Confessions of an Intern

Week Forty-nine

Week Forty-nine

Cardiology feels so warm and cozy to me. I am so happy on this service, I don't know how to express myself. While I am not interested in being a cardiologist, it takes me back to my nursing roots, where I spent so many years on critical care units, learning so much. I had an insatiable quest for knowledge back then and it has carried through.

It is a refreshing change from twelve to fourteen hour days to nearly bankers hours. A late day for me now is til five pm. Oddly enough, I still feel tired, and I believe it is that thing called "sleep debt" that our bodies exact from us, either through sleep or decreased function. We may think we can go a day or two without sleep or deprive ourselves of a few hours of sleep every day, but eventually our bodies will get us one way or the other. Despite still feeling a bit tired, and on edge because I'm not doing the things I want to do with my "spare" time, I am much more content. This is the last month of my Intern year. Can you believe it? To all of you who have followed, what do you see as the biggest thing to stand out through this first year's journey? I'd love to know.

For me, my mom asked me this week what is the biggest thing I've learned this year. I had to really think about it. Today I would say, the biggest thing I've learned is not scholastic. I have learned that I have good instincts and I should follow them. They will lead me down the right road much more often than not. I do have a lot of experience and I should not be ashamed of it. Earlier on, upper classmen would do things that did not make sense to me, and tell me I should do things a certain way, even though I thought it was unnecessary or not the right way. Now, I know to trust myself. You do not have to treat every lab abnormality you see.

Rule number one: Assess the patient. Treat what you find on your exam and what the patient tells you in your history.

Also, I do know more than I let on, but I also still have a lot to learn. This allows me to take it to the next level. I'm beyond basics on many things, and am ready for more challenging aspects of many things. This is the challenge I give myself: to not quit thirsting for knowledge.

Rule number two: Never let a day go by without learning something. Every day holds a lesson, you just may have to work harder some days to get it.

The next question my mom asked me was "what do you wished you would have learned in medical school that you had to learn in residency?" My answer was how to deliver a baby. Now, don't get me wrong, I learned the text book method. We all did, but there is something to be said about hands-on training. I learn far better elbow deep in it than I do reading the procedure a hundred times. I was able to deliver a breech baby because we practice it on models. Now that I am over twenty deliveries in, I feel much more confident in my ability to handle a normal uneventful delivery, and I also feel confident in my ability to pick up when things are heading south.

Rule number three: Know your limits! There is nothing scarier than someone who is clueless as to what they don't know or who refuse to ask for help.

So far, I realize I have shared very little about cardiology. This first week, I worked with a couple of cardiologists, doing consults and discussing cardiology basics with them. I decided not to tell them up front about my twelve years of critical care experience. I'm glad I didn't, because I was given an excellent lesson on EKG interpretation starting from square one which did well to fill in some blanks I've been struggling to grasp about more difficult aspects of the EKG. I enjoy the people I'm working with, and feel respected. The first doctor I worked with asked me on the second day working together, "What did you do before medical school?"

I smiled and told him, and was given a huge smile in return. He said, "I thought so. You are far advanced over the other residents in your ability to present the patients and focus on the real problems." Or something to that effect. Made me happy and a little proud of myself. I actually thanked him for the compliment, as I was told by an attending on OB that I should take them where I get them and not poo-poo them off. Anyway, here we are, friends, on the home stretch of Intern year. It's been quite a ride, and I am excited for the next phase. It will be another chapter...or book!