Estoy decepionada.

Making my exit from St Vincent's in the next 24hrs. Wishing it were a graceful and elegant exit of which I could be proud of... instead I fear I'm stumbling over my own feet and clipping the doorframe on the way out. Not the last thing I would like to be remembered for. Bruising my ego as well as my shoulder!

Handed over the pager this morning ending my last call ever at St. Vincent's. Was not the most pleasant of calls. Started the day off with GSW victim, for which ridicule was received on multiple levels for choices in management. Thankfully I'm still low enough on the totem pole that blame doesn't come with that ridicule, but since pgy3 is just a month away I voluntarily put myself in that position and blamed myself anyways. I should know better.

I stayed post-call to do a couple of quick cases. Well... they were supposed to be quick, but ended up being horribly delayed, and as the time wore on my patience ran progressively thinner. And then after waiting all that extra time I couldn't manage without a third hand and needed to rely on my Attending for assistance. So disappointed in myself. He noted my frustration and told me not to worry about it, that my chief can't even manage it yet either. Really didn't make me feel all that much better. I was starting to succumb to my lack of sleep at that point, and honestly probably wouldn't really have been cheered up by much.

And as a grand finale, I get to present a mortality for our M&M meeting tomorrow morning. :( Sigh.

All in all, the exact opposite of a graceful exit. Oh well, such is life!  I humbly take my bow. Thank you St. Vincent's!

 A few of us who attended Dr. Demestihas's (Chairman of Surgery at St. Vincent's) annual Clambake this past weekend! (L to R: Artem, me, Rachelle, Dr. D, Min Li, (Dr. Genova's kids), Adi and baby Abhi Mateo, Luis and Danny)

Estoy azul.

Our resident team at St. Vincent's decided to purchase t-shirts. It started with Adi and myself. We had wandered into the gift shop and found them, then proceeded to plan a photo shoot for one of our calls together.

Our co-residents caught wind of the idea and hopped on board. The more the merrier! Now since all were involved we couldn't stop there. As I said, the more the merrier! So a new plan was hatched. We have our weekly M&M every Thursday morning. This morning, we all showed up in our T-shirts. Our Attendings, responded as expected. It made them happy, which made us happy! And of course pictures were taken with whomever was able to be there, many attendings were missing.

 Back Row L to R: Dr. Manjoney, Dr. Genova, Dr. Carlson, Artem pgy5, Dr. Demestihas, Aditya pgy3, Dr. VanCott
Front Row L to R: Dr. Cho, Mohamed pgy1, Joseph pgy3, Angelica pgy1, me

Back Row L to R: Adi pgy3, Artem pgy5, Me
Front Row L to R: Jo pgy3, Mo pgy1, Angie pgy1

We are going to miss being a part of Surgery at St. Vincent's!
Much Love.

Estoy teniendo la fe restaurada.

As I progress through residency, the medical students that rotate through are becoming younger and younger. When we talk pop culture, I frequently find myself outdated and out-of-the-loop. Easily explainable by residency and its demand on time and energy. In general, I like having the medical students there. They play an important role on the surgical team. However, none of us residents are actually paid to teach them. We don't mind teaching, but recognizing it takes time away from getting work done, if received in any way unappreciated we quickly move on. It makes us a little bit different type of teacher than your typical school teacher or professor. It's an additional expected yet undefined role required of us. "Teacher of medical students" is nowhere in our contracts. Therefore we wait for the student to show interest first. If a student makes himself or herself scarce, I'm speaking from experience when I say that he or she is paid no mind and quickly forgotten. The student that on the other hand shows interest and willingness to get "dirty,"it ends up being a good experience for everyone involved.

As I mentioned, it seems that our medical students are becoming younger and younger. The culture of learning that they bring to the table is not what any of us residents recognize and we look at each other almost baffled as to how to teach them. With our current group of students I have seen more tears and breakdowns than ever before. Now, this could just be culturally these new students are more open and willing to shed tears than past years of students. Or on the other hand you could argue that they have been sheltered throughout their whole lives and when a patient dies, reality hits them hard and unexpectedly and they are not prepared to handle it. I've seen some students opt for the option of making themselves scarce after that. Then there are a couple students who have responded by asking how and why. I've actually been quite impressed by their foresight. I have been asked questions about surgery, imaging and procedures, and then in addition, questions about life of a resident. Everything from how to handle loosing a patient, to how do I keep from getting sick, to how to respond when an attending makes an inappropriate comment.

Ultimately, the answer to all of those questions is balance. In residency, the scale is heavily tipped on the side of work and sacrifice and lack of sleep. Having those people in your life that can periodically bring you back to sanity is vital.

Emily Walder and Amanda Virkler helping keep me sane! We tried our hand at an escape room, choosing Sherlock's Library as the game to attempt some benign clue solving. Good times.

Much Love.

Estoy aprendiendo a maniobrar dentro del sistema

I stayed post call to do cases again today. I choose to stay and operate, my program isn’t making me stay, so no one can really get mad at me for not logging the hours. Our program is in enough trouble already...  I have probably hinted at how morale is low among the residents, and things in general have been difficult this year.  Residency has been stretching me in ways unexpected. We as residents have gone through various stages of dealing with the situation. Initially we all ignored it. Pretended it wasn’t happening and attempted to act as normal as possible without admitting that something was wrong. Denial. The pent-up frustration from our denial then started to leak out in short bursts, vents and rants. We would find release in commiserating with each other. Anger.  Admission that something was wrong, was no longer a problem, and if we allowed it, we could get very angry.  But holding onto all that anger is just as poisonous as frustration, perhaps even more so. It boils up, deep bitterness, and we look at each other and at our situation.... and laugh. Acceptance.  Acceptance that 1) we are in a difficult position within our program and  2) there is no one that will advocate on our behalf.   If we didn’t laugh, we would cry. We, therefore, laugh. One of my co-residents came back to our program after being away to do research at a different program. And referring to his transition back made this comment, “I came back with the mindset that the grass is not always greener, but... the grass here is dead!” And we all laughed, and laughed, and laughed. Laughed at the truth in his comment. Laughed at our situation. And laughed just for the sake of laughing. We have each other.

#postcallface and ready for 5 more hours of surgery!  (Angie is one of our prelim interns who will be going onto Anesthesiology in Miami)

Much Love.

Estoy establecida.

Sometimes, I ask myself if I have anything to say, any thoughts to process or ideas to develop... and come up with nothing.  Sometimes, I'll be honest, I feel embarrassed at how little my life changes.  I mean... I have childhood classmates that have had a career, done a 180 and are now well into their second career. Classmates married and children, like a whole bunch of them. I've even friends that have run so far ahead of me they've already made it home. And I'm just here, case by case. Only thinking ahead to when I get to have my next coffee. You know... small, short term and achievable goals! Everyone should have at least one cup-of-success a day!

But, they aren't new feelings of embarrassment when I have them. The ol' devil has been throwing my face in them long time now. Seeds of discontent and unhappiness that he trys to plant. Got to keep weeding so I can grow where I'm planted.

I just got paged to the floor, 3 pages in 5 minutes. Patient throwing a temper tantrum, because she wants a sandwich. And so on and so forth...

I have been attempting to put together this blog post for some time now, and if it wasn’t a patient’s temper tantrum it was a patient succumbing to the effects of gravity or reacting to an overgrowth of bacteria, either way, there was always something keeping me going. By this morning we had a line of patients waiting for the operating room. I needed to stay and help out the on coming team with case coverage. My arm needs no twisting for that. I was just having an extremely hard time keeping my eyes open this AM. Was bad enough that I fell asleep trying to drink a cup of coffee. cup didn’t even make to my lips. Really had to focus hard to get it to my lips safely and then to coordinate a semi swallow. With time, the caffeine kicked in and I was back in business.

Much Love.