Estoy estudiando.

I took the ABSITE today. Our yearly in-service examination. Our yearly reminder that we have still so much to learn. I didn't have to be at the hospital campus until 7am this morning so set my alarm for later, which sent me into a panic this morning when it woke me up and I thought I was late for work.

Despite the abrupt start, I got to the hospital calm and coffee in hand.  Was even one of the earlier ones and had to wait for the test to start.

2nd question: okay next question. hmmm review. I wonder what that is. *Click* Oh no I don't want that. How do I go back? *Click* Would you like to finish your exam? *Gasp* shoot! shoot! how did I get here? cancel. back. back. Question #3. hurrumph, talk about a rough start. 

One hour: Argh!! Same as last year... and the year before that... I don't know anything. Still don't know anything. Will I ever know anything? I'm so stupid. This is stupid.

Second hour: Coffee.  I need more coffee.

Third hour: 55 year old male with abdominal pain and distention. There was an xray. Dr. Con wanted a chest xray and a KUB. He asked for a KUB! Oh shoot, Did I get the KUB? Christy!!! That was two days ago, KUB is old news for that patient. Ahhh! What am I doing? Back to the question. Focus Christy. Focus. 55 year old male with abdominal pain and distention...

Fourth hour: One more hour. 50 more questions. You got this Christy. You can do this! Into the final stretch!

Fifth hour: Done. Nailed it. Wow. Now, to go home and start studying for next year. Maybe one day I won't have to fake the confidence.



Much Love.

Estoy oliendo el yodo.

This week of days in the TICU has drawn to a close. Nothing too difficult. Honestly, our patient’s haven’t been as sick as TICU patients tend to be at times. I’m not going to complain about that; leaves more time to study. So, not complaining, but I will admit that I don’t particularly care for the fact that our patients have not exactly needed us. If I’m not doing anything for my patient, well, I feel rather pointless. No sense in feeling pointless, so I would push to have our patient’s downgraded from ICU setting to the floor setting. One day I came in, the TICU filled up with patients, and we put in for multiple bed requests first thing in the morning. When the Attending entered the TICU shortly after, he stopped me to let me know I had “missed a few transfer recs,” or I had left a few patients without bed requests. He was joking with me of course, but guess I have made a reputation for myself! Don’t worry, always stable. Always safe.

Having been rounding in the ICU for the week, I was able to go to the OR for one of my patients who needed a feeding tube and a tracheostomy. Standing across from my attending on either side of our patient’s neck we made the incision for the tracheostomy. Dissecting down through the layers to clear our path to the trachea we came upon the isthmus of the thyroid gland. There are different ways to go through the isthmus. Sometimes you can just retract it out of the way. Other times, when large, or concerning in appearance you can resect the portion that is in your way and send it for pathology. Or when you find the isthmus to be nice and thin… you can just go right through it, which is what I did on this particular case. Electrocautery in hand, I burned right through the thin band of thyroid tissue, to which my Attending emphatically exclaimed, “ah! The smell of burning thyroid!” May not be as pleasant or comforting as some occupational smells such as a fresh baked pie in a bakery, leather binding in a printing factory, or new rain on the farm. Perhaps just as unique as others such as cleaning solution in a cow barn, old fish at the market or buckets of paint for the walls of a stairwell. But the way he said it, was almost as if he was trying to cover up his pride. Pride at recognizing such a unique smell covered with an icing touch of sarcasm. 

To the smells of burning iodine, Clorox, apple pie and fish, may we all work well and happy.

Much Love.

Estoy de regreso.

Last month was nice. I would almost liken last month as 'play.'  I got to spend a whole month of my professional training, playing, and it was oh so much fun. But now I'm back. Back in the Trauma ICU. Back to being me again.

Plastic surgery had an incredibly flexible schedule. I was never needing to show up early to the hospital, and frequently we'd arrange different starting times for the day pending our schedule. I was assuming that going back to an earlier schedule and the increased weekly work hours would prove difficult after basically "playing" all last month. But thankfully, the transition back was easy and smooth.

I started my month in TICU covering nights. The ICU keeps you busy, and after this week my jacket definitely needed washing. There were blood spatters from arterial lines when I took two seconds too long to connect the tubing. Or just last night when one of our TBI patients projectile vomited ketamine-laced emesis at my attempts to place a tube down his nose. I knew he had to involuntarily swallow eventually and I got that tube all the way to the duodenum. Success!

Jacket is now washed and hanging up to dry. :)

Much Love.

"Sounds very Vermont-y."

"Should be beautiful this time of year in Vermont. All that snow.

Fir trees, and the clean pine air, brrrrrr, very beautiful, just what we need."

 

If you can name the reference, let me know. We should be friends! ;)

Much Love.