Yo estoy sangrando.

Last week was SICU for me.  Got off to a rough start.  Felt lost. Floundering. Treading water....in the ocean...in the middle of a storm.  Finally, after analyzing for the hundredth time why I felt so lost, I came to the understanding that in Mexico, patients of this degree of sickness, such as the ones I was currently trying to manage, would have been dead months ago.  Realizing this, kind of calmed me down.  I could stop being so hard on myself, because there is no reason that I should be adapt at something that I've never handled before.  Being steady on my feet once again, and feeling as if I was on solid ground again, the remainder of the week went much smoother.  I could have used more time in the SICU, so much to learn, but alas Monday came once again and it was time to move on. 

This Monday I switched to the Burn Unit.  It sounds scary, but to be honest I was really looking forward to it.  Burns is also something that I've never had the opportunity to deal with and manage personally.  An area with lots of potential for learning, and new experiences.  Yesterday there was no OR time scheduled so it worked out that I got more or less a days introduction to how the service works.  And then I got to spend all day today in the OR.  And I think I found a place for me.  You can expect a typical OR to be freezing.  But for a burn patient the OR is kept warm, quite warm.  I was scrubbed in and felt the sweat start to bead and trickle.  It brought back fond memories of my OR days in Mexico.  The surgery itself, I have to be honest and admit was a bit humbling for me, as a few times I had to pause and simply think, Oh My....Wow!  Burn surgery has been the most brutal form of surgery I have yet seen, Mexico and in the States.  I knew what I was in for, but that couldn't prepare me for actually seeing it.  Let's just say that last night I was going to rewaterproof my danskos and ended up running out of time.....and today, I was really wishing I'd taken those five mintues to work some wax into my shoes.  There is currently only one burn surgeon at Westchester, and I'm liking working with him.  In the OR, he'd show me how to do something, then hand over the materials and say, "now you do it." So I got to do a lot.  It would be very beneficial time wise, especially in those with extensive burns.  We could be working in two areas at once.

I've also made connections with a Dr. Blood.  Which means...The return of Captain Blood!  No, just kidding.  hehe  Dr. Blood is a funny Irish surgeon no longer practicing surgery, and therefore has kind of taken myself and two other students under his wing, offering us extra education meetings.  It's the type of attention that we would be completely foolish to pass up.  It's also extra beneficial for me.  We meet in the Tauma/Critical Care offices and therefore encounter the directors of the department.  So hopefully I'm replacing that face they knew from a couple weeks ago of the girl that caused trouble.  But even without, I'd still enjoy Dr. Blood's lectures. 

Hasta!

Yo estoy morado.

I spoke too soon last post when I said I was impressed with WMC.  And that confusion I mentioned…..well, it blew up into full-blown hullabalo on Thursday.  I was assigned to a thoracic case Thursday and then by sticking with the same chief resident I got in on a second case with him.  Both times I got P.I.M.P.ed (Put In My Place) by the attending.  Some attendings do and some don’t but basically you just get asked a lot of questions, and I was on a roll Thursday.  Was the first time in a long time that I felt like I actually knew something.  I even impressed the attending a couple of times.  So I was having a really good Thursday.  But then...when I got out of the second case I had 4 voicemails and an email.  All from my program director, his secretary for NYMC and his secretary for my program.  All wondering where I was at.  Apparently he had called the SICU to check up on me, and when they reported having no clue who I was, they were under the impression that I was not showing up for my elective.  I will spare specific details, but since then I have been making phone calls and setting up meetings.  Multiple attendings were involved even the Director of the Department of Surgery.  Like a said…one big hullabalo.  I would have loved to crawl under a rock and hide.  Positive way to look at all this is that now they’ve all seen my face, in a way been forced to talk to me, and now are more likely to remember me.  Negative way to look at all this is that they will forever remember my face as the girl that caused trouble.  I’m probably making this sound much worse than it actually was.  My program director I think could have been much harder on me, but was probably just so relieved to find out that I had actually been at the hospital all day, everyday that he just sort of shook his finger at me and told me not to let it happen again (in his own gruff way).  By the time I left on Friday things had calmed down.  I am now relocated for my last week of SICU/TICU actually in the SICU/TICU and with the correct corresponding team.

I was a bit thankful to leave the hospital today.  Thankful that stuff got figured out.  Thankful my new team was accepting of me as a random add-on.  All except for one resident who’s a bit excessively Type A.  Although shortly after I joined the team the attending actually made this resident cry while on rounds.  She had to excuse herself for a good 20 minutes.  She didn’t make eye contact with me after that, so perhaps she’s just a bit embarrassed, but she needn’t be.  It was just a reminder of what I’m in for. 

I have stayed all week at Kevin and Cheryl Ryan’s apartment.  It’s about 4 miles from Westchester Medical Center (where my elective is at).  At the beginning of the week I kind of enjoyed having an air-conditioned place for a change.  But after a week of freezing both at work and then again when I get home; I walked into my nicely unair-conditioned apartment Friday evening and it feels sooooo good. Friday while working with a PA to do a dressing change he looked at me and asked:
PA: Are you blushing?
Me: No, I'm probably just purple right now, because I'm cold.
PA: Ok...., I was wondering why you looked purple......Do you have Raynaud's?
Me: Probably....just not diagnosed.

You know, patients have always been understanding when I apologize about my cold hands, but I really wonder how often they actually understand or if they're just being polite.
What's your talent?  Me?  My skin changes colors to match the temperature of the environment.

One of the patients up on the floor this past week nicknamed me Sunshine.  If he didn't see me when the team rounded he'd first ask, "Where's Sunshine?" then once he saw that I was there he'd answer the chief resident/attending's questions.  Mrs. Finck would be proud!

Hasta!

Yo estoy nueva.

Started a new rotation at Westchester Medical Center on Monday.  It's a nice hospital, and the newer part is really nice, but the part where I am just feels really cramped.  Low ceilings.  Narrow hallways.  Can't. Breathe. That type of thing. But, for the most part I was impressed with WMC.  They actually knew that I was coming, which is a big plus in my book, having it be the opposite more often than not in my past experiences.  I was issued an ID right away Monday morning.  Given a scrub code, so I could suit up even before meeting with my team.  Unfortunately, as I'd had to dress professional for lack of scrubs on arriving, I looked a bit awkward sportin' some flats with my nice green scrubs.  Plus it wasn't long and my feet were complaining.  But then things got confusing.  For my first two weeks I was assigned to the SICU and given a preceptor to contact when I was all set with my ID and scrubs, etc.  But once I had finally joined the team for rounds it didn't take long at all for me to pick up that they weren't SICU patients.  I asked my preceptor, and apparently he's not even on the SICU team this month.  So in the end, I haven't really been sure of what I'm actually doing, or where I doing it.  In addition, after Monday they had told me start time was 7am.  Very fishy....there's no way a surgical team "starts" as late as 7am.  So today I stuck like glue to the team intern and found out how the team really works.  So i think by tomorrow I'll have finally gotten into the groove.

Hasta!

Yo estoy pensando.

It's been a whirlwind of the last couple of days.  Amy Hohulin and Tara Prevo decided to come out for a visit.  I arraigned my schedule so that I was on call Thursday.  When they arrived (at about 11:30 pm) I ran out to meet them and get them situated in the apartment so they could sleep then I went back to work.  The doctor that I was on call with ended up falling asleep at about 2 am leaving me to finish up all the paperwork by myself.  To be honest it kind of frustrated me a bit.  Even when pages would come in I'd wake him to relay the message.  He'd just wave me away and tell me to take care of it.  He'd given me his password so I could do just that.  Perhaps I could take it as a compliment that he trusted me that much.....but I couldn't help thinking that he was being irresponsible.  I was a bit sad to leave Friday morning.  I'll be back in March for 3 more weeks of surgery at Sound Shore but by that time all of the current residents will have rotated out, so it felt much more like a goodbye leaving.  I went home and took a quick nap but then before starting our day I went back to the Surgery offices one more time and had them make a few calls for me.  Trying to make use of my connections to perhaps get an elective downtown.  We'll see what happens...fingers crossed.  Then we headed downtown and took the subway all the way out to Coney Island.  Ate corn dogs.  Walked along the boardwalk.  Rode the Wonder Wheel.  Then we made our way back stopping to walk across the Brooklyn Bridge. Meander through Chinatown.  Eat pizza in Little Italy.  Just all around a really good day.  We took Saturday a bit easier, relaxing in the afternoon and then young group Saturday night.  And today we enjoyed the Rockville congregation.  The visitors for the conference are already starting to arrive.  Tara is a bit of a celebrity as many from the Rockville congregation move to Fort Lauderdale for the winter.  I meet many new from the church as the visitors (Amy and Tara) attracted them.  And right now we are waiting.  While at church the Viens invited three different couples for dinner so we've got the dining table all set up, ready and waiting.

I start a new rotation at a new hospital tomorrow.  Time is passing.

Hasta!