best laid plans

i had great designs on regular posting as i began residency and i was off to a good start. but i ended up taking a huge emotional blow in my second week and i had to withdraw into myself simply to get up and go to work. so i quit writing. i also quit reading and watching tv or really interacting. i survived by text message and meaningful looks. i also lost weight, though i think lacking appetite isn't the recommended method.

i am improving. every day is better. i am still hurting. i will hurt a little for a very very long time. but i have not been taken down by anything yet and if you know me, that IS saying something.

on the up and up...ER was a good rotation. a great way to start - a chance to remember my basic skills. thank goodness. now if people would just stop coming to the ER for non-emergent problems. and if the ER staff would learn that abdominal pain is not a catch all and certainly does not include pelvic pain. those are different.

i am glad i didn't choose ER as a career though. and i wonder about the FM trained docs who end up doing ER. what was so unsatisfying about FM - where the idea is to follow the pts forever - that you have to go all the way to ER where you don't follow pts even as far as the door.

now i am on to OB which would be great if i weren't suffering for the sins of those who came before. long story. lets just say i am walking uphill both ways in the snow. but i get to catch babies, so that's fun.

right?

so, i am a linguist deep down. always will be. was one before i was a doctor and don't plan to give it up...

linguistic tidbits of my first few weeks in milwaukee:

1. right? as a response, as a rhetorical end of sentence. i say 'yep' or 'hmmm' or nothing. i think this is used in the exact distribution of the ubiquitous canadian 'eh'

2. weed. in kentucky if you say 'weed' in reference to marijuana, i think you are over 50. here, i haven't heard anyone say 'pot', which is what i would say. well, that is, if i for some reason needed to.

3. vowels. i never want to hear anyone here refer to southerners and their vowels. they are just as f'd up here. oh, and i'm not a southerner, you just need to travel here.

4. barley soda. i blame peter for me knowing this one. i appreciate that he felt the need to define it. i got it but won't be adding this to my vocabulary.

5. i been doing that for a minute. in response to 'how long have you had this pain?'. ok, to be fair this isn't specific to milwaukee, or evn the midwest. but seriously. if it had been a minute, you wouldn't be in my er. do you want my help. then QUANTIFY!!

i will post more as i come across them!

my first complaint

yep. it took one day. my very first patient of my career complained. she told the clinic director that i didn't listen to her and i rolled my eyes at her. i suppose the second is entirely possible, but i know i didn't mean anything by it. but believe that i listened - and i remember. anyone who knows me well knows that!

what she actually didn't like was that i didn't treat her problem the way she wanted me to. i wanted to investigate her problem and she wanted a quick fix. a quick fix that i thought would be dangerous. my attending stood by me. and so did the clinic director. i acknowledged what i might have done wrong. i accepted criticism on day 2.

did i forget to mention i stayed late on my very first day to fill out paperwork for this lovely lady??

new beginning

today was the first official day of doctoring. i walked into a room, looked right at a patient and introduced myself as dr. m. without laughing. not a bad day overall.

it is a bit surreal to take over someone else's patient population. this led to unexpected and rather surprising paperwork and emails today that required answering. how on earth am i really supposed to know is mr. white should or should not have his benzo refilled. thank god for my marvelous nurse. who, in addition to knowing the computer system inside out, shows incredible guidance in helping stupid interns.

if the rest of this year is like today, even if far busier, i will be a happy happy dr. chica.

oh and i got to staple a head. :)

new percentages

i started this to record, really for myself, how far along in medical school i was and now that is over. i reached 100%. now i find that a new discrete part of my life begs to be recorded. so we go back to 0% family physician - and in 3 years, i will hopefully be competent and even good at it.

i don't wish my life away by any means, but i like the discreteness of a three year block.

so here we are - looking forward to a year of 4 months of FM service, 2 months each of peds, surgery and OB, 1 month each of ER, NICU. a third licensure exam. meeting a whole new group of colleagues and patients. learning a new city, a new state.

a new life.

i'm ready.

100% there

a lot has gone on since last i posted.

1. Finished fourth year - after that family med month, there was inpatient psych (which i really should have blogged about), anatomy, research, university health (a wonderful rotation - no, really!!), pharmacology, trauma surgery, and family medicine offsite. then, that which i thought had become impossible happened...

2. i graduated. yep. i'm 100% there. that's me STM, MD. you know, if we put my other letters i'm, STM MD MA - which I think makes me a hallucinogen.

3. so those interviews...i ended up doing seven - Cincinnati, St. Joe's/MCW, Smiley's/Univ. of Minn., St. Joe's/Univ of Minn, North Memorial/Univ. of Minn, Tufts, Palmetto Health. i cancelled two - one in milwaukee and one at UofL. don't think i could be a cardinal anyway. was hard enough to be a tarheel.

aaaanyway, ranked five. matched at #1!! starting residency at St. Joe's/MCW in just a few weeks. yippee!!

4. moved to milwaukee. obviously necessary considering the job thing. that's more or less where i am right now. surrounded by the smell of cardboard. slowly the boxes are getting unpacked and our fabulous duplex is looking like home. i have never lived somewhere that i could just throw the windows open and cool my home. it's lovely. yesterday, we drove downtown and j hadn't seen the lake yet (um, that would be lake michigan). when i said, hey there's the lake (like you could miss it), he said no it's not, we are going the wrong way. um, seriously dude? i know i have no sense i direction, but there is only one gigantor body of water around here.

so far i love it here. i suppose we shall see what happened with odd hours and little sleep. j is still looking for a job or basking in the glow of being the doctor's husband. he is officially the househusband until he finds a job, once i go to work. he desperately needs to learn to cook.

i won't lie. this isn't the easiest thing i have ever done. i'm scared and underconfident. i'm worried that my patients won't get good care if i am the one providing it. i keep reminding myself that residency is an apprenticeship - right now i know a very little about a lot of things but my knowledge base will change. i start on ER, the OB, then NICU....NICU?!?!? i have assurances from a good friend that i can make it.

Travel and training

A few days from finishing the first rotation of my fourth year, I feel I should pause and consider. I am finishing a month of family medicine clinic - which was really a lot of reading time and a little clinic - a schedule for which I am amazingly thankful. Because they allowed me some free days I have been able to study for boards, sleep, and go back to having a normal life.

I have also had the privilege of remembering why I really do love family medicine - the variety of ages, genders, family structures, pathologies. I can't get bored, which is good since I tend toward it anyway.

I continue to plan residency interviews - truly surprised at how many I have been offered. I admit to overwhelming underconfidence where this is concerned, but I didn't expect to hear so quickly. The first programs didn't wait for grades or all my letters of rec. I have scheduled at University of Minnesota (x3), Medical College of Wisconsin, University of Cincinnati, University of Pittsburgh, Tufts, Palmetto Health in SC and am waiting for dates at University of Louisville and Aurora Healthcare in Milwaukee.

Step 2 CK on Thursday and then I am free of exams until February (I think). One weeks until psychiatry AI. Looking forward to it.