Good Morning from the ER

1:12 AM. Just over halfway through my ER shift tonight! I'm working a series of 7pm-7am shifts (fondly called "overnights"), beginning last night and going through Monday night. Certainly not my favorite thing I've done in residency so far, but at least I'm 1.5 shifts down, 4.5 shifts to go....

The Children's Hospital ER is an interesting place, to say the least. We have such a range of patients who come in - for example: between last night and tonight, I have:

• sewn up 2 facial cuts (one hit chin on bathtub; one hit forehead on coffee table)
• seen a few patients with wheezing (they all went home)
• admitted a 6 year old girl to the psychiatry ward (she was threatening to kill her mother and sister, bad situation)
• admitted an 18month old who swallowed a coin and is going to the OR tomorrow morning to have it removed
• seen a few patients with colds (seriously.... there are WAY too many people who come to the ER with snotty noses and cough...)
• seen a few patients with abdominal pain, diarrhea, etc.
• seen a 7 week old with a VP shunt (a tube placed in the brain by a neurosurgeon to drain excess cerebrospinal fluid)

Trying to think... not much else that's been exciting.... Right now I'm just killing time until the next patient comes in, who knows what that will be.... or when, for that matter!

Why I'm Learning to Love Medical Conferences

I'm at the North American Cystic Fibrosis conference this week, in Anaheim, California! Finally, all the work I did in medical school on my CF project (a questionnaire that I gave to adolescent & young adult CF patients, focused on what they know about the genetics of CF & various related issues) has paid off.... with more work, of course (I submitted an abstract for this conference last spring, got accepted, & then had to prepare both a poster and a presentation of my research). But, I'm learning to love medical conferences:

1. Location, location, location! Southern California weather (70's and sunny!), beautiful hotel, and..... Disneyland right down the street (walking distance!)
2. Time with my wonderful husband, who came out to be with me and attend my presentation as well as enjoy the location (see #1)
3. A great conference tote bag (free)
4. Free delicious dinners out, courtesy of your friendly neighborhood drug reps
5. Free stuff - again, thanks to drug reps & other conference sponsors - lots of pens, highlighters, hand sanitizer gel, breath mints, a rubber duckie, a personlized cell phone charger (okay, I haven't stood in the long line for this one yet, but I will), popcorn, Dippin' Dots, Starbucks coffee, sodas, and (which I just found in the free WiFi lounge) a soft-serve ice cream cone machine
6. Oh yeah, and I might actually learn something...

Anyway, today was the last day & was the Big Day of my presentation. I think it went pretty well! I presented to a "workshop" (series of short research presentations) with topics specifically related to genetics. I had 10 minutes to present, followed by 5 minutes of "discussion" (which ranges from research critiques to questions to personal anecdotes). I stayed within my time limit, and only had a few times where I "ummm...."-ed or hesitated, and I got more comfortable after getting my nerves out in the first 2 slides or so. And from the discussion afterwards, I think my presentation was very well received... and I'm SO glad it's over (and fairly proud of my efforts, I must say...)!!

September Update

Only 3 days left in the NICU, and I haven't posted since - well - before I started Heme/Onc, so it's been awhile! I'll start with a general update and then try to post more often. :)

Heme/Onc (i.e. hematology, which deals with blood disorders, and oncology which is cancers of course) month was my first "real" month as an intern. I had done so well with my clinic month in July that intern year didn't seem very hard - or real - yet; but once I started heme/onc in August, which was my first inpatient month, the fact that I'm an intern hit home fast. I cried after work almost every day for the first two weeks... and not so much from the emotional piece of dealing with kids with cancer - more just because I was working such long hours (over 95 hours my first or second week, but don't tell anyone...), and felt so tired and stressed and overwhelmed! I almost constantly felt like I didn't know enough about what was going on, yet there were people looking to me to know & to make good decisions about the patients, and that was a very bad feeling. Fortunately I learned as the month went on and I actually ended feeling fairly good about it, and even enjoying it. Oncology was certainly fascinating, though I wasn't as excited about the hematology part.

From there I moved on the NICU (neonatal intensive care unit) at UAB, which is notoriously one of the hardest months of intern year, and it has certainly lived up to that reputation. I am responsible for up to 10 babies every day, with problems ranging from extreme prematurity and its associated issues (babies born as early as 23 weeks into what should be a 40 week pregnancy - sometimes as small as 1 pound in weight at birth!), to babies that are just little & need help keeping warm, to babies that are full term at birth but have birth defects or just difficulty transitioning to life out on their own. It's long hours - I'm on call every 4th night, which means a 30 hour shift with no sleep. Thank goodness for the legal 30 hour limit, though, so that I can leave around noon on my post-call day and go home and sleep!! I am really ready for this month to be over!

In other news - I got to be a model for our friend David last week - he was doing a photography project for a class. Look at his blog (see the link at right) for one of the pictures! I'm trying out for America's Next Top Model next fall. (Ha, ha.)

Thoughts on Laziness

I love being lazy.... in the moment, that is. It was so nice to spend the whole day yesterday in my pyjamas, never leaving the house, sitting on the couch playing board games and watching baseball and brainless movies (Jackie Chan and Owen Wilson being very silly) and working on a crochet project. But I always pay for my laziness later. I wish I'd gotten up at some point and gone to the gym and/or the grocery store, or done laundry, or cleaned, or studied, or done any one of those things that I had meant to spend all weekend doing!

So I loved being lazy yesterday, but today I hate that I was lazy yesterday. I think it's mostly because I still have to do all the cleaning/laundry/studying/errands/etc., as unfortunately the laundry didn't do itself, surprise surprise, nor did any of those other things get done without my putting the energy into the doing of them. But, I think that a large part of me wants to be a go-go-go kind of person, always on top of things, always with lots of energy to get everything done & learned on time, and so I hate it when the real me comes through and turns out to be just a lazy slug!

By the Numbers: Oregon

19: hours spent in airports or planes while travelling to & from Portland, Oregon last weekend.

50: pound limit on each piece of luggage, which I overshot both going & coming home... oops.

3: full days on the west coast.

4: rowers in a boat that beat an eight!

7,000: feet elevation of Timberline Lodge, on Mt. Hood, otherwise known as Brian & Ginny's wedding location.

16: approximate number of times my ears popped (between flights & travelling up & down the mountain...).

130: wedding favors (packages of s'more supplies) made by the bridesmaids the night before the wedding. (We had waaaaaaay too much fun with this, by the way.)

1: husband I missed very much while I was gone!

Vacation!

I have worked exactly 12 days. (Not including orientation.)

And now I'm on vacation.

Woo-hoo!

(I can't get used to this!)

A Day in the Life - July Edition

I know at least a few of you are wondering what it is I do all day, so here is the first of a monthly series on that subject - it will change monthly as I move through different rotations. Enjoy!

6:00am. Alarm goes off - hit snooze.
6:09. Dang that alarm clock -there it goes again. Snooze.
6:30-6:40-ish. Finally get up after hitting snooze (and thus aggravating my sweet husband) a few more times. Stumble toward shower.
7:00-ish. Running late for quiet time (my goal is 30 minutes every morning), but sit down for a few minutes for QT & prayer, accompained by breakfast (usually cereal).
7:15. Final touches before heading out the door.
7:25. Leave house; drive to Children's. If really running late - eat breakfast in car.
7:45-8:15. Morning report.
8:15-noon. Attend one of the clinics - mostly different types of pediatric surgery (general, ENT, Orthopedics, Urology, Neurosurgery, etc.). Sometimes I just shadow the attending surgeon; sometimes I see a patient on my own, then present the patient to the attending and accompany him/her while s/he sees the patient and makes all the decisions.
Noon. Noon conference - a lecture (usually) on some pediatric topic, aimed at educating the residents and medical students. They feed us lunch, too, which is great.
1:00-4:30/5:00-ish. Afternoon clinic - something different from the morning clinic, but my role is similar.
5:00ish. Drive home.
Evening. Various activities - e.g. attending Matt's softball game; going to Bible study; running errands; fixing dinner. (It's nice to actually have time & energy to do these things in the evenings.... though I need to start incorporating a bit more exercise into these possibilites, especially given the lunches they feed us at Children's!)
9:00. Start thinking about going to bed soon. Keep watching the Braves with Matt.
9:30. I really should go to bed.
10:00. Drag self off sofa and to bed. Read for a few minutes - then sleep...