Estoy contenta.

On call the other weekend, I got a call about a liver transplant. The recipient had arrived to the hospital and needed his admission taken care of. I recognized the patient's name, wasn't sure where from, but figured he was a chronic patient due to his liver disease and so had probably taken care of him at one point. Even talking with him, I didn't quite recognize his face. Just couldn't figure it out. Then I started going through his medical records and past operative reports. Light bulb! That surgery! now that I remembered in detail! Still couldn't quite remember the patient, but couldn't forget the surgery!

This month, the longest of the past 12, has finally come to a close. And with it, the end of Intern Year 2.0. Thank goodness! I propose a toast. Cheers! To never being an intern again!

The surgery program at Westchester has undergone immense change this past year. We had seven Attendings leave. Seven teachers. Seven mentors. Seven friends.  In a way, it hurts to see so many that I hold in respect move on. I want them to stay and teach me! Furthermore, the empty space left in their absence creates instability and uncertainty. New Attendings are slowly being hired, and they are excellent. But requires even more flexibility and adaptation. It's not an ideal situation for us surgery residents. Hard to build on a cracked foundation.

As brand new interns start tomorrow, July 1st, there will be even further change, as our resident roles themselves will have to shift to accommodate different numbers of residents. For example, next year instead of eight 2nd year residents, there will only be six of us... to fill the role of eight?  So, not sure how it'll all play out, we go forward. Willing to work and Ready to learn.

Much Love.

Romans 8:38-39

³⁸ For I am persuaded, that neither death, nor life, nor angels, nor principalities, nor powers, nor things present, nor things to come,
³⁹ Nor height, nor depth, nor any other creature, shall be able to separate us from the love of God, which is in Christ Jesus our Lord.

Estoy casi al fin.

There's always a moment of of subconscious pause each morning when you pick up your list. What was the damage done overnight? Breath held waiting for the result, is released in one of two ways 1) relief  2) sigh. This summer is proving to be full of trauma. Drug deals gone bad. Hate crimes. And then of course the typical array of motor vehicle collisions and people falling down. My held breath tends to be released with a sigh every morning. Six new names. Seven new names. Only three new names!!  It's even more difficult in my position when the ICUs unload their patients to the floors overnight to make room for all the new admits. My job, to pick up where the ICU left off for those patients. Sigh. It's like Westchester turns into a Trauma factory during the summer. They just keep coming in, and its all I can do to keep them going out at the same rate. If I don't, we drown. It can be stressful. Take today for instance. Two of my discharges were ready to go when I saw them at 6am. But we rounded, then morning report, then rounding with one attending (during which they reminded me they were ready to go), then I had a case, then rounding with the second attending (they were still waiting) and I finally got to sit down at a computer and my co-resident texted me, "Is there clinic today?" I was already 10 minutes late, and clinic was clear across campus. I walked there at the typical brisk pace of someone with somewhere to be... my head hung down. I try so hard, I don't let a minute be wasted. All my notes written by the time morning report is finished. Morning orders in by the time of rounds. Consults called. Dressings changed. Touch base with social work, case management and physical therapy. (Make sure they take care of your patients first ;) While anesthesia is intubating get through as much paperwork as possible on the OR computer. But, you just can't physically do it all. Clinic will take minimum three hours and your lovely patients who were ready to go at 6am, were fully dressed by 9am, will still be sitting there at 4pm, just waiting.  And they look at you like, "why?" FAIL.

Believe it or not, my chief actually helped me out today. Took care of the easy discharges. Then inbetween patients over at clinic, I was able to log on and complete the work for a few others.  And then after all that... at the end of the day... the list is still just as long. Sigh.

Much Love.

Estoy lista.

I'm ready for the residency year to end. Programs all around are having their graduation banquets. Ours is this coming Friday. For those ending residency, we celebrate and congratulate. For myself, I'm so ready to not be an intern anymore. I had internship under wraps two years ago. Now having spent a year on repeat, I can perform these duties blindfolded and one arm tied behind my back. So thankful I had short reprieves with new rotations, like plastics and pediatrics. But trauma this month, provides no educational benefit for an intern, evenmoreso second time around. Zero. However, it has sharpened by prioritizing which lends itself to efficiency. I have a feeling that I cause borderline annoyance of ancillary staff and our allied health. To the social worker: I'm asking every 30-60 minutes, can I? can I? is everything set up? can I finally discharge? To the seasoned NP who goes to check labs and reorder: Already checked them, it's taken care of. And just like that they're thrown off their routine. Not that anyone has actually said anything, it's just a feeling. Probably born from the fact that I even annoy myself.


Here's a few pictures from my cousins wedding out in Illinois!

Our Stoller cousins had a wide age range. Luke, three months older than myself, was in between Carrie and I growing up in the Gridley school system. We were on the tail end of the Stoller cousins. As we've all grown and moved away, very few of us made it for his wedding. I'm sure Luke didn't take it personally, but it made me extra glad that I could be there.

Above: we grabbed a Stoller cousin selfie in front of the Illinois State Capitol building as the wedding was in Springfield, IL. (Troy & Carrie Blunier, Jeff & Cynde Stoller, Chelli and me)

Stoller table at the reception. Lucas and Megan are both pharmacists. They had pill bottles filled with personalized M&Ms for all the guests. Made it look like everyone was popping pills all evening long.

Lucas and Megan Stoller 

Lucas and Megan Stoller

Much Love.

Estoy viajando otra vez.

I left the hospital early today. Wanted to give myself extra time due to reported construction around the airport. It wasn't early enough. I pulled up to my apartment with 7 minutes to the arrival of my train. The train station is a 10 minute walk. I ignored that last fact, changed, grabbed my already prepared bag and was out the door with 4 minutes to the arrival of my train. I set off half running half walking, which turned into just straight running by the last half mile, I was at under 2 minutes. Seeing my hurried state a lady rolled down her window and yelled at me if I wanted a ride. I grabbed the offer. She asked me when my train was, and when I told her, she cracked up laughing. And laughed the whole short minute drive up to the stairway that led into the station. I made my train.

Sometimes you just got to go for the impossible. Who knows what will happen.

Heading to Illinois for my cousin's wedding. Gonna be a good time. Best part is the list back at the hospital is nice and neat. We've worked hard and cleaned it up over the past week and a half. It would have been even nicer, but we were gifted a patient just yesterday. A real gem. Working on her plan today I called multiple services for a consult and without fail, when discussing the case, they would stop me and say... "so....Why is she admitted?" (With extra emphasis on the 'why' and extra inflexion at the end). To myself, I ask the same question.  In response to them, I deliver a well practiced story. They sigh. I sigh. We all sigh. And then move on. If I dig enough, I think I'll actually be able to find something that will justify her being our patient. In the meantime, she has some of the worst drug-seeking behavior I've seen yet. Like I said, a real gem. She's borderline buying herself a Psych consult already. I have no doubt it will be paid in full by Monday.

Much Love.

Estoy ajustandome a trabajar de nuevo.

Adjusting back to the grind. I knew I was ready to go back. Even before leaving for Argentina, when I returned to New York from Illinois, I knew I could have handled returning to work at that point as well. Which was encouraging, and in a way freeing. I could go to Argentina without the stress of knowing I had to be ready to go to work when I returned. I was already ready, and therefore had the freedom to simply enjoy traveling.

Kind of sounds like I just talked in a circle and actually didn't say anything...

Point being, I'm back to work. Returning, I am on the trauma team. Trauma hits its high season in June. I was the first one to hit the floor June 1st and was handed a list of 50 patients. It's simply impossible to know 50 patients in 90 minutes, all their stories, injuries, histories, numbers and plans, but you hit the floor running and you try anyways. I'm pretty confident to say that I would not have been able to handle this month very well prior to vacation. As is, each day has gotten better. Long hours and little sleep, but that par for the course. Each day you know the patients better which makes handling the million questions and issues that arise much more efficiently. Due to end of the year scheduling issues they put me on 24 my first weekend back. Thankfully I had the time to work throughout the night so that by morning I had all of my work already done. It was a blessing in disguise, because the PA assigned to assist the trauma team for the following day... actually things run smoother when he doesn't try to help.

I've also found so many changes at Westchester during my absence. It had been 4 months since I had set foot at the Chester. Many Attendings are different, many left some new. Some of the teams have changed responsibilities. My co-residents have had changes in their social lives. There's been changes to how a few of the orders go into the computer and a few of the protocols of patient care. That and everywhere I turn someone is commenting about "where have you been?!?!" In a way, it's nice to have one's absence noticed.

And every day, I miss Argentina, and traveling. Seeing something new everyday. New people, new experiences, forming memories, and being a part of this World that is so much bigger than this small corner of New York, this hospital and these patients. I look forward to being able to travel again when next able. But now it's back to the task at hand. Every day learning something new, solving this issue or answering that question, and ultimately becoming the best surgeon I am capable of.

Much Love.


Here's a few videos from the trip.