Callous

"Intern year makes you callous in a way that you'd never imagine yourself being" ~2nd year resident.

Wise words, and oh, so true.  Is it the long hours, the feeling of helplessness, that what you are doing has so little effect on a person's ultimately outcome?  Or is it the rude patient, the inpatient nurse, the demands of too much to do in too little time?  Or is it simply the exhaustion that wrings your temples, turns your brain is a fog.  All you can do it stare at little blue check boxes and check them off.

We are all preparing for the holidays, a time in the hospital where residents work at half staff.  It means double the work for everyone.  It's so half of us can get a few days off while the other work.  We call it a "war."  It is not a good time to be in the hospital.

But I was reminded today by an attending, in a simple email.  That however hard it is for us to be in the hospital during the holidays, it's even harder for the patients.  So wear a jolly hat and stuff your pockets full of little candy canes. 

That's exactly what I'm going to do.

Dear (in)patients...

Here's how you can make your inpatient stay more successful:

1) Carry a list of your home medications.  I want to hug you when you whip out a piece of paper, however scrappy, with the meds you take at home and their doses.  If you can't do that, at least bring all your pill bottles.

2) If you get most of your treatment at one hospital and have been admitted to that hospital several times in the past year, for the love of God, please go back to that hospital!  Please don't decide on a whim to come to this emergency room, because "I was at my aunt's house and it was the closest one." Your usual hospital is only 5 minutes away from this one!

Fact: your care WILL suffer since we have NONE of your past medical records.  And you know none of your history.  And while we try very, very hard to figure out what is ailing you, it is impossible to get the whole story at 2 AM.  We will waste a lot of time on our part and your part figuring out what you did and didn't have done at the other hospital.  And this will make our treatment of you here much slower and worse.  All the extra CT scans you get here because we can't look up your scans at the hospital...well, that extra radiation will give you cancer later on.

3) Be an active participant in your care.  We love it when you ask questions; we like it even more when your family is involved.  (Family involvement = positive prognostic sign)  To maximize your ability to participate, ask your nurse about the hospital workflow.  What time does the team round in the morning?  What time does the attending (chief) doctor round?  When does the team discuss your daily plan?  These are opportune times to ask questions. Even if we don't have time to answer right away, your questions let us know what's on your mind.  And then we can better prepared to come by later to discuss them.

Random bits of pregraduation insight

>At a graduation party, in a discussion on succeeding in academia:

"Don't take no for an answer - paper's rejected?  Don't resubmit it?  Nonsense!" - Dr. H

"The rejection never stops...it gets worse the further along you are in academia, so keep forging ahead!" - Fellow

>Re: taking the boards

"If this is an issue of national security vs. taking the boards, I'm taking the boards!"

Post-interview, pre-match time

It's the beginning of February.  I am done with interviews (who hoo!) and just waiting.  How come nobody tells you that the waiting part is the hardest?  As an eager, premed college student, I remember an article describing Match Day at our school.  Exciting, but it was so far off then and only a dream.  I came across another one of those "Match Day" articles and it felt totally different.  It's real now, baby.  Somebody please write me a script for Xanax. :)