Also, you can add a comma here for comedic relief- Why, Cardiology?
Anyway, its just the best. I didn’t say this in interview season, but I am often amazed at how much I love this field and how cool I think it is.
Cardiology is one of the fields of internal medicine that is just so broad. Though people in residency made it seem like only one type of person goes into cardiology, I am pushing back against that, because it’s just not true.
July 1 is here! You’ve likely started your first job as a doctor and you are scared (petrified).
Some VERY normal questions that may be going through your mind…
How do I write notes again?
Where is the bathroom on this floor?
Will there be lunch at this lecture?
All of these were questions that were swirling through my mind as I entered my 3rd week of residency (recall that I had 2 weeks on night float to start out).
I have some practical things that I would share with myself if I could do it all over again.
Microaggression- “a statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.” (From Oxford Dictionary)
Before I took my graduation picture for medical school, the photographer said, “And what do you call that hairstyle? Do you need to fix your hair or something?”
I was wearing my hair in the puff that I had grown so fond of during my then 7 years of being natural. That day, my hair had made the most glorious puff in its own history.
This guy jumped in and made me feel small while I should have been celebrating one of the greatest achievements of my life.
Rome does a funny thing anytime I introduce myself to a new person and we get into the small talk of where I work and what I do.
“Oh I work at the hospital, I’m a resident.”
Rome gives me a death glare and subtly motions for me to go on.
“I’m a resident physician.”
Rome face-palms.
“She’s a doctor!” He basically yells.
I know that it has been quite literally 6 months since I “put some ink” on my blog, as one of my friends puts it. I have been so busy doing some major ADJUSTING to my new schedule and my life as not a med student but a newly minted doctor, New Jerseyan, and apparently adult. It has been so hard but so good and so rewarding and I will have to write about that in another post.
Anyway, I thought that I would write this post to discuss one of the rotations that I have completed already this year. I’ve actually done it twice by the time that I am writing and editing this post because I was one of the fortunate people to have a whole month of it in my intern year. I wanted to talk about this one both to provide some encouragement and so people can see what I did wrong and maybe make better decisions. Enjoy!
My intern year (first year of being a resident) began at night. I came into orientation that glorious morning and got my pager (an indestructible device resembling a small brick that rings when people want to contact you, for you generation Z people). Then I went home, took a nap, and showed up bright and early for my 7 pm shift.
Teams came in and began giving me the signouts for their patients. In other words, they gave me the pertinent information that would help me (or not) when I got paged for their patients. I took them all, attentively listening to the stories for all the patients because they were all so unfamiliar and interesting. At the end, I was drowning in lists of patients from all the medicine teams.
After all the teams left and it was just me and my two senior residents who were busy admitting new patients, reality and panic set in.
Me: Wait a minute, how do I log into the computer? Which team was I supposed to order a CT scan for again? *PAGE* Where is the bathroom? Where can I find this patient? *PAGE* How do I even order things? What blood pressure do I need to treat overnight?? *PAGE* Do I need to call the fellow on this patient? *PAGE* Am I hungry or just anxious? Are those fireworks outside? *PAGE* *PAGE* *PAGE*
My nights were crazy but I can honestly say that there were some things that I did to try and make logical decisions at 3 am.
Get organized early
At the beginning of each shift, before any of the teams came in, I would have a blank sheet that I would label “To Do” on one side and “Pages” on the next.
The to-do side would have labs that I needed to follow up on, the patient’s name, medical record number (MRN), and the patient’s team. This really helped me because I would just go through the whole list of things for follow up anytime I was at a computer and because all of the MRNs were there, I could run through them quickly.
The pages side of my sheet held the number that paged me, which patient it was for, and the problem that they were having along with what team they were on. This was so helpful because I could just call back the number without having to guess which one was for which patient. Also, it just helped me stay on top of my pages.
The learning point here is that you need a system. The first night I didn’t have a system in place yet. It was a mess. I’ll just leave it at that.
Go see the patient.
I first heard this when I was in medical school and it is something I have taken with me into residency. Frequently a patient will have abnormal vital signs or an abnormal symptom that requires evaluation. These patients, after I got a page I would put a red “I” with a circle around it to remind me to go see that patient. I had to go “lay eyes on them”, if you will. This gave me time to think about what I needed to possibly do for this patient and time to text my seniors if it was someone who was potentially decompensating. This leads me to…
Your seniors are here to help you!
No, they are here to admit patients. However, if you need help, don’t hesitate to ask them. There were some times that I really just didn’t know what to do from lack of experience (I was a medical student like yesterday!!), and other times, a patient’s symptoms were really concerning and I needed them to help me with the next steps to evaluate a patient overnight. Each time I needed their help, they were extremely gracious toward me because it was my first time being a real doctor and trying to make decisions.
Now, for the practical, non clinical stuff
Eat now, ask questions later
So night float was a funny beast, in that I wanted to eat at normal times at first, but couldn’t because my stomach was confused. I would get really hungry in the middle of the night when nothing was open, and when I would bring a large meal, my stomach was still confused because it isn’t used to eating oxtail, rice and peas, cabbage and a large drink at 3 am (I realize I am probably the only one with this problem). Anyway, I had to eat at some point. What I ended up doing that helped was eating small meals during my shift and a small meal when I woke up around 3 pm. I was able to eat in small portions much better than larger ones. I still ended up losing some weight on night float, but I wasn’t a hangry person during my shifts.
Stay connected
One of the hardest things about night float is the isolation. I think this was the one that I had the hardest time getting around. Honestly, I didn’t see Rome for almost a week when I was working for my last week. Plus, when you are awake and want to talk to all your family and friends, they don’t answer, because it is literally 3 am and apparently calling working people during that time isn’t polite. *rolls eyes*
Some things I did to combat this was facetimeing when I had my awake and not at work times. So when I first got into the house in the morning and Rome was at work, I would facetime him briefly and talk to him about my night and whatnot. I would call my mom when I woke up from my nap, and call my friends when I got to work, etc. I would work around my schedule, per usual. Telling everyone that I had a crazy schedule at the time helped so much too because people understood that I wasn’t ignoring them, I was just hibernating.
Don’t be unpleasant
It is easy to complain about how you’re tired, how you’re hungry, how the vending machine doesn’t have the special doritos that you like. If you do this, however, you’re forgetting that you have 2 other people who also are going through the same things that you are. Bringing up how uncomfortable you are won’t make you feel better, if anything it will make you even more upset. This is not the way to happiness and success, my friends.
Instead, try to be a light. Don’t be another grumbling, complaining person. It won’t help anyone.
Take a Walk
There is a blissful time between 3 and 5 am that the patients who were in pain in the beginning of the night have finally fallen asleep and no one is checking vitals in order to call you about hypertension. This is the time that I found myself in the basement of the hospital, walking laps. At first, the staff down there thought I was crazy, and eventually those same people were looking for the doctor in all purple to go down to the basement and walk a couple of laps.
It was a fabulous thing to do for my stress level and for my step counts. I did this every night that I had a free moment and I would always make a deal with myself and say that I would only stay down there until I got the next page (the blessed pager works in the basement). I would sometimes have 5 minutes before *BEEP BEEP BEEP* would sound and I think one time I had a full 30 mins. Either way, whether it’s 5 or 30, the effect was still the same.
I know I’ve been MIA, and thank you for showing me grace while I figure out my ever changing schedule. I’ll try to be posting once every two weeks or so as my schedule and my sanity allow.
Love you guys,
Lise
This post is mostly for the current student doctors who will be residents next year (Or if you haven’t done orientation yet for this year). Congratulations in advance! This time is extremely busy with moving and all the random onboarding things that are required to start your first job as a doctor. Here are some things that helped me get through orientation without any snags.
Extras:
Hope this non-exhaustive list helps you! The general idea is just that it’s better to be safe rather than sorry and that you shouldn’t make some of the mistakes I did.
Love you guys,
Lise
Before I got to college, I knew that I wanted to become a doctor. I just wasn’t aware of all the time and effort it would take to complete this journey to MD.
Disclaimer about this post: I am going to forever keep it real with you guys. I am not afraid to share my failures in hopes that someone else can learn from them. I can’t pretend to be perfect.
I went to college with a goal in mind, but I didn’t attack my classes and my life in general as a future physician would. I pretended as if I didn’t already know my weaknesses (Hey Math, I’m looking at you). Flailing around and hoping for the best was my mode of operation because I was brilliant, right? Answer: no, Lise is not brilliant, and even if she was, I don’t know that it would have helped her.
Some things I wish I had done:
I was taking some of the hardest classes on campus, yet I thought I would be able to keep up with the same apathetic high school class work effort. I went to all my classes, but I didn’t go to them prepared. I wasn’t focused and I essentially went as if I was going to watch a rom-com. I did this every day for an entire semester! You would think I would have learned sometime in the middle that I needed to get my life, and quickly, but no.
I didn’t keep in mind that I was LEARNING a lot of this stuff for the first time. In high school, I was just memorizing facts that I knew would be on an exam. It came easily to me then, so I thought it would come easily to me this time around.
This was a completely different ball game. “You mean anything is fair game? Even if we didn’t talk about it in class? So you don’t have to use the questions that you gave us on the study guide? There is a book associated with this class?”, were all questions that went through my head as I drowned in my first semester. I learned later that all this information I was avoiding learning would be resurrected when I was studying for the MCAT.
Why is this even important, Analise? Because when these topics showed up again on the MCAT, I wasn’t prepared. As much as I hate to admit it, I should have been taking notes and learning like I wanted to be able to REVIEW (instead of truly learn it the first time) it to prepare for this exam.
I had MCAT prep classes, I did the studying. However, if I had studied for the MCAT as I have studied for STEP 1 and STEP 2, it would have made a huge difference in my score (Hindsight is always 20/20 right?). This just means that when I studied for the MCAT, that was supposed to be my job. I was supposed to set a schedule and have a plan, but that is not how it went. I was haphazardly studying here and there, getting distracted then coming back to it, and wasting time and then wondering where it went… and then I took the test. That is not how I succeed in life, I’ve learned.
I could have taken the time to delve deep into my studying and given myself the freedom to put everything else on hold for that short time.
I knew that there was no way to simulate the situation that is medical school. I was told this many times before I started school, and now that I have almost finished school (Yay, 2 weeks away!), I completely agree. There is no reason to try and simulate it, nor do I think any simulation will be accurate.
However, I do think that having a plan when beginning matriculation is invaluable to success. This is especially important in the beginning when we learned so much, so fast. I simply didn’t have time to sit and think about how I was going to study. My study style changed when I went through the different classes and years, but the tried and true methods were good places to start.
The way that I studied for the MCAT was an excellent way to start off with studying.
I wish that I had taken organization seriously! After my first year in college, I realized that my same methods that I employed in high school would still work, I just needed to make fit my schedule more. I started doing them and didn’t look back. If I had employed these methods in my first year, I would have been less dazed and confused and more prepared.
Love you guys and hope this helps!
Lise
“You are always so busy!”
“How do you even have time to be here right now?”
“I feel like you are about to rush off somewhere to doctor on someone!”
These are just a few of the many quotes I got during my stint in medical school. Yes, medical students are extremely busy. We are always studying, learning how to be a doctor, or asleep.
The things that my friends, husband, or family members did to encourage me made me feel like a human again after all the studying. These are some of the things I loved.
Encouraging texts/calls. Even though I didn’t respond within normal-person timeframes, seeing these and knowing that my friends were thinking about me energized me to complete my next task. There are a number of rough days that I had that were made bearable by the kind and encouraging texts that I got from my friends (I guess this has to do with my Words of Affirmation love language). The texts contained scripture, encouraging words, or simple messages of love and changed the tone of my entire day.
Understanding if “something comes up”– I frequently tried to estimate when I would be leaving the hospital and was quickly reminded of why I was not a math major. I was COMPLETELY WRONG. I said things like, “Oh at 5 pm we can go grab coffee,” and then I wouldn’t leave the hospital till 9 pm because “something came up”. Real things would come up, too! If a patient was dying, I couldn’t just say, “Oh you guys got this? I have a coffee date with someone, see you tomorrow!”
This one really bothered me because I valued the time that I got to spend with my friends/family and it was sad when I had to cancel plans with them. Because of the wonderful friends I have, they were understanding and we would just take a raincheck.
Coming with me to random medical school functions that have nothing to do with you. I wanted to take part in everything that my medical school had to offer, so I had to attend at least SOME of the parties for students. My husband was a champion for this one. He was at EVERYTHING. He loved being there and was always engaged. This meant the world to me and was another way for us to spend quality time together.
Make adjustments to align our schedules. Once my friends got the hang of what the medical students were doing and when, we worked our schedules accordingly to fit each other in. For instance, on some rotations, lunch is from 12-1. Rome would sometimes come and pick me up from the hospital as soon as I was released for lunch and we would go somewhere and spend time with each other and eat. Another time, during my preclinical years, a friend of mine came up to the hospital and we grabbed some food in the hospital. We adjusted our schedules so we could meet up and spend some time catching up with each other.
Honestly, if you are taking the time to read this post and think through how best you can support and be there for your friend/significant other during a time that is arguably the hardest in their life, you are already a step in the right direction. Anything you do from here will be greatly appreciated by them, even if they don’t verbalize it.
Love you guys!
Lise
Every year in March, type A personalities all over the country find out where they are going to be spending the next 3-7 years of their lives. To say that this month is filled with tension, anxiety, and excitement is not quite wrong, but incomplete. It is more accurate to say that this month is all of the excitement from an entire year bottled up and being shaken to Coke+Mentos proportions.
This is the story of my experience.
On Monday, March 13, we found out if we even matched with a residency program. I was having breakfast with a friend for the first time and we spent the entire morning avoiding the topic that was undoubtedly on our minds- Did we match??? I found myself having the word vomit I always have when I am trying to distract or fill silence unnecessarily. She was forgiving and we are still friends because we have been through tough times like these together.
We got the email, which, cruelly had “Did I Match?” in the subject line.
Thankfully, we both matched.
Then ensued a weeklong celebration designed to distract us from the looming results of WHERE we matched, which were to be revealed on Friday.
First up was Karaoke night at Fenians Pub. We revisited 1st year memories of Med School Mondays, when we used to hang out after Monday exams. Monday night is a strange night for partying for normal people, hence, our #medschoolmondays tag. Our classmates crooned and swayed to the sweet melodies of “Thong Song” and “Hit Me Baby One More Time” this time around.
Next up was High Heaven, a trampoline park. My classmates insisted that this was a dangerous event, but most of them showed up anyway because the champions all walk across the Match Stage with a limp. Although most of us were careful, one poor guy did injure his toe.
After the bounce at High Heaven came the Crawfish Boil where we got to practice our “barbaric” eating techniques. My friend K, on eating crawfish, “You must rip the animal in half. Look it in the eye and throw its head into the garbage. Peel the exoskeleton off the tail for this small amount of tail meat. Then repeat x 50 at least because it takes forever to get full.” Love that K girl and her antics. She was totally eating the crawfish, in case you wondered.
Moving on, we attended a Happy Hour at Hal and Mal’s, a popular haunt for many of our medical school parties and a Jackson staple, to be honest. This one was full of tense giggles and encouraging elbow squeezes about the day that lay ahead.
Match Day started with a beautiful breakfast with our classmates and some family members. My stomach was in knots but I made myself eat because passing out on stage is embarrassing.
Walking up the many stairs of Thalia Mara Hall in downton Jackson was surreal. I kept telling myself that this was just another lecture or random medical school event to keep myself calm. Before I knew it, someone called my name and I walked across the stage.
I read where I matched.
I matched in Internal Medicine in New Jersey.
I. Was. Thrilled.
I was so happy to be starting residency somewhere. Also, going somewhere my husband and I would both flourish was the cherry on top of my proverbial cupcake.
Match week was full of events trying to help us ignore the fact that it was match week. I had a great time participating in every single one of them and getting to be that young fun girl I imagine myself to be. I now get to be young and fun in New Jersey.
Adventures await.
Lise
Some friends and I at Fenians on Monday Night after learning that we all matched!
Rome and I pointing in the general area of New Jersey, where we will be moving!