The get together

So one of the most difficult things about being in surgical residency is actually getting together with your friends. I know this seems silly, but it's true. I live outside of the city where I work. Most of the single residents live right near the hospital and can almost walk there. I on the other hand have a handsome husband who actually has a great job. Unfortunately this means we have to split the commute. In the evenings it sometimes takes me an hour to get home, just cause I can't get out of the city. What this also means is that once I get out, there is no way I'm going back into the city to hang out. Sometimes on the weekends if I'm not on call we'll venture to an event, make it easy and take the metro. But on a week night it's just not going to happen. I'm sure the single residents looking for love have a much more robust social life. That of course may be due to desperation, and not wanting to actually sit all alone in their tiny apartments. I don't blame them.....I like coming home to my husband and our little cats (and soon our baby).

The other complication is call. I'm buddies with lots of people that aren't the same year as I am. If I want to have a bunch of people over together I have to scour over the call schedule to see if anyone is even available. This also means that whenever we go someplace someone is cranky cause they are post call. So tomorrow night I have finally managed to get all my peeps together for dinner at our place. I'm terribly excited. There will be 8 of us, and one baby (not mine, a toddler). I've been living here for about a year and a half and I haven't had any of my close friends to my place yet. Slightly embarrassing, but true. Let's see how joyous the 2 post call people will be....

Code time

So one of the joys of being in the SICU is that I get to carry the code pager. Fortunately for me this means a couple of things. First of all I have a good excuse to ge out of rounds unexpectedly. Secondly I don't actually have to run the code. I could, and sometimes I do if I'm the first one there (don't let us fool you, us surgeons will run a code as well as the next guy, I would just rather not)....but the real joy of being the surgery code pager person is that I put in the line and say goodbye. If you're in the field I'm sure you've had the joy of placing a femoral line during CPR. If you haven't, well let's just say it's a serious treat. My intern likes to come to the codes with me and watch my mad skills at work. I let him tag along for teaching purposes, but that line is really my responsibility so there is no way he's going to touch it....at least not during an emergency. Putting in a line during a code is like trying to tie your shoelaces while jumping on a trampoline. The body is going all over the place, the patient only has a pulse from the CPR, and you are just praying you don't stick yourself.

This week has been a code filled week. Truthfully they have been pretty interesting. One in IR, one in an endoscopy suite, and one in CT (now that bites). But the best was actually outside. I didn't know this but my hospital actually requires us to respond to codes within 200yds of the hospital. So this guy got hit by a car outside the hospital and was thrown into the air like a rag doll. Who shows up with just the firemen there?...well that would be Dr. Me :)

When I was younger I was a firefighter/EMT. It was slightly nostalgic rubbing elbows with my old counterparts. But at the same time it was slightly ridiculous. I had forgotten how much EMTs can do....and for that matter cannot. I think that's one of the reasons I got out of EMS. First of all I never felt like I had a complete picture of the patient and really wished I could see them get better. The second was that I hated going to people's houses. I remember going to one house where the women was passed out in her bathroom, and I could see her through the window. We knocked the door down and went running inside. Her house was filled with newspapers and other clutter. There was a tiny path to the bathroom. When we got in it was obvious she had been dead for over a day. I hated the idea of someone dying at home all alone....it really bothered me. I guess at least now, even though I'm surrounded by the dying, I feel at least like I am either fixing them or preventing pain and suffering.

K-ankles

So I think i may be developing "kankles". You know, where your ankles become so big they look like they are as big as your calves....well I guess Kankles should be spelled with a "c" then...hmmm SO as a surgeon standing is the norm. I probably stand for eight to twelve hours a day, much of the time in multi-hour blocks. Yeah, it's not easy, and it takes some getting used to. I remember when I was in medical school I was a total fainter and it was a serious problem. I would be in a big case assisting...then something would happen. I don't know what it was, maybe I saw something new and absolutely gross, or maybe I just locked out my knees for a little too long. But either way I would just turn pale white, sweat through my scrubs and the world around me would begin to tunnel in. I never ended up flat on the floor, but I'm sure given another minute there were many times when I could have been.

So it's kind of expected that most surgically associated activities are done standing (unless you're a hand surgeon I suppose). This of course includes rounds. Now I'm currently on a SICU rotation, and that means that there is more of a medicine feel to the course of the day. It also means my attending is a medicine doc running a SICU. I was always more of a fan of surgeons that ran SICUs because I always felt that if they had actually done the surgery at some point in their career they would have a better understanding of the patient and their problems....plus it's truly a different style of practice. For those of you in surgery or medicine, you know what I mean....it's not that there is anything wrong with either side of the coin. Granted I think the surgery and medicine residents spend countless hours throughout residency mocking the other for their ridiculous consults whether they be for lactates not associated with any other symptom, or for DM that for some reason they can't control. But regardless, my current rotation involves a lot of rounding. Surgeons make fun of medicine docs for all of their incessant rounding and hours and hours of differentials and deep discussion into a BS of 99. But it looks like I'm currently doing the same....whether it be by choice or not.

This week was out of control and completely off the hook. Our attending (who I'll refer to as Dr. Cupcake) is the most strict, anal retentive, scares the crap out of you on a daily basis SICU attending in our hospital. Needless to say I am so happy to be done with his torture. Granted I did learn some important stuff this week....but I never like it when attending treat you like the scum of the Earth. It's not like I want to be scum. I'm actually quite interested and trying as best as I can. I really don't give the wrong answers just to ruin your day. In fact I feel bad and embarrassed when I don't know how to read your mind and give the answers required. See...I'm working it here. Of course this guy likes to round for multiple hours a day. This is after the residents have already seen the patient and written their notes. So we end up standing in the SICU for multiple hours at a time. There is no cool surgery going on, there is nothing to really lean on, it's just you and the constant pain and humiliation.

Being pregnant makes this even more difficult. I'm pretty used to pain and humiliation. I'm pretty thick skinned and just try to take crappy comments as a refection on the person they came from, and focus on the info I failed to regurgitate, and try to do better the next time. Otherwise I would be a wreck and wouldn't be able to to sleep at night. But the standing is killing me. I think I'm getting some swelling in my ankles too. Hence the worry about kankles. So I'm going to sit during rounds from now on (if I can manage it)....I think I'm going to steal one of the nurses rolly chairs and drive myself around the unit. Maybe I should even sport my suport hose from back in medical school. Let's see how this goes.

Exhaustion

So for those of you that know what tired is like, imagine being pregnant and a surgery resident. Now THAT is tired. I'm currently rotating on the SICU. At first I was pretty excited about this prospect....but now I think I'm completely over it. And the main reason, is that I'm freakin' tired. I haven't been on call, because I'm the only resident, and therefore cannot be post call....amazing how that works. But I can guarantee that I'll still be hitting my 80 hr mark this week. It seems that everyday around 4pm something terrible happens. By the time we agree with the attending on a plan and have intervened it's 5. Then when the chest x-ray finally comes back and we realize we gave the patient a pneumothorax or the line is going up the IJ instead of down, it's 6pm and we're scrambling to get stuff done. I am not a fan. I like to have things done and to be able to chill. My poor med students are convinced I'm a crazy pregnant women driven only by adrenaline and hormones. Quite frankly at this point I think they may be right. I'm currently afraid of the attending I'm working with and therefore I'm feeling almost forced to tough it through certain situations. But frankly I really can't round for multiple hours in a row without sitting in my current state. I got so hungry that today I and ran out of pocket food that almost threw up during our rounds. I'm sick of being tough. I'm a surgeon and it's looked down upon if you show weakness....really...it's true. I look at other residents and if they're good, the next thing is if they are bad-a$$ or not (cause if you're not good it really doesn't matter how tough you are). At this point though I think I'm going to have to take a break....I think I'm going to start sitting during rounds perhaps. I wish my belly was bigger so I could get a little more sympathy....and I wish my second trimester would come so I could stop being so miserable and actually enjoy this process.....

First ultrasound

Well today I had my first ultrasound....man I was nervous. Fortunately everything went really smoothly. All the measurements are exactly where they are supposed to be too! It was actually rather comical going to the OB. First of all I went during work. Yeah, I decided to deliver at the hospital I work at cause otherwise there is no way I could get time off to go to all of the appointments somewhere else.

So I'm currently running a SICU single handedly....ok I have 2 med students, but that really just increases your workload. So I had to convince the attending I work for to let me go even though all of our patients are sick as sh!t. I also had to give my code pager to one of the other residents. I didn't want to end up stuck in stirrups when a code came through and be stuck with my pants down (literally). I must have said something right cause I actually got there on time to my appointment. The waiting room of my OB is always a strange sight as well. It's an inner city hospital....there are tons of pregnant teens with their no good boyfriends, and people with a billion kids already. I was the only doctor in the room....and I think maybe the only person in the room who actually had a planned pregnancy. It's really sad actually. Big problem in our society that I probably shouldn't get into.

Needless to say it was nice to have another data point. I ran around my SICU for the rest of the day dropping Swans and tapping lungs with a pic of my baby in my pocket. I'm living the life....

Anticipation

So tomorrow is my first official OB appointment. I admit I am seriously nervous about it. I think as a physician I have seen a lot of terrible things and I worry that they may happen to me. I remember in med school on my OB/GYN rotation these poor women who had miscarriages they didn't know about til we told them there was no baby. There were patients with children that just came out all wrong and we didn't know in advance....I know just enough and have just enough real experience to put myself into a tizzy. My husband fortunately is great and is trying (although not completely successfully) to calm my fears. Our current stance is that more data is needed before any conclusions can be made, so it would really just be a shame to worry so much. But now I guess I've gotten into a mode where nothing is going to fix this until I go to my appointment...I think I'm going to puke.

Airlines

So today we ventured back home from our short vacation to see the rents. I'm not even that pregnant and I realized today how horrible plane rides can be for the parasite impaired. Fortunately for me the flight was only a short one hour in the air, but the landing was a different story. My husband is a seriously tall guy so every time we fly he gets the aisle. Yes I know I'm pregnant and I should just make him deal, but it's painful to watch him crunch up like and accordion.....so I was stuck in the window seat, with a kicking toddler behind me, and a pilot who got his license driving bumper cars. Seriously, I thought I was going to toss some cookies during our landing. My husband nervously removed the air sickness bag from the seat pocket just in case. Thank goodness I didn't actually have to use it. This was kind of like keeping a scalpel in your pocket. For those of you who aren't in the field, or those of you who are and think I'm silly....keeping a scalpel in your pocket keeps the bad vibes away :) Yeah a senior surgeon told me that once. So I carry one, in hopes of never having to actually use it for an emergency. I will wave it in the air during a stressful moment in the trauma bay and it seems to calm the masses. (Yes it's still sterile and wrapped, it's not like I'm waving a knife in the air like a crazy person.)