home. Some of them are very angry and upset that they are unable to live on their own anymore.

Today I saw an old man cry and it tugged at my heartstrings with such force that I almost had to leave the room. As we were examing him he started to talk about how much he wanted to go home. Then he started to talk about his wife and how he felt he was a burden to her and the family and that is why he was in a nursing home alone. Then his lips began to quiver and tears rolled down his cheek. Once again, my stomach was in knots and I felt tears welling up in my own eyes. The PA looked over at me and I couldn't make eye contact with him. If I did, I probably would have lost it. I just focused on looking at the patient. The PA put his arm around him and hugged him until he stopped crying. It was an amazing gesture on the part of the PA. Nowhere in our education are we taught about how to deal with patients in that capacity. It comes naturally for this PA and that is what makes him so good at what he does.

Seeing the old man cry tainted my day. I had a sinking feeling in my gut for the rest of the day and I realized it's probably because there is nothing more that I can do for these patients. They are dying. They have lived long lives and it's their time to leave this earth. And it will happen to everyone. That is what probably bothers me...everyone will die. I can help ease their physical pain but their suffering is a different story. Some accept their fate, but others are angry, bitter, and defiant of their fate. Some have outlived their entire network of family and friends and others have family, but no visitors.

I'm not saying that nursing homes are a bad place. They are very necessary in today's society and they do provide a social network as well as opportunities for arts, recreation and exercise. It's simply not an environment that I'm comfortable working in...not yet, anyway. For now, I want to work with younger patients and focus more on preventative health. I have more to offer in that capacity. Dealing with end of life issues is not my forte.

I'm sure that will come with time.

Not For Me

I'm not cut out for working in a nursing home. I have found something that I definitely am NOT interested in doing. I had an open mind going into this rotation, but overall...it brings me down.

I don't like watching old ladies cry.

I don't like being asked, "When am I going to die?"

I don't like being told, "I'm ready to die."

I don't like having conversations with families about "comfort care".

I don't like the desperation in the eyes of those with thriving minds, but failing bodies.

I don't like it when they curl up in a ball at the side of the bed and stay there all day.

I don't like the psychological torment that plagues the majority of them.

It's uncomfortable. It's awkward. It's not for me.

It's not death that frightens me.

It's the prolongation of death that does.

Medicine = a double-edged sword.

Home Sweet Home

The nursing home that I'm at now was built to resemble a resort. It's a very impressive looking complex with sunny yellow siding and manicured lawns. The lobby is bright and cheerful with a huge fishtank, chandelier and a spiral staircase. At first glance, it's a very comforting and elegant setting.

When I pulled into the parking lot this morning there were two ambulances parked outside the lobby. My stomach sank. I knew it was going to be a long day...and it was.

I met the PA in the lobby and we started the day off with our daily ritual. We stopped off at the cafeteria for a cup of tea. Since it was a relatively mild winter day we drank our tea outside on the loading dock. The PA quizzed me with board like questions as we sat in the sun and drank our tea. As we were sitting there a family-sized, powder blue caravan pulled up and a man in a three piece black suit got out and walked into the building. We both thought it was odd for a man dressed in a three piece suit to be entering a building through the loading dock area. But, we shrugged it off.

The man returned a few minutes later...pushing a stretcher with a body bag on it. The body bag was full. My mouth dropped open. I looked at the PA and he was equally confused. The man in the three piece suit opened up the back door of his caravan and slid the stretcher with the body into the van....right next to the other full body bag that was already in there!

The man in the three piece suit jumped back into his powder blue caravan and drove away. It took me a couple of minutes to process what I had seen.

Then the PA reminded me..."that's the only way home."

A Time For Change

2007 is all about change.

I change rotations every 5 weeks.

I finish my last rotation in August.

I graduate in September.

I PASS the boards in October.

I consider my options in November.

I start anew in December.

2007 is all about change.

I Miss Brooklyn

I miss the freedom I felt while living there.

I miss the neighborhood I lived in.

I miss the culture.

I miss the grocery store where English was the second language.

I miss the diversity.

I miss the twin-size blow up mattress I slept on for 12 weeks.

I miss the alternate side of the street parking.

I miss the fire hydrants.

I miss the pitter patter from the apartment above mine.

I miss the subway.

I miss the part of me that felt at home everywhere I went.

I miss Brooklyn.