morning edition

one of the good things about being on my ED month is that i get to listen to the entirety of morning edition, as opposed to the 10 minute snippet i usually get on my drive into the hospital. so today, there was a really neat piece on jerry falwell. i was not aware of this, but apparently, everyone sends him Tinky-Winkys and the guy who ghost-wrote his autobiography has come out of the closet and sits front and center in his church every sunday. talk about poetic justice. i highly recommend a listen.

last day as an intern

so, it's almost done. everyone has been congratulating me today for getting through this year. like it's some great accomplishment, like i did something more worthwhile than running around like a chicken with my head cut off.
truthfully, i'll be glad when tomorrow morning comes and i can sign out the ward to the new crop of interns, all bright-eyed and trepidatious (if that's even a word). but i have no real sense of accomplishment about it. i've just been barely keeping my head above water. if that's an accomplishment or giant feat of strength, well, then i guess congratulations are in order.
frankly, i'm just exhausted and numb. everyone says second year is better. is it better or are you just used to feeling this way?
i am the runner up for the black cloud award (an award given to that lucky resident who has the worst call nights). my chief said i would have won it outright, except the girl who won it was graduating and i had 2 more years to achieve that particular honor. my goal for my pl-2 year is to win the white cloud award. my fortune is bound to change. here's to quiet nights (knock on wood)...

i'm an aunty!

well, sort of.
my housemate for most of med school recently had her baby.
she's absolutely beautiful. really, objectively beautiful. her head wasn't even very squashed, which is impressive.
i'm an honorary aunt, which translates into buying her lots of really cute baby clothes and toys.
aren't kids amazing?

what do you do when you don't know what to say?

i went to visit a boy today. i've taken care of him a lot on the inpatient floor. i wrote the discharge summary when he was going home after his 207 day hospital stay for his bone marrow transplant, complicated by everything you could possibly imagine. he's in our picu right now, on an oscillator, edematous, in multi-system organ failure. he has graft vs host disease from his bone marrow transplant. he's dying. i had no idea what to say.
i stood awkwardly in the doorway for a second, my eyes meeting his mother's. there was still so much hope in her eyes, as well as defiance. it was almost as if she were silently daring me to say something sympathetic, as if that would be confirmation that her son was dying.
so i said nothing.
i walked past him, barely glancing at him but seeing immediately that look...if you've ever seen a dying child, you will know what i mean.
i sat down on the chair by the window next to his mother.
"how are you?" i asked.
she smiled. apparently, i had passed the test.
"i'm doing ok," she said with a shrug. "he looks better than yesterday."

national headache awareness week

it's day 2 of national headache awareness week. does this mean that i'm going to have this headache that started yesterday all week? 

things that irk me...

...that are, in the long run, not important, but irritating nonetheless.
a friend of mine was supposed to call me before she left her house (as she is without a cell phone) to give me directions to a picnic that we're going to today.
she didn't call.
luckily, she was picking another friend up on the way, so i called him and got directions after all.
when asked, she said she just forgot. she was sorry. that's just how she is. maybe she'll get better about calling people.
i guess it irritated me because if the roles had been reversed, i would have called her. i'm sorry. that's just how i am. maybe i'll learn to be more forgetful.

rainy saturday idealism

So I awoke this morning to the sound of the work truck backing up the driveway. They're here to put in the new kitchen counters. They were supposed to come yesterday, along with the plumbers, so I could have a functional kitchen. The plumbers showed up yesterday afternoon as planned, but the installers did not. So here they are now.
It's gray and raining here today and fairly dreary. So I guess it's a good day to have workmen tromping in and out of the house, drilling and filling the air with the smell of silicone. Mmm, silicone.

I spent the morning sitting on the couch trying to develop a new curriculum for professional development, something that has been fairly ignored in our program to date. But now we have an RRC site visit coming up and our new program director is suddenly very interested in what research and advocacy projects the residents are involved in. Not very many, that much is clear. How many residents attend national professional society meetings? Hardly any. How many residents have an updated CV? Probably only the ones graduating who nad to finish them for their job applications.
So the idea we came up with is to have a certain number of PEDs, or personalized education days, to devote to professional development. The pun wasn't my idea. But it's a good idea. Maybe it will inspire people to try again to make a difference on a larger scale, something that seemed to be more expected when we were med students.
I think we've lost something in medicine of late. A sense of professional responsibility. Collectively, we've lost our way and have gotten bogged down in the quagmire. A respected surgeon from my med school once said, “There are three professions in this world: law, clergy and medicine.” The implication of his words is that being a doctor or a lawyer or a religious leader entails more than going to work everyday and going through the daily grind. There is a professional duty and responsibility that pervades every aspect of life.
In this era of the 80-hour rules, rising health care costs, and cynicism about the practice of medicine in general, there is the temptation to do only what is necessary to get through the day. The practice of medicine is becoming ever more specialized and compartmentalized. The 80-hour work rules that were intended to protect us from grueling hours and fatigue have only served to give us a sense that what we do is shift work; our hours are up and we punch out, not literally but emotionally. There is an emphasis on more efficient delivery of care and RVU-generation that attendings have likened to working in a factory: 15 minutes in one room, then on to the next and the next and the next. There is an emerging sense that we, as physicians-in-training and future leaders of our profession, cannot make a difference. This in contrast to the dewy-eyed new medical student who fought to get into medical school so they could make a difference in the world and help people. There has never been a greater need to promote professional development and responsibility in our learners, to re-instill in them that sense of passion and motivation to do good works.
I'm not sure that this new curriculum will change anything, but maybe it will give someone an opportunity to try. An idealistic attending that I respect enormously for his passion and dedication to some of the most desperate children in this world once said to me, "We've got to save the world." At first, I thought this was a silly thing to say. But then I realized that he was right.
Who else will if we don't?
Here's a rainy day toast to passionate idealism...