I am surprised at how much fun it is to have med students around, more confused than I am, making me feel like I’m a genius, or at least that I’m a doctor. Hey, after five months I know things! I know the abbreviations people use! I know what’s probably serious and what’s probably not! I know when to call a rapid response! I

I try and sit down and teach the med student when i can, even if its only for 5 minutes. I remember being a med student. I remember how awesome it was when the interns and residents helped me out like that, and it definetly influenced my decision to pick internal as a field. So I’m trying to be a good intern and help them feel not so lost. I’m actually starting to figure out what I’m doing and getting comfortable. It’s probably some of each.

My one complaint would be that is is kind of hard to make friends in the program. Mostly because there is no communal downtime. Everyone is on a different rotation, in a different part of the hospital or even a different hospital, and we never actually have a chance to get to know each other. In med school you have classes, you have lunch, you have extracurricular activities.

Not to mention there isn’t a lot of “not at work” time that people have in common and can make plans. My day off might not be your day off, my early night is probably your on-call night, you’re on days and I’m on nights… so even if I wanted to make plans with someone, it’s almost impossible. But bit by bit the five minute conversations add up. I just have to try harder to motivate people to go out, I suppose

Outside of medicine, I will be performing stand up comedy again in the next couple weeks at a relatively well know LA comedy club. Anyone in the area should swing by and check it out

While on my way to noon conference today one of the med students stopped me and asked me how I liked the program. I told him truthfully, I was very happy with it. Then he asked if there was anything I didnt like about my residency program.

And I had to stop and think about it. I remember not so long ago when I was in the exact same position on the interview trail, questioning every resident I could find about hidden flaws, what the program directors werent telling you. It was almost cute to be so interrogated.

So I wanted to give him an honest answer. I thought long and hard, and at the end of it, I honestly couldnt come up with anything. There are certainly things I dont think are perfect, but they are the same things I would be complaining about in any program. As things go I have it pretty good. No overnight call, a q6-7 call schedule on wards, great coworkers, attendings who are enthusiastic about teaching, a prompt and efficient ancillary staff, the list goes on. Nothing overtly bad or unpleasant really came to mind.

I told him so, and then I smiled to myself. It was nice to rrealize that I picked the right program for me.

After all, the man who is truly happy is the one who smiles when there is no one else around to see

Residency is hard work. There’s a lot to keep track of, whether it is patient care issues, studying for licensing exams, or just wondering about my overall performance and what the other residents/interns think of me. Am I the intern that has the horrible notes? or the one who everyone is glad to have on their team? I know the medication i need to prescribe, but what is the proper dosage and why does everyone but me know it? WHY DOES THE PAGER KEEP GOING OFF?

So with the minute little stresses throughout the day, it’s important to find ways to keep myself grounded in reality. Or at least my reality. So what helps me get through those stressful days?

–Taking the stairs from the 6th to 7th floor and pausing to look at the hollywood sign through the glass wall

–shouting “wheee” and throwing my hands up as i enter the steep highway ramp on my way home from work

–wandering the halls of the hospital humming whitesnake when nobody’s looking (and journey when they are)

–checking off boxes on my to do list for patients

what helps keep YOU sane?

I have been neglecting those of you who still come here, I know. I also know that this meta-regretting is a typical way for me to start posts lately. So by way of brief apology, let me just say I do miss those of you who i have virtual conversations with, and I will make more of an effort to at least comment, if not post more on my own.

That said, I finally began service on the wards today! Yes, my 2 months of night float are over, and now I am back to a more classical residency block…admitting patients, rounding on them, and treating them until they get better, get transferred, or get dead. Ideally less of the latter.

Now I am a fairly proactive person, so when the resident was handing out patient assignments I volunteered for the liver patient. Liver patients tend to be complicated, as since the liver metabolizes most drugs and produced the majority of clotting factors and proteins, pts with defunct livers have a ridiculous amount of things they cannot be prescribed or have to be monitored closely to prevent multitudinous complications.

One of these complications is known as Ascites. It is basically a fluid buildup in the abdomen due to loss of proteins by the liver. But while i could get technical all day, lets consult Dr Google for a picture, shall we?

The main way to treat an ascites that has gotten this bad is to drain it. That’s right, just stick a needle in and deflate the belly by draining all the liquid into vacumn sealed liter bottles. Did I mention the yellowish ascitic fluid can occasionally be reminiscent of beer

That’s right, my first day on wards and i was setting up my own microbrewery!

So cheers to my first completed procedure of the year! Anyone want a stella?

This weeks contestants for most disturbing patient story:

1)The 45 year old lady with a gc/chlamydia infection in her stoma. For you laypeople, have you ever heard of a colostomy? If not, that is when the surgeons repurpose your intestinal tract so you can poop out your stomach. The stoma is the opening created for this function. Unless of course, you and your husband happen to be kinky-then it’s a brand new opening for intercourse! Also, std’s

Winning Quote: “It’s like anal, but through your bellybutton”

2) The 32 year old female with a vaginal infection who was offered antibiotics. Until her boyfriend stepped in and asked (no I am not making this up, please stop reading here, I mean it, you have only yourself to blame)

Winning Quote: “Actually, can you not give drugs? I kind of like the taste”

3) The 50 year old naked homeless man who comes in complaining of chest pain to get a warm bed and hot meal, and also has scabies. Well, one of the things he has is scabies based on the trademark sign of burrows on his hands. There is also a couple fungal infections, and oh yeah the bugs which are now crawling over the blankets which I cant even identify.

Winning Quote: “I still have those?”

I will be so happy when night float is over