Estoy luchando.

Unknown to me, my attending snapped a couple pictures today in the trauma bay.  What struck me about the picture is how horrible I look.  A couple hours later, when I had finally tied up my service and was passing by the trauma bay to pick up my jacket that I had shed in preparation for that previous trauma, my co-resident told me to go home and get some sleep. "I look that bad, huh?" Too polite to tell me I looked awful, he instead just slightly nodded yes.

We're gonna be just fine!
Much love!

Estoy enojada.

First four weeks of 4th year finishing up, and I'm trying to put together my team's rounding schedule for the next block. I'll be moving over as trauma chief beginning of next week. After many last minute changes, I'll once again have a team made up of rotating residents from other programs. I'm wondering if I should take it personally... nah. We are moved around between services on whims like pawns, only here to serve. No extra thought is paid to who the actual individual is, we're just a body. Someone to do the work.
I know I sound bitter, even to myself. As the residency years keep evolving, I've found myself struggling with more and more anger. I look at these interns, and remember how it was five years ago. I was just as lost if not moreso than they are. It's rather profound the change I can feel in myself. I didn't do it on purpose. Like continuous unrelenting pressure over time forces coal into a diamond. Not that I'm a diamond, but the continuous unrelenting pressure... that I feel, and the change associated with it. Anger is the byproduct.
This is playing highlighted on my mind this weekend, knowing that our trauma rotation is notoriously frustrating for a plethora of reasons. I'm worried how I'll manage the increased anger. Extra prayers, I guess. Extra prayers.

Social interaction away from the hospital helps as well! We had our first W.O.W. event of the year.

Dinner at 3 Westerly L to R: Dr. Rajdeo, Carly (med student), Alex (intern), Dr. Bhuta, Clara (intern), Alex, me, Monica, Clara, Sara (intern) 

Conquered the Surgery escape room!

Much Love!

Estoy en casa.

Pressing on for another week on the transplant/hepatobiliary service. It’s been raining livers. Which is a bit odd, usually its kidneys coming down. But in the midst of a kidney drought, we find ourselves drowning in livers. Which is good, that many more patients getting better!

Set a new personal record with a nigh 48hr shift. Went into the hospital 1:00 am Monday morning and finally left again at 11:00pm Tuesday night. It wasn’t planned like that, but Sunday a liver became available. My rotator went to get it and I went in to receive it and put it in our patient. I was scheduled to be on call then Monday, and thankfully I was able to get a quick nap overnight. Because then the next day I stayed post call to take out part of a liver during which we found out that another of our patients was allocated a new liver. So we finished up and tucked away our patient with just enough time to catch the transport for the procurement. Thankfully we traded off, I went for procurement this time and one of the rotators took care of the recipient.

Concerning interns: After my nigh 48hr shift, I get woken up this morning by a text from my intern that one of our patients has a high potassium level and he wants to give a specific medication. First off, it was the wrong med to give so I deny that immediately. But as for the potassium level, it made no sense why the patient would have such a high level. So I asked the intern how the patient was and what did her EKG show? To which he responded, he had not seen the patient, had just gotten the call from the lab and wanted to let me know. I gave him a plan, and got myself into the hospital. He needed a little... discussion, one which needed to be in person. We understand interns are trying to figure out how to transition from mere reporters of information to one who gathers information, analyzes that information and then acts on that information. They aren’t going to get it right the first time, and that’s okay, its why there’s an internship. But, they need to at least attempt, and I’d had this conversation with my intern before. Take this morning for example. I pointed out to him that the lab had called him with a number, a number which he immediately then simply passed on to me. In effect he was no better than a lab reporter to me.

Much Love.

Estoy viva.

Year starts, and we're all swept away with new co-residents, new rotations, new roles, and yet the same old Chester. "The thing that hath been, it is that which shall be; and that which is done is that which shall be done: and there is no new thing under the sun." Ecclesiastes 1:9

On the 4th of July our Chief of Surgery hosted a party at his house. After tucking in my patients for the day I changed and drove out there for the free food. I ended up staying for many hours talking with people. One of my old Attendings, Dr. San Filippo, now retired told me stories of Westchester when it was still Grasslands Hospital, almost 100 years ago now. The politics involved with the hospital back then and as it changed through the decades.... seemed to be the same story, the characters just dressed in a different style. Here's another picture of one of my Trauma Attendings and his wife.

Dr. Policastro plays heavy metal in the OR and believes in aliens. When asked about his hat, "it was they only thing I had that had USA on it!" We all loved getting to meet his wife. She stole the show with her red sequined tennis shoes and red white and blue knee high socks.

Bonus picture: L to R, Monica, Mariju (Joe's wife), Alex, Me

Concerning interns: it's funny how it comes as such a shock each year when the new batch starts and they are so incredibly wide-eyed. They learn quickly, the kinks get ironed out, and as time progresses we all fall into a new rhythm. And then it happens all over again the next July 1. I am chief of transplant this rotation, I have a full team of rotators. It's good and bad. Good to have a four person team, yet bad because I'm the only native resident on the team so have to be responsible for all levels of education. I can't rely on my mid-level to teach the intern, because they are both new to the system. I've got to teach the mid-level and the intern separately. At first, I was  coming around behind them and just doing everything they missed myself. Two weeks in I let them know I was going to stop, and it's so incredibly frustrating for me, because I know it means things will go missed. One of my patients got sick the other day because of something that was missed. Fixed it easy enough, and now I get to remind my intern of what happens when things get missed. It's a scary way to teach, yet very quick, efficient and impactful.

Changing subject again: did you catch the women's World Cup! USA won! Following their victory I ran into one of my patients who was making his way through the hospital hallways with walker and physical therapist . He stopped short and pointing at me said, "You look like Megan!" Who? "The soccer player!" But I don't have pink hair! "You look like her! Strike a pose!" When I hesitated to do as he commanded he threw his arms up in celebratory pose, causing his PT to startle and jump thinking he was going to fall. Calmed my patient down, which then calmed the PT down, and everyone went on their way. 

Transplant has been keeping me busy. When we get the call that an organ is ready we scramble and cover it at all hours of the day and night. I've done multiple 36 hr shifts within the past few weeks. It's good to be busy, yet rather exhausting as well!

Much Love.