July 07, 2003

Well I spent most of July 4th planted facedown in my bed. Call on my current rotation involves 24 hours on with 24 hours off the next day, an intervening "short call" day, and then 24 hours on again. I've never been much a sleeper during the day, but I'm pretty impressed with my ability to be Glasgow Coma 3 within half an hour of getting home.

When interviewing for residency positions, a interviewer astutely asked me at one point whether I felt like I could accomodate entering a new milieu where I would be bottom of the totem pole when up to now I've been regularly interacting with Chairman-level people in a collegial environment. Good question.

The simple fact is in a clinical context I am indeed an intern and have a lot to learn about what wielding an "MD" (paint still wet) means; and that entails a lot of "yes, sir; no, sir". A surgical chief resident simply isn't going to ask me about the difference between metagene analysis of breast cancer and hierarchical clustering. There is a good deal of administrative/secretarial work, but paying dues is part of any process isn't it?

I have a lot to learn, and the learning curve is still near vertical.

Then there the small satisfactions: I placed a chest tube in the MICU in a patient with a huge exudative effusion/empyema in his right thorax. The chief walked me through it--when you punch through the parietal pleural and see 1600 cc of pus come out of the tube and fill an entire Pleur-Evac, you know you did good. The patient claims he feels better. After seeing his pre- and post chest Xrays you'd think he would! Imagine carring almost a 2-liter bottle of Coke in your chest, that's gotta come out.

Posted by erich at 08:54 PM