short call

today was my short call day.

this means that i come in at 6am, pick up an overnight admission and have it worked up by 7am. then i do work rounds until 8am. then i round with the resident. at 9:15am we round with the attending. this is supposed to last til 11:15am. then you resume work. from 12:15-1pm, there is usually a noon conference with lunch served - this has been cancelled for the first few days so the interns have time to adjust. then you finish your work and sign out to night float by 5pm. then you go live your life.

so what REALLY happened was:

wake up at 3:45am. out the door and on the brooklyn train platform by 4:30am, hoping to get in a bit before 6am so i can have a cushion of extra time to work up my admission. i sweat it out in a shirt and tie in a humid and stagnant station and the train doesn't arrive until 5:05am. i get on and after a few stops realize that this 4 train isn't running express. i don't know if it's because the 4 runs local before 5:30am or something, or if i picked the wrong train, or maybe i was on the 6 (shout out to j.lo!) the entire time and didn't know it. so i actually arrived at 6:15am.

got my admission, get sign out from night float, immediately start getting pages. finally see the new patient at 6:30am. not really paying attention to time very well, and being very inefficient overall, i work on the admission until about 7:45am. then i realize i need to see the other 7 patients before 8am.

that obviously doesn't happen.

look like an ass in front of my resident (and later, my attending), because i haven't had enough time to check up labs and see all my patients - but the 3rd and 4th year student have all their data. i feel like an idiot.

attending rounds just kind of dissolves on the floor about 11am or so for some reason. we all separate and resume work. i have 8 patients on my board.

and then, somehow, i start to get the hang of it a little bit. the nurses are tough but all of them are super nice (and all of them think they're making the "OHHHHHHHH DOCTOR OHHHHHhhHHHHhhhH" joke for the very first time. some of them repeated the joke from yesterday) and they seem to like me, which is a plus. something happens. i start feeling a bit more confident. i spend a bit more time going over my orders and the patient's vitals and labs and my pager screams a bit less. i end up discharging 3 patients, gearing up 1 for discharge tomorrow, and one for a transfer. that would leave me with 3 patients (right now i'm sitting with 5).

so i didn't eat lunch again today, but i got a lot done, and signed out an hour earlier than yesterday (actually since i got in an hour early, i guess that works itself out).

tomorrow is my "pre-call" day (since i'm on overnight on saturday), so i will not be taking admissions! nice! and i'll be sending off 2 of my 5 patients. TECHNICALLY i'm supposed to be done by 3pm on fri pre-call, and it really seems like i might be able to pull it off. definitely NOT eating lunch tomorrow.

tomorrow night tv on the radio is playing in prospect park. i can't wait to pass out in the grass before they start playing and lull me to sleep with their throbbing basslines and peter-gabriel-on-heroin melodies. that's not hate, i totally feel TVOTR, but i've been averaging 4 hours of sleep a night, so i'm just sayin.

saturday morning i will move in to my apartment in the bronx (thus eliminating the million-year commute) and live out of bags and on an aerobed for a week. saturday 3pm i go in and work overnight until sunday 3pm (i get 5 admissions). monday the whole thing starts all over again.

still don't remember a damn thing about medicine. but i'm getting the hang of working the system, which is really what this is all about, anyway. see you in brooklyn.

today was my first day

the long awaited first day of residency.

i had to be in at 7am. so i woke up in brooklyn at 4:30am and left the apt by 5:20am. it was pouring. my pants were soaked up to mid-thigh (even though i had an umbrella, apparently those don't stop SIDEWAYS RAIN). i got to my station and it was closed. so i doubled back and took a different entrance. then i waited 15 minutes (it seemed like eternity) with wet legs for the 4 train. i rode with the sleepy people until nearly the end of the line, and made it into the medicine conference room about 10 minutes before our scheduled 7am start time. i drank two dixie cup things of black coffee and ate a blueberry minimuffin. i was too anxious to eat too much.

i met the intern who was on his way out. it was his last day, off to another hospital for his ER residency. ("so how was the year?" "are you kidding me? don't fool yourself into thinking it's anything but tough.") he was on call last night, so i got slammed with his 5 brand new admits on top of his established patient list (my co-intern had 4 patients total). they gave us until 8am to walk around, meet the patients, say hi, maybe get the "S" (subjective) part of the SOAP note done (that's the progress note we write daily). needless to say i spent most of that time relearned where everything was and how to log on to the computer based orders system.

by 8am we were to recongregate in the conference room for a 1 hour intern crash course orientation. my pager blew up about 4 times during that orientation. i couldn't listen to how to survive because i was answering pages. incredible. the novelty wore off in like a second. although it was fun hearing nurses refer to me as "doctor".

at 9am we had attending rounds, which is where we meet with the senior-most physician on the service, and discuss our plans with him. since i had no clue what was going on, the former intern did most of the talking. these rounds tend to last a while, but today's rounds last a painful 4 hours. this is the nightmare of internal medicine. ROUNDING ALL FUCKING DAY. (there is no rounding in anesthesia)

so i didn't get much done by 1pm. now, after answering all these pages and calling for consults and just trying to figure things out, i had to go see patients and drop in notes on everyone. but not all the patients are in their rooms (some are off to radiology, some are off to physical therapy, etc), not all consults have been called, not all the blood has been drawn (i drew 2 bloods today and 1 blood culture), not all the labs have been sent, not all the radiology has been read, etc...

by the time i figured out what i was doing (to a point) and how to do it (for now), it was 7:30pm and time to sign out.

by 8pm i was out the door. 9:15pm i was back in brooklyn. 9:30pm i had dinner (my first meal of the day - had no time for lunch). 10:30pm i am writing this thing for your enjoyment.

tomorrow i need to be in at 6am for my short call admission. this means waking up at 3:45am to be on a train by 4:30am. so if i passed out instantly, that would be about 5 hours sleep.

also i feel very stupid like i remember ZERO medicine.

and that was my first day.

ohhh boy

I am scared, nervous, excited, anxious, eager, tired, sleepy, confused, ready and totally and completely terrified for the start of residency. We begin on June 28 (that's in less than a week!).

I take my first overnight call that Saturday.

My hospital ID badge says "MD" after my name. I am also not smiling nearly as much as I thought I was. It was pretty early in the morning when they took those pictures.

Anyway.. let's tell stories.. as soon as we get some stories to tell..