Welcome to Shmeens

I was going to start this post by saying how awesome it was being home post-call for the snowstorm, but as it turns out, it won't get started until I'm already asleep.  Not that this should matter at all, but I'm all holed up in my jammies with my Belgian cocoa dusted truffles and glass of milk and bucket of korean wings and kimchi (awesome combination, I know) and dammit, I want me some snow.  I continually have great things to say about my house and neighborhood, and the latest in that list is that I live one block from an old subway rail line, which in this area runs above ground and transports freight only twice a day.  So I have a ready-made garage under which to park my car, and my neighbors and I will all be able to pull out in the morning without having to additionally dig out the car.  Hooray!!  No damaging the car paint with my shovel this time =P

I woke up yesterday morning to a sweet text from my chief resident, wishing me luck on the upcoming Shmeens rotation.  I feel that I have a lot to prove these two weeks, as I am the only intern from my program being sent here, and I want to make a good impression.  Fortunately, all of the other interns I rotate with seem both capable and nice, and I even ran into a med school friend's boyfriend, who I had forgotten was doing his traditional rotating internship year at Shmeens before starting anesthesia next year.  I really expected the service to be rough and rigid, like a bigger boot camp than my home base hospital, but instead it turned out to be oddly casual.  There were no lunchtime or evening rounds, since the OR was so busy that it simply wasn't practical.  There was minimal pimping, and I didn't get yelled at for the many simple mistakes I made (most of which came from being so disoriented in the hospital, since I had never been there before).  I kept asking the interns when the other shoe was going to drop, and getting blank stares in reaction.

The hospital reminds me a lot of my home base, in that it is neither wealthy nor prestigious, but it is bigger and attracts a reasonable number of patients.   I couldn't believe that in one day, they had two appendectomies, one strangulated hernia (into which a third appendicitis seemed to have perforated and caused abscess formation), one EVAR for AAA repair, two sub-total thyroidectomies, and a million other routine cases.  I'm really looking forward to my non-call days, when I hope I can scrub on a few of the smaller cases and get some more experience.  In that sense, I'm becoming more and more sad that I'm not spending more time at Shmeens, and I'm getting really excited to come back as a second year resident.

So, for now, it's ominous clouds and Gilmore Girls re-runs for me.  Laugh, but know that I have everything I need in my little hole.

Closing The Gap

Yes, yes, I know, I have been inconsistent yet again.  But I'm baaaaaaaaaaaaack!!  (Hmm.  Creepy.)

I've spent the past month at Medium Class Shmanhattan Hospital, which is an outside rotation that my program arranges for us to attend a few months each year.  I state that it is Medium Class so as to avoid confusion with those Super Duper Fancy Shmancy Manhattan hospitals, which of course, I will not get to go through.  But for me, it is in fact SUPER DUPER because nearly anything looks brand spanking new next to my home base hospital.  (But I love oldies!  OLDY BUT GOODY!!)

It's a place that many of my senior residents wax poetic about, because it has things like an EMR and several operating rooms and lots of cases.  And overall, I had a pretty good time rotating there, from a surgical standpoint.  But it wasn't quite what I expected.  For starters, at my base hospital, being on call is busy, sometimes overwhelmingly so.   But the other interns don't chill out while you're working your ass off - they help, because we're The Team.  In contrast, I was only on call a few times for the month at MCSH, but each call was more or less torture.  The pager just explodes with consults and clarifications and so on, and you are fielding all of them while also running the patient list and trying to discharge people.  You hope that the many other surgical residents milling around will help you, but unfortunately, they don't always.  You have an army of students to help you, but not all of them are motivated to stick around in case you need a spare hand to grab paperwork or help patients walk after a procedure.  The nurses were shockingly worse than at my home base hospital - I actually got called several times because I had ordered a medication or a blood test, and the nurse wanted to know if I wanted it.  One could make the argument that this is just an example of a nurse wanting to be thorough, but when it happens 18 times in a day (literally), it gets a little old.  Read the fine print, lady, I want what I want.

I also drew the short straw and rotated during the holidays, during which there were noticeably less patients and cases to see.  The 40-50 cases my co-interns were seeing wound up being more like 20 for me.  Of course, being an intern, it doesn't really matter as much, but it still would have been nice to Do A Fricking Appendectomy like my co-intern did, or scrub on any case bigger than an elective hernia procedure (like an exploratory laparotomy), like others did while on call.  Of course, getting to assist in small cases is good for an intern, it's how you get your feet wet.  But there were days where I didn't get a single case at all, and other interns got 3.  By the end of the rotation, I started getting a little grumbly about a lack of equity when it came to case division, and finally got fed up when I had a bad night on call during which some residents refused to help me divy up the work.

So, I'm done now.  Because of a complicated issue involving intern supply at another outside rotation hospital, I have been switched off of my upcoming rotation with surgery at the home base to do two weeks of surgery at a large Queens hospital, a place that no intern from my year is assigned to.  Onwards and upwards to the next new thing, I suppose.

Hmm.  Now I need a name for the Queens hospital.  Maybe it'll be Shmeens.