I feel like I'm settling. Not in a way of accepting less... nothing like that kind of settling. It's more a giving up of the resistance I've had to be a "chief," and a giving in and acceptance of being out of my comfort zone. After all, it is out of our comfort zones where we can grow the most, and learn the most. Where Jesus can meet us and call us up even further. I never would have signed up to be a chief; I don't want to be chief. But it's part of the process, and it's here whether I want it or not. I'm finally settled and ready to try, to do my best. Let's see what is in store for me to learn!! A whole bunch, I can only imagine!
My batch mates and I have made the transition to 100% chief call. As we were so starved for chief call last year we've collectively decided to take q4 call for the first few months of the year and then slowly transition, taking less call as the year progresses. It means we'll be working extra hard for the next couple of months... but that's nothing new. With us taking so much call the remaining years are very happy with the call schedules we have released, as it's much lighter than what they are accustomed.
As for taking chief call... it's a blast. I can literally operate all night and finally let my team deal with the... let's just call it lack of common sense, that drips from the consults we receive at times. Yesterday I went to the OR at approximately 2-3pm with one of my level 1 traumas that had just come in, by the time we finished and I got my patient to the recovery unit my attending was calling that GYN was in over their heads in the OR and calling for an intraoperative consult. We went in and took over. By the time we finished there one of my team members came to transport my patient for me as a transplant was on the table and about to start. By the time I finally got to leave the OR it was after 3am. I knew that it was a busy call for the team, but my job was to operate and let the ED senior handle the management of the business. For example, it was the ED senior that came to the OR to transport my patient so that I could cover the transplant case. He was managing the cases, the traumas, the ED consults and he needed me to cover the transplant, and I was happy to oblige. I started taking ED senior call as a PGY2, and after 3 years in that role I am so happy to not be there any more. And barring a second wave of COVID19 coming and wiping us all out, I don't plan to ever stand in that role again!
Much love and prayers.
Tuesday, June 30, 2020
Sunday, June 21, 2020
Estoy la jefe.
Officially Chief.
Not that I did anything special to be called Chief Resident, in general surgery the PGY5s are all automatically considered the "chief residents". But it is significant. It signifies I'm almost there, almost to the end, almost done with residency. One. More. Year!
This past Friday was graduation for the chief class, half of them didn't even come into the hospital that day. And of the other half, only one of them actually operated. But as they moved out of the chief call room. I moved in. I was more ready to get out of the crowded senior call room, than ready to move into the chief call room. But whatever the motivation, I was happy to be there. I picked a shelf and set my loopes down claiming it as mine. As our incoming interns are in the process of going through virtual orientation, our chief class made a virtual appearance. There's more than usual interns coming in for this year, so we've got our work cut out for us.
Our chief's graduation was virtual as well. Of all years I'm glad that I'm PGY4 as I got an invite to all of their small graduation gatherings. All 6 chiefs had their own graduation party and attended the virtual party collectively.
You can't read it in the picture, but the cake says "We survived!" So true. What a reason to celebrate!
Hanjoo: Colorectal Fellowship in Dallas, TX
Alex: Robotic Minimally Invasive Surgery Fellowship outside of Boston, MA
Monica: Minimally Invasive Surgery Fellowship here at Westchester
Joe: Pediatric Critical Care followed by Pediatric Surgery Fellowship
Michelle: Surgical Critical Care Fellowship here at Westchester
Adi: Vascular Surgery Fellowship in Cincinnati, OH.
I'm going to miss them next year.
Much Love and Prayers.
Not that I did anything special to be called Chief Resident, in general surgery the PGY5s are all automatically considered the "chief residents". But it is significant. It signifies I'm almost there, almost to the end, almost done with residency. One. More. Year!
This past Friday was graduation for the chief class, half of them didn't even come into the hospital that day. And of the other half, only one of them actually operated. But as they moved out of the chief call room. I moved in. I was more ready to get out of the crowded senior call room, than ready to move into the chief call room. But whatever the motivation, I was happy to be there. I picked a shelf and set my loopes down claiming it as mine. As our incoming interns are in the process of going through virtual orientation, our chief class made a virtual appearance. There's more than usual interns coming in for this year, so we've got our work cut out for us.
Our chief's graduation was virtual as well. Of all years I'm glad that I'm PGY4 as I got an invite to all of their small graduation gatherings. All 6 chiefs had their own graduation party and attended the virtual party collectively.
I had put together the "chief roast". Granted not really a roast at all. I couldn't pull off a roast if I tried, let alone try to do it virtually. So I made a video including clips from every one in our program. They seemed to enjoy it, everyone laughed. And they were all happy. They deserve to be happy.
L to R: Hanjoo, Alex, Monica, Adi, Joe (Michelle was late again)
Hanjoo: Colorectal Fellowship in Dallas, TX
Alex: Robotic Minimally Invasive Surgery Fellowship outside of Boston, MA
Monica: Minimally Invasive Surgery Fellowship here at Westchester
Joe: Pediatric Critical Care followed by Pediatric Surgery Fellowship
Michelle: Surgical Critical Care Fellowship here at Westchester
Adi: Vascular Surgery Fellowship in Cincinnati, OH.
I'm going to miss them next year.
Much Love and Prayers.
Tuesday, June 16, 2020
Estoy trabajando mucho.
Had my own mass causality yesterday.
It started out by simply being a Monday. That right there is a bad day on the trauma service as inevitably the hospital has filled up over the weekend and needs major decompression. As if the conveyor belt stalls each weekend and everything gets backed up. So Monday was a bad start. Then it was a busy trauma day on top of that. We were already up to four traumas when an ED nurse runs up to me. There was a 15 passenger van in an accident. Multiple casualties. Multiple nonresponsive. Varying ages. And that's all they know at the moment. Thankfully I had a midlevel with me that day to handle the work, but this was bigger than us two. I sent out a message to my fellow co-residents asking for extra hands, and I messaged my Attending letting him know he needed to show up, and just in case he wasn't fast enough I called one of our critical care fellows. Organized as best I could with the little warning we had, and then the first level one rolled through the doors. I received that one and my attention was then focused to the task in front of me, broken only by each new trauma alert as it was paged out. With each alert an old familiar panic rising from my inability to be in multiple places as once started dancing in the back of my head. But slowly, and one by one a handful of co-residents started showing up able and willing to do anything. My Attending (he did finally show up) encouraged me to start managing everyone rather than running any one trauma. I think back on my co-residents showing up and all working together. It was absolutely chaotic, and at the same time so smooth. Multiple patient's went to the OR, lined up one after the other (trauma, orthopedics, neurosurgery, even OB). I took one of my patient's myself. By the time the mass casuality was handled, all patient's dispo'd, consults called, clearances granted or not granted and I had finally finished with my case it was 4 am. I remember walking home through the parking lot in a surreal state; That I was going home to sleep knowing full well that my alarm is set for less than 60 minutes later. I did it though, showered, took out my contacts, and snuggled under my covers. All to turn off my brain and finally end the day.
It kind of worked. Being able to wake up and start anew. Relied on caffeine for the rest. I think back on craziness and get choked up with gratitude at my awesome co-residents. At morning report, the other attendings listened to each trauma being presented, eyes getting wider with each one. "Why?" they asked. "Why wasn't a Code Triage called?" I didn't have an answer per se to that question, but I could say my co-residents, they had it handled!
Much love and prayers!
It started out by simply being a Monday. That right there is a bad day on the trauma service as inevitably the hospital has filled up over the weekend and needs major decompression. As if the conveyor belt stalls each weekend and everything gets backed up. So Monday was a bad start. Then it was a busy trauma day on top of that. We were already up to four traumas when an ED nurse runs up to me. There was a 15 passenger van in an accident. Multiple casualties. Multiple nonresponsive. Varying ages. And that's all they know at the moment. Thankfully I had a midlevel with me that day to handle the work, but this was bigger than us two. I sent out a message to my fellow co-residents asking for extra hands, and I messaged my Attending letting him know he needed to show up, and just in case he wasn't fast enough I called one of our critical care fellows. Organized as best I could with the little warning we had, and then the first level one rolled through the doors. I received that one and my attention was then focused to the task in front of me, broken only by each new trauma alert as it was paged out. With each alert an old familiar panic rising from my inability to be in multiple places as once started dancing in the back of my head. But slowly, and one by one a handful of co-residents started showing up able and willing to do anything. My Attending (he did finally show up) encouraged me to start managing everyone rather than running any one trauma. I think back on my co-residents showing up and all working together. It was absolutely chaotic, and at the same time so smooth. Multiple patient's went to the OR, lined up one after the other (trauma, orthopedics, neurosurgery, even OB). I took one of my patient's myself. By the time the mass casuality was handled, all patient's dispo'd, consults called, clearances granted or not granted and I had finally finished with my case it was 4 am. I remember walking home through the parking lot in a surreal state; That I was going home to sleep knowing full well that my alarm is set for less than 60 minutes later. I did it though, showered, took out my contacts, and snuggled under my covers. All to turn off my brain and finally end the day.
It kind of worked. Being able to wake up and start anew. Relied on caffeine for the rest. I think back on craziness and get choked up with gratitude at my awesome co-residents. At morning report, the other attendings listened to each trauma being presented, eyes getting wider with each one. "Why?" they asked. "Why wasn't a Code Triage called?" I didn't have an answer per se to that question, but I could say my co-residents, they had it handled!
Much love and prayers!
Saturday, June 13, 2020
Estoy contando los días.
The burden of COVID19 reached a new low this past week at Westchester. The remaining two COVID units staffed by surgical staff were disbanded, the remaining patients consolidated in other units, which in turn freed up the few surgical residents that had been assigned COVID. Those residents were reassigned to various surgical services after discussion amongst ourselves and then appropriate teams were notified of the upcoming resident coverage changes.
One of the current chiefs, unhappy with how the reassignments had affected him and his team, called me angrily demanding to know who had made the decision. Just one example of the many angry conversations I've been having over the past few weeks. Although one could say I'm used to being yelled at; doesn't make it any more enjoyable. I own up to the fact that, in general, I have a serious personality, but defend it by offering that I at least can still appreciate a joke and love to laugh and smile. I think I've smiled twice in the past two weeks, and both times it was forced. If not the truth, it honestly at least feels that way. Between managing the trauma attendings, and attempting to transition our program into a new year I'm not having a whole lot of fun currently. At the same time, and on a more positive perspective... I'm definitely praying exponentially more. It's more of a pleading. Begging for an increase in my ability to love. It's gotten me through many a conversation. Thankful I can forever rely on an unending supply!
Back on a COVID note, our hospital has now settled into a semi-normal setting. The halls are busy again, as all nonessential workers are starting to return to their offices. How the virus is affecting my patients specifically is the fact that every patient that presents to the hospital is automatically on precautions as a "rule out COVID" until their swab results come back. Imagine it, you just fell off a ladder, or wrecked your motorcycle, or jumped off a bridge. You've been wrapped up and whisked off to the hospital where you're intercepted by a swarm of blue-gowned, masked and shielded aliens. Before you can blink you're clothes have been cut off, catheters inserted into veins and everything that hurts poked and prodded... but wait that's not all. To top if off, swab goes up the nose until your brain is tickled. Just in case you weren't hurting before, you do now!
It's necessary, almost daily I have trauma patients whose swabs come back positive. Asymptomatic from a COVID perspective they still get sent to the COVID units, unsafe to be mixed with non-COVID patients.
Much Love and Prayers!
One of the current chiefs, unhappy with how the reassignments had affected him and his team, called me angrily demanding to know who had made the decision. Just one example of the many angry conversations I've been having over the past few weeks. Although one could say I'm used to being yelled at; doesn't make it any more enjoyable. I own up to the fact that, in general, I have a serious personality, but defend it by offering that I at least can still appreciate a joke and love to laugh and smile. I think I've smiled twice in the past two weeks, and both times it was forced. If not the truth, it honestly at least feels that way. Between managing the trauma attendings, and attempting to transition our program into a new year I'm not having a whole lot of fun currently. At the same time, and on a more positive perspective... I'm definitely praying exponentially more. It's more of a pleading. Begging for an increase in my ability to love. It's gotten me through many a conversation. Thankful I can forever rely on an unending supply!
Back on a COVID note, our hospital has now settled into a semi-normal setting. The halls are busy again, as all nonessential workers are starting to return to their offices. How the virus is affecting my patients specifically is the fact that every patient that presents to the hospital is automatically on precautions as a "rule out COVID" until their swab results come back. Imagine it, you just fell off a ladder, or wrecked your motorcycle, or jumped off a bridge. You've been wrapped up and whisked off to the hospital where you're intercepted by a swarm of blue-gowned, masked and shielded aliens. Before you can blink you're clothes have been cut off, catheters inserted into veins and everything that hurts poked and prodded... but wait that's not all. To top if off, swab goes up the nose until your brain is tickled. Just in case you weren't hurting before, you do now!
It's necessary, almost daily I have trauma patients whose swabs come back positive. Asymptomatic from a COVID perspective they still get sent to the COVID units, unsafe to be mixed with non-COVID patients.
Much Love and Prayers!
Sunday, June 7, 2020
Estoy quemando velas.
Reality right now:
Out of bed by the third alarm, take my coffee with me and into the hospital extra early in order to get a handle on the damage done to the trauma list overnight before the day starts. Grabbing a free computer in the TICU, take my mask off to swallow some coffee, and then wait the 5 minutes it takes to log onto the system. Feeling like it's been a long week on trauma thus far, then proceed to sink into my seat realizing that... it's only Tuesday morning. Realization shrugged off, face the day head on, corral the team, mobilize the patients, navigate the Attending's moods and address all new traumas including injuries and disposition.
All in all, each day got better, and we finally caught up with my Tuesday morning attitude and made it to the end of our first week. I even had time on Friday for administrative duties involved with transitioning to chief residents July 1st.
As the rest of the world grapples with social distanced celebrations and graduations, so is our program. All celebratory events cancelled, a few are trying to now find alternatives. The vascular surgery party hosted by Dr. Babu was moved to the backyard of Dr. Goyal and invites limited to the current chiefs and PGY4s. As these individuals have been by my side, all of us breathing the same stale hospital air filtered through our masks over the past few months, we had no qualms about taking class pictures. We overstayed the party time as stated on the invitation preferring to just sit by the pool (some swimming) enjoying the sun, and fresh air, and each other in a non-hospital setting. It was wonderful!
The chiefs with Vascular Attendings: sitting Dr. Babu and Dr. Shah; standing L to R: Dr. Mateo, Dr. Laskowski, Hanjoo, Adi, Monica, Alex, Joe, Dr. Goyal (not pictured Michelle and Dr. Carroll)
Out of bed by the third alarm, take my coffee with me and into the hospital extra early in order to get a handle on the damage done to the trauma list overnight before the day starts. Grabbing a free computer in the TICU, take my mask off to swallow some coffee, and then wait the 5 minutes it takes to log onto the system. Feeling like it's been a long week on trauma thus far, then proceed to sink into my seat realizing that... it's only Tuesday morning. Realization shrugged off, face the day head on, corral the team, mobilize the patients, navigate the Attending's moods and address all new traumas including injuries and disposition.
All in all, each day got better, and we finally caught up with my Tuesday morning attitude and made it to the end of our first week. I even had time on Friday for administrative duties involved with transitioning to chief residents July 1st.
As the rest of the world grapples with social distanced celebrations and graduations, so is our program. All celebratory events cancelled, a few are trying to now find alternatives. The vascular surgery party hosted by Dr. Babu was moved to the backyard of Dr. Goyal and invites limited to the current chiefs and PGY4s. As these individuals have been by my side, all of us breathing the same stale hospital air filtered through our masks over the past few months, we had no qualms about taking class pictures. We overstayed the party time as stated on the invitation preferring to just sit by the pool (some swimming) enjoying the sun, and fresh air, and each other in a non-hospital setting. It was wonderful!
Me, Monica, Alex
Dr. Babu and Alex
Dr. Goyal
Hanjoo, Adi, Monica, Alex, Joe (not pictured: Michelle)
I worked with half of this group since they were interns, and the other half even longer than that. Many, many memories. Wish them all the absolute best on their future endeavors! Will miss them next year.
Much love and prayers.
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