some days you eat the bear, some days the bear eats you

a favorite saying of one of my high school teachers.

anyhow, yesterday's call day was one of those days where the bear ate me.

playing doctor is fun and all that, but the right of passage of being the intern, especially this time of year, certainly puts you in your place, constant reminders that you are the bottom of the totem pole, the scum on the floor of the pool, the lowest on the pecking order, if you can even say you have pecking rights.  getting yelled at by attendings and even senior nursing is something that comes with the intern territory, and we're taught by the residents before us to just roll with the punches, but that doesn't mean that the punches don't hurt.

for the past few weeks in my ob off-service rotation, i won't say i've eaten the bear, but surely done a decent job from not being eaten by it.  yesterday was just one of those days where a floor run by three to four residents and overseen by one senior was down to one resident (me) and my senior to control a whole bunch of bursting ladies...of course. 

private attending of MULTIP lady in 12 gave instructions not to check her until 5pm then call him with her exam - of course so he could conveniently finish is office hours then perfectly come in for a fast delivery.  but lady in 12 complains of urge to push with funny looking strip at 4:40p, so can't just leave her there; go check, she's complete and can't hold back pushing on her own, i page private attending, page my senior, and page back-up in-house attending (of course, in-house is in on emergent case).  private says he's coming now, senior confirms my exam and decides lady can't wait for even back-up in-house to give the okay, as she's pushing with or without us.  back-up in-house arrives a few pushes before baby's born, i assist senior in delivering and afterwards get the assignment of cleaning up patient/instrument count/note/orders as senior runs off to extinguish smoke somewhere else.  finally get out there to do my note/orders and private storms in (at least 40 minutes after original page), furious that patient was checked early, that he didn't get early notice about her being complete (?!?), and that no one called him to say that pt delivered so that he didn't have to continue driving like a madman; what can i say accept apologize when he won't listen to the thought process that obviously involved seniors and in-house attendings above me and that we just finished delivery.  private's pissed about missing his delivery (still going to get paid for it anyhow), and the lowly intern is the easiest thing to vent on.

not a few minutes after 12's private attending finishes with me, and i'm boiling inside while finishing entering computer orders, get call from room 15's private asking why there wasn't the hourly report on her pt with a good number of risk factors as requested, and proceeds to demand labs.  of course i putz and have to pull it up on computer 'cause i haven't seen any new changes in ANY of the other patients in the past 45-50 minutes.  delay prompts her to ask what year i am: intern; and what service: em off-service (i'm just icing my own cake here), which leads her to go off about how this patient is too sick to be taken care of by an off-service intern and instead should have a more senior ob (um, i don't disagree, i was handed this pt when my second year had to run into the fore-mentioned section...now i'd just love to have an extra OB-2 just hanging around to help)  as if someone was giving me an answer, an OB-3 that is not on service walks out of 15 and starts talking to me that "i'm sure you're very good, but pt in 15 is one of my best friends and definitely needs a resident with more experience covering her" while i'm on the phone with 15's private.  the private asks who's talking to me, and asks to be handed to the OB-3 after i answer.  getting this over the phone is one thing, but getting this in my face was a little too up close and personal; i feel my eyes welling up as i continue pulling up 15's labs with the off-service OB-3 on the phone next to me, and as indiscretel as possible (which probably wasn't at all) wipe of on my scrubs when i go to the end of the bench to grab some charting sheets.  after the off-service OB-3 gets off the phone, as she tries to nicely do the "no offense to you or anything, i'm sure you're very good, but. blah blah blah blah blah..." i can feel tears welling up again and some nice nasal drip starting, never letting them fall, but certain that nothing was being hidden.  can't imagine how hayppy i was to see my ob-2 round the corner as this conversation was ending, having completed teh emergent case; thankfully handed the patient back. 

pretty much set the mood for the rest of the evening.  nothing nasty happened, but my ears totally burned with frustration/embarassment/fear/anger for a while. 

p.s. for my weekend call tomorrow, my senior (OB-3) is yup...rm 15's dear friend.  oh boy.  daily pracitces of humility.

when's it my turn to eat the bear? 

graduation

Can't Help Myself - Must Take Quizzes!!

(1) Single in Chicago (2) Predictable?

So as many of my fellow graduating medical students would agree, Match inevitably asks and answers many questions, creates and solves many problems - where are we going, what are we doing, is it happening, how is it happening, who is being left behind, who is moving forward...

Surprise, I'm status quo, staying in Chicago...by choice.  Am working on updating my Friendster site 'cause I feel like with the knowledge that I'm going to be here for a few years at least, it is worth the time to work on expanding my acquaintences here outside of my very comfortable NU and UIC circle.  If you haven't been harassed by me already and hence have become aware of it, there is a renewed and refueled interest in more actively looking for seeking that special person. 

I feel as if friends around me are going transitioning into "next level," for whatever they are doing: many getting married, many becoming first-time homeowners, having babies and more babies, going through major career changes...but I feel, well, status quo.  Sure, will finally be making money, but as a resident, still a very much a protected participant in the "real world."  Living at the exact same place and will probably be driving something different by the end of this year, but both generously sponsored by parents.  There's a negative connotation to "feeling as if I'm stuck in a rut," so can't really call it that, but there is undoubtedly a hint of fatigue? frustration? at being "status quo" and not entirely sure of  where and how to start changing.  Maybe that's why I'm hoping for the entrance of new people, or even a new re-entrance of existing friendships, that will help me either figure that it is okay, or where and how to break out.    

In talking with my big brother a few days ago when he asked what I was looking for in that special person, I want to say that just hearing what was coming out of me made me feel like there has been a lot of change and a lot of growth in my approach and way of thinking since that first significant other in college (now married with kid).  Almost like I know better what I'm looking for, that I know better the strengths and weaknesses I bring with me, and that I now truly understand that compromise is an essential because nothing in a relationship can be perfect as to completely satisfy all parties.  In this small way, there has been change to the "status quo" that I have been hovering at for the past long time.

In a separate conversation with another good friend, I kind of expressed, "yeah, after all the interviews and travel, here I am, still in Chicago."  To this he quickly and non-chalantly replied to the effect "well, your family's there and I know they are extremely important part" of any of my decision-making processes; what struck me was how obvious and certain it seemed to him that I was of course going to end in Chicago.  You know how sometimes you think you're so smart or maybe so deep into something that you don't even realize it, but you are so clearly obvious and predictable to those around you?  You know - you think you can hide your emotions real well, but it is so clear to everyone else that you wear your heart on your sleeve - kind of like that.  My brother says that I treat my family as second to my friends, but then friends so casually point out that family is so recognizably HUGE to me and suggest that I so often pick family over friends...which way is it? who's right? i'm confused.  Does everyone else think that I am anchored firmly here...'cause I never consciously thought that way. 

As much as I enjoy traveling, somehow I am still here, in Chicago.  Each time a big choice comes by:  where to go for college, where to go for med school, where to go for residency...somehow or another, it ends that I am here.  I think college was a big factor; I only applied to four schools, uncertain who number 1 was, but when the coast school turned me down, Northwestern was the hands-down choice.  Four years committed in Chicago, fate deciding that at thsi first chance of getting away, I wsn't going to.  Med school was more of a conscious and rational decision: I was an Illinois resdient, average candidate with A- college grades, and having paid four years of private school tuition...going to the one state institution isn't all that surprising...but that was second chance of going away gone and another four yeras committed in Chicago.  This third time around, residency...during the application process, I applied to where the "strong" programs were. 

Fate again?  ER was born in the Midwest, so logically, many of the older, more established, and hence prestigous and "good" programs are right here in the Midwest with a couple outlyers sprinkling the coasts...but NY and Cali, two places that seem to draw so many of my peers like bugs to lights, just didn't have the programs.  Honestly if San Fran had it, I might have been drawn more in that direction...can imagine having fun there; beautiful Pacific fog lifting off the Golden Gate, weddings at the Marina across from great-aunts, the bakery in Chinatown that sells the ear-shaped biscuits, the tourist trolleys, retreat to the wineries a couple of hours away...In the more central U.S. though, its hard for cities like Detroit, Indy, Dayton, Philly-ish to draw me away from the city of Chicago.  By the way, I came into med school wanting to be an ob/gyne...how's it now ER that was born int he Midwest?!?  Anyhow, next three years here.  It's not that I'm not excited to be where I will be, but how is it that at decision point #3, still Chciago?  Is it really the comfort of the familiar?  Can that also be why, sometimes out of the blue, I like to check up on how easy it can be for me to take my American M.D. and practice in Hong Kong, where the most of the rest of the family is, especially in the young specialty of ER.   

I never thought I was anchored, but maybe that's just me trying to pretend that I am the adventurous, curious type...who in the end, hasn't wandered far.

Top Ten

From Dave Letterman on the night before Match 2006, 3/15/06.  Thanks for mentioning this, Parthiv :)

Top Ten Signs Your Doctor Is Drunk