Estoy avanzando.

Contact information was sent out for all residents in preparation for the start of a new year. My name was listed under PGY 3 Categorical. I paused for a moment of spontaneous unexpected elation. They tell me, the year will be the same as PGY2, especially now that we no longer will be rotating at St. Vinny's. They tell me it's nothing special, and not to get excited. What they don't understand or fail to realize is what it took for that PGY 3 to follow my name. Nothing short of a miracle, and I reserve the right to be elated, thankful, and at peace.

I'm starting PGY3 on a brand new service. I mentioned the major renovation our program has been going through before, and tomorrow is the day everything drops. July 1st everything new. I will be senior on the minimally invasive service for the next three months. It'll just be me and one intern. Being just two residents on a team, lends for an easy rounding schedule. Took me a whole two minutes to make it up and send my intern the schedule and the email welcoming him to the service and outlining some of my expectations. We'll see how it goes.

Here's a few pictures from our graduation party a week ago.

 Back row: Dr. Savino (Director of Surgery), Dr. Latifi (Chief of Surgery), Dr. Con (Program Director)
Front row: Graduating Chief residents: Min Li Xu D (Vascular Surgery fellowship), Artem Dyatlov MD (Starting practice in PA), Seungwhan Pee MD (Surgical Critical Care fellowship), Rachelle Lodescar MD (Burn fellowship)

 Chief residents with a handful of our Attendings

 K. Dzeba, one of our new Chief Residents, Monica and me

 Me, Ansab and Danny PGY2 going on PGY3

 All the PGY2s able to be at the party. Me, Clara, Danny, Ansab

Another of our new Chiefs Dr. Bronstein, Monica and me

Much Love.

Estoy manteniendo la respiración.

Last week of June. Prelim residents have left, moved on to their respective categorical residency orientations. Chief residents have likewise bid their adieus. Those of us remaining buckle down for a rough week, the past couple of days spent battening down the hatches in preparation. I feel like everyone is holding their breath, or maybe that's just me. Still counting down the days. 8!

Tonight is our program's graduation party. Despite how difficult the year has been for everyone, the low morale is slowly being addressed. I am encouraged to notice residents and attendings alike are excited and anticipatory for the evening's festivities. Take this in comparison to December's Christmas party... which no one went to.

I think everyone, in general, is looking forward to what a new year can offer. A theoretical fresh start. We kept waiting for someone else to make a change, make it better. No more waiting, we'll make it better ourselves.

Here's a few pictures from Dr. Babu's party a couple weekends ago.
 

 The newly completed Tappan Zee Bridge (I guess officially now the Governor Mario M. Cuomo Bridge) next to the old Tappan Zee being taken down piece by piece.

 Sunset on the Hudson. Tarrytown, NY

  Sunset on the Hudson. Tarrytown, NY

Christiana (and son Rokimi), me, Alexandra, Niu

 

 One of our graduating Chiefs, Artem, with his wife and twin girls

 End of the Year Party at Dr. Babu's with the Vascular team.

 End of the Year Party at Dr. Babu's with the Vascular team.

Much Love.

Estoy lista para futbol.

We had a trauma come to us as a transfer from an outside hospital. Activated as a level one trauma as she had been intubated at the outside hospital. Intubated for combativeness. The trauma bay is a highly protocoled area, for both the patient's safety and the safety of the health care workers involved. Patient's, often intoxicated or drugged, blood coming from somewhere, but refusing to lay still or cooperate, often combative, and they get tubed. There is no patience in this setting for deviation from the protocols set in place for everyone's safety. A patient gets intubated and sedated, the trauma exam can then be completed isolating source of bleeding, and various injuries. This particular patient had avulsed half of her forehead, the laceration extending from her scalp in mid-forehead down to her left temple cutting her left eyebrow in half. We repaired her face before extubation, approximating muscle to muscle, dermis to dermis and eyebrow to eyebrow, etc. I worked with my Attending, one of the new ones, we all like her. But unfortunately, the rumors were already spreading of her moving on. I asked her about them. She looked at me surprised. Unfortunately, she could not negate the rumors, but wondered at their origin, as she had not yet even told many of her fellow attendings, and definitely none of us residents. I had been the first to even ask her about the subject. So sad to know yet another attending is leaving. I am so ready for this high turnover rate to slow down and stop.

Our daily lives on the trauma team have not gotten any better this past week. June continues to prove to be a very high trauma volume month. Thankfully I have multiple co-residents that have made themselves available and are willing to help if I ask, which I have from time to time. Our long hours have not gone unnoticed, and I've been told multiple times "I want you to leave the hospital at 6pm tonight" or "You have to be physically out of the hospital by 8pm tonight." That's all well and good. Unfortunately, they are only words. The same attending who tells me to leave at 6pm, also stands by and watches as I take the new incoming trauma at 5:45pm and with it any hope of leaving any time soon goes out the window. gone with the wind. Sigh. As hard as I try, I can't perform magic. Starting next month, our program rotations are undergoing a major renovation. Starting July1st, what is currently managed by our three person team will be taken over by two different teams and a total of 9 residents. I feel this is the main reason why words are not backed up with action. The change is in place, just not for another 14 days. Just 14 more days!

One good thing about being so busy is that my caffeine intake has reduced. Simply because I don't have the time to go and get any. I definitely could use it. On Wednesday's we dress up for our M&M, Grand Rounds and education hours. The other Wednesday I didn't have time to change afterwards, and one of the nurses in the ED has called me "ballerina shoes" ever since. You never know what's going to get spilled or splashed around in the trauma bay, and I think she was more worried I'd ruin my shoes than anything else. I didn't share her worry myself, they're just shoes. Whether I'm wearing danskos or ballerina shoes is not going to alter my ability to put in a chest tube if needed.

Much Love.

Estoy edificando mi casa.

In the words of my fellow co-residents, our team has been absolutely “pulverized” this past week. Our chief was going over the stats last night on the computer beside me as I was desperately trying to focus long enough to finish up and get out of the hospital before the string of midnight traumas started rolling in. The stats revealed that in the first week of June we have had more trauma than the entire month of April and almost half of the entire month of May. And just counting the traumas does not include the acute care surgery consults and admissions our team has been given. As I offered to work this morning to help round on our long list of patients, I inwardly panicked at my own naivety. Thankfully my chief was wise enough to tell me no. Being able to sleep this morning was better for my mental well-being than any medicine. Or forget my mental well-being, my physical well-being as well. Walking home last night my knees and feet were aching more than I’d like to admit. I was painfully reminded that I am not 24 anymore. Not by a long-shot. But aches and pains gone after a nice long rest and I was able to go for a run this morning. God grants me the grace to persist, but I’ve also got to keep my heart strong to endure the grind.

Be safe out there everyone!
Much Love.

Estoy más que esto.

Power outage. Very common in Mexico. In fact, my morning was very reminiscent of the time I lived there. It made me smile this morning when I turned on the faucet and water came out. Wasn’t always so when a small tinaco was all the water reserve until power came back on. The power outage affected the whole hospital campus, which unfortunately included the campus housing and therefore my small studio.

It was rather surreal to see the hospital so handicapped. The main hospital generators failed as well. Therefore we had only the back up of the back up. At one point frantic messages were sent out to all the residents to respond to the ICUs immediately. Ventilators failing, extra hands were needed to bag patients. This didn’t last long. They have a back up of the back up to the back up. No one died... that I know of.... jk! I think...

Finding a computer that would turn on was difficult. And once you did find one, if it was hooked up to a printer that would print, was the next question to ask. As it was June 1st, many of us residents arrive early to spend extra time going over our new patients. But today we spent that extra time just trying to find our needed information! I am on the trauma team this month. My second challenge of the day was a bleeding patient that needed an emergent procedure. But... without reliable energy source the Interventional Radiology suites were not given clearance to perform any procedures. Hours spent going back and forth between services and different Attendings, and possible suggested solutions, each one worse than the prior. All the while, patient still bleeding!!!  Third challenge of the day of course while trying to figure out disposition for our bleeding patient is traumas. Splitting off to handle them, and then to round again. Fourth challenge, and honestly could have potentially been the worse was my lack of caffeine. No power in my appartment, so I couldn’t make my own, then the cafeteria closed due to no power, so the day was well underway and my headache started. Still without a chance to break-off, I continued on despite the headache and tried to tough it out. But when I became nauseous I finally forced myself to stop and take care for a second. I could just picture myself start to vomit, and realized I would be of no use to anyone at that point. However, forcing yourself to drink something while nauseous, and then keep it down as well... easier said than done. Made me break out in a sweat and my hands shake. But then again that could have just been the fact that the air conditioners weren’t on generator power and the hospital temperature was steadily rising.

All in all, it was quite the welcome back to Westchester!

Much Love!