Estoy al fin de paciencia.

I need to vent.
This journey has taught me quite a bit a patience thus far. I've gotten better handling getting yelled at, or at receiving the results of a families' pent up anger in either English or Spanish or both. Somewhat better at handling the sensitive, anxious patient requiring extensive tender hand-holding and who will cry at the drop of a hat. Or those in denial as well, to just name a few. However, there are some areas that plague me continually, as my patience is seemingly used up leaving the patience barrel dry. One of those areas is pain, to which I alluded to in the second half of [this post] from a year ago.

And then another is shameless immaturity. When a grown individual lays curled up in fetal position, crying and half ready to throw a temper tantrum, and then when asked about it, does nothing but whine; my pupils dilate and my nostrils flare. (not really, just metaphorically).  As I attempted to have yet another conversation with him for the second night in a row I struggled with one idea. Rapidly trying to discern if it was or was not politically correct to simply outright call my patient a 'baby' and ask him to 'act his age'/'be a man'?
I mean, if you are man enough to go out and get yourself stabbed, then you had better be man enough to deal with the consequences. Especially... when the stab didn't actually hit anything!!!

The nurses tried to hide their smirks at seeing me all worked up. But honestly, my desire to help someone who refuses to help them self = next to zero.  Right there with my patience level.

Needless to say, I've still got quite a bit of patience to manifest in my life yet before this journey is over.  Might as well start by loving the shamelessly immature.

Much Love.

Estoy ajustando.

I think I've figured it out. You know the annoying tag-a-long little sister... That's my new role as a 3rd year intern. It's not exactly fun, and most definitely unsatisfying.  For example, once you have done a whole laparoscopic cholecystectomy from start to finish yourself, it's more than a little difficult to content yourself with merely retracting the fundus of the gallbladder for someone else. Or, you're finally feeling comfortable sticking for lines on your own, capable to handle the difficult sticks and trouble shoot the snafoos, and now you suddenly have no claim over any line, but must stand by while someone else gets the stick. It's a bit hard to explain, but in a way it's almost painful to only get to watch. I know it would be much easier and less painful to go about my intern duties and not bother seeking out procedures being done. But the idea and fear of loosing what little technical ability I currently have out-ways the difficulty of watching someone else take the stick. So I continue to pester my seniors, asking to be present for any and all procedures, and as I watch, I mentally go through each step myself.

The last two years have blurred together. I am not sure of what I learned when, or of how much I have changed. Wasn't even sure I had changed, but interacting with my fellow interns every night and morning during sign outs is illustrating for me those subtle ways in which I am different. NONE of which I am proud or even happy to realize. Jaded, with complete lack of faith in the system, which I had made such a conscious effort to avoid. But I've watched over the past weeks as my fellow interns have started to lose the stars in their eyes. Already, at the very beginning, the process wearing them down. Their disappointed looks when they get a glimpse at the difference between what they thought this was and what reality is.  And the fact that I am recognizing the process in them, tells me I too went through the process without even realizing it. How much more will this effect me? Based on what I was saying earlier, I would venture to say that this year is most likely going to be my most difficult year of residency. Not the hardest, but the most difficult.

I do my best to keep things encouraging in the 4th floor conference room. Pep talks and cheers of congratulations for my fellow interns when and where appropriate. I play music for them all by logging onto my Pandora station and taking requests. Oddly enough the most commonly requested is my Spanish station. And we manage to laugh at the events of the day. One evening as the trauma interns were leaving they signed out a chest tube that had just been placed. I asked if either of them had gotten to place the tube. "No," they sadly responded. "But!," one of them said his face brightening back up, "I got to place the dressing!!"

Cracking up!! Finding excitement in the little things! Interns get the crumbs. We'll take the crumbs!

Much Love.

Estoy parte de una gran producción.

How does Shakespeare put it?  "All the world's a stage, and all the men and women merely players..."

The other night I get a text from my senior that "Little Miss is having a panic attack, can you pls check it out." It is close to midnight, and for the most part things should be settling down, but I go to investigate.

I walk into Little Miss's room and stop in my tracks at the scene in front of me. Now granted, family members can be overwhelming from time to time, but this was a bit beyond excessive.  Little Miss is lying in her bed with not just mom and dad, but seven adults plastered at her side.  All of them wide awake, and all of them jumping at any little movement or sound that our Little Miss is making.

I am informed that Little Miss is getting feelings of tremblings inside and they cause her to cry. I am further informed that it is because of the morphine she was given. She has never had morphine before, but her father is allergic to morphine, and so she is too.

Eventually one of them does step aside so I can approach the Little Miss myself. She lets go of whomever was at her right side to take my outstreached hand with her right hand. She is calm, skin is dry and warm, pulse is regular, breathing is regular. At one point, in the midst of our short exchange, she moves her left hand, and someone frantically points out that she has moved and "it's going to happen again."  And... I am reassured. Our Little Miss is just fine. I have simply entered into the midst of a grand theatrical. Our Little Miss, the Star, playing to her captive audience.  I stand up again quickly deciding to go ahead and play along.  Without much ado, I finish playing my role, followed by a quick exit to stage left.

Much Love.

Estoy en un enigma.

July 1st, and a brand new batch of interns walked into the hospitals across our nation. I walked into the hospital same as June 30th, but instead of heading to the Trauma Bay I walked up to the 4th floor. Same as the night before, but completely different. A step backwards signifying a giant leap forwards. I waited until my fellow interns gave me sign out, gathered my collection of lists and then headed down to the trauma bay. I found I wasn't quite sure what to do. Two years ago, as an intern, I stayed up on the floor the whole night. At that time I was unaware of goings on in the Trauma Bay or what my seniors did all night long. Nor was I particularly interested, so focused I was, on doing my own job the best I could.  But I can't do that now. It's hard to describe what this year will be like, especially at this point, in its first few days. Mainly because I'm not even sure what I'm supposed to do myself. Do the intern job, sure, that'll be the easy part.  But what more, or how much more? In one way it has been explained to me that "people will expect you to function like an intern but ask you to function like a senior." Whatever this year, or even the next two years end up being, it'll be an adventure.

From my first night as a categorical intern. L to R: Irony (5th year Chief), Rachelle (4th year night float senior), Me (Night float floor intern), and Adi (2nd year night float junior). At least, those are the official titles. In actuality, in the same order, we're 6th yr, 4th yr, 3rd yr and 4th yr. In the words of Rachelle, the "stacked" night float team. Let's just say, it wasn't a mistake that Adi and myself were both scheduled for July night float. ;)

Much Love.