August 29, 2009

• Metamorphosis

  
  marriedtothesea.com

  My first month of Night Float is almost done (I think, timekeeping is a little tricky with my sleep schedule) and It has been an eye-opening experience to say the least. Residency is three years for a reason and I hardly expect to become proficient in medicine only 2 months in.

  That aside, I have occasional sensations of stepping outside myself and seeing how far I have come in only 2 months. Certain facts have come back to me instantly from med school, and I can create a differential and plan for conditions like dark stool or chest pain almost immediately, while things as obvious as back pain or shortness of breath leave me drawing a blank.

  Its as though after years of seeing all the information in medical school, I was blinded and am learning to walk again in fits and starts, sure of my stride here, hesitantly stepping there and hoping that I dont walk into a bus while I wait to regain my vision.

  Even as recently as my first night ago, I remember handing out pain med orders like pez because I honestly couldnt assess if the patient actually needed them or not. Tonigh has been just the opposite-my jerk side is in full swing and despite prodding from the nurses and whining from some of the patients I will not prescribe opioids simply because you ask for them. Doubly so if no history and physical is available on the patient its being requested for. My job is to handle crises as they arise and while it is unfortunate and uncomfortable that people are suffering, people are unlikely to die from not receiving morphone for their pain.

  Certain decisions have become easier, and I am beginning to develop an idea of how to screen which patients require visitation, which calls are wasting my time, and which people are trying to pass the buck to me because I sit on the bottom of the totem pole.

  My metamorphosis has begun, and it simply remains to be seen what will emerge at the end.

  “Confusion never stops
  Closing walls and ticking clocks
  Gonna come back and take you home
  I could not stop what you now know
  Singing: Come out upon my seas
  Curse missed opportunities
  Am I a part of the cure
  Or am I part of the disease?”

  • 9:07 am
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