Day 31: Hope

In an hour I'll be at the hospital, the only intern covering the floor. ALONE. I hope I make it through the night. I hope no one codes. I hope no one complains of any pain. And above all I hope this is not how I feel in the AM.

I feel like I'm in the movie Independance Day, the part where the president gives the speech. Too bad Will Smith doesn't work at my hospital.

Godspeed.

Day 30: The Pep Talk

I caught one of my co-interns post call and this is what he had to say about the experience:

Being on call is like that initial scene from Saving Private Ryan. The scene where they are storming the beach and something blows up near Tom Hank's ear and he loses his hearing and is looking at a silent scene of battle unfold in front of him. There is carnage, gunpowder, blood, gore, complete chaos. War.

And then all of a sudden he regains his hearing and immediately hears a loud explosion.

That is like being on call, and that explosion is your pager.

I'm on my first overnight call tomorrow.

Day 29: A Healthy Home

I had a patient today, who was well and stable enough to go home. I thought it was difficult and overwhelming for me to figure out how to treat his cardiac issues. I did not realize until today that, that was only one piece of his illness.

This man is an illegal immigrant who is chronically ill and cannot work; and as a result lives meal to meal and is home less. Hospitals cannot discharge patient's to the street. That is neither an option on the form we fill out, nor the option your consciousness should allow.

And on top of it all he cannot afford his medication. He is not eligible for a government voucher, nor can he afford medical insurance or apply for it without a SSN.

This is a sickness.

He may have exacerbation of his heart failure which causes him to feel suffocated and unable to catch his breath and to make him feel as though a giant weight is on his chest. But that is 1 week of a disease manifestation. The social issues this man deals with are a life time of suffocation, of an insurmountable weight on his shoulders.

This is what my task is tomorrow, to help him sort out his life enough to find a safe and stable place to sleep and to get him the medications he needs; at least for a short while.

Cherish your life, because you have no idea how good the hand you were dealt really is.

Day 27/28: In the Dark

Today I went to work while it was dark out and came home in when it became dark out - 5.30am-10pm. I am even more disoriented than usual, and I am pretty sure I am seeing double at this point.

For the last 2 days, I have just been doing, doing, doing. There is no time to sit and process what is happening. It's just a blur of interns running around with to do lists, hoping their patients are getting better and not worse. And above all hoping no one dies or codes.

So, essentially I am in the dark on all fronts.

Day 4 on the floor and I pretty much hate my life. Where is that inspiring patient? Where is that motivational attending? How DID JD have so much time to day dream and play out musicals in his imagination? You led me astray scrubs, you led me astray.

Day 26: Bunny Ears

Basically, today on the floor the inside of my brain was like when you get "snow" on your T.V. Not just the "snow" but also with a lightening storm electrocuting it continuously.

I don't even know what I did over at the hospital today, it's mostly just a blur of beeping pager and this one nurse and social worker continuously harrasing me. I think I got most of the work done and everyone was still alive at the end of the day. Day 1 : success? We shall see, if when I show up tomorrow no one is handing me a pink slip.

I don't know what the intern equivalent for the "T.V snow" is, but if those bunny ear antennas would help do some paperwork, I would definitely strap on a pair.

Day 25: Second, First Day Jitters

Tomorrow is my first day as a floor intern- if you're fortunate and not familiar with the hospital world, the "floor" refers to the general medicine inpatient service. Or where sick adults get admitted when they are in the hospital.

I was not nervous on my actual first day of work. Today my body decided that it was time to teach me a lesson for being so chilled out all month and having a lovely time on electives; and so due to that pukey stress feeling, I was reduced to vegetating on the couch watching Netflix dvds.

About a month ago "swimming pool party" was going to get me through the first day; I have become immune to the magical healing power of the swimming pool party Youtube video; and now must smack myself into forced optimism. Hence, this is what I will be doing at 4 am for the next 4 months.

Day 24: To Be Cotinued

If you take anything away from this completely tangential blog, let it be this:

If you ever feel like you are in a ridiculously awkward situation and it could not possibly be more uncomfortable; you are wrong my friend, things can always become more awkward.

Stay tuned tomorrow for a real life example.

Day 23: Boogie Woogie

Have you you ever had one of those moments when someone is pronouncing something horribly incorrectly and you think that you should correct them, so that they don't go the rest of their life making that mistake? Now what if that person is your boss, your senior, basically someone higher up on the totem pole?

Now what if the same sort of "higher up" is pronouncing your very name incorrectly? Do you correct them, do you loudly introduce yourself to other people in their presence, do you glance pointedly at them when someone says your name CORRECTLY?

To go even further, what do you do if your boss or senior has a booger in their nose? If you are me, you try to first ascertain that, that is in fact a booger. Then you wonder if pointing it out would embarrass your senior so much that he/she will resent you forever. Then you wonder if you, yourself may have something awful sticking out of your nose or on your face (then you would just be a pot calling a kettle black). And hopefully, you will spend so long reasoning this out, that the person will eventually leave and you will be left reassuring yourself that someone else will point out that booger to them.

Day 22: What's for dinner?

Monday thru Wednesday I am a fairly efficient human being. Since I'm trying not to be the dumbest intern in the history of interns I try to come home and read about a thing or two. Thursdays I usually hit a wall and turn into a completely different person, the disheveled kind of person that other people shake their heads at, wishing she would pull herself together and maybe brush her hair also.

This usually ends with me attempting to do a regular task and crashing and burning instead. Today, I thought I would go over the section on asthma for the billionth time and maybe because I've read it so many times things would be quick. I recall reading the first three lines, then it was half an hour later and I regained consciousness with one leg on the couch, one off; leaning sideways into the back rest with my head at a painfully awkward angle and the book miraculously still in my lap.

Subsequently, I decided to make up for the lost time by "making" myself something to eat. Unfortunately, I was still not awake and put some frozen samosas in the oven and realized 20 minutes later that I never turned the oven on. I then debated eating the frozen samosas as is because I was so hungry. But that induced nausea so I made a sandwich instead.

Don't complain, nobody ever said every blog entry would be riveting.

Day 21: Sleep Fighter

When I was a medical student attending teaching conferences at the hospital, I was pretty shameless about my fatigue. I would start nodding off, and my blinks would became progressively exaggerated, eventually I would end up with gaps in my recollection of the past hour; unless of course, a trusty friend was sitting next to me to play hang-man with.

Now that I am a resident, I am probably more fatigued; however, not once have I even thought about feeling tired during conference. What is the secret? A new coffee laced with lethal doses of caffeine? No dear reader, my stimulant is fear itself. I have so little medical knowledge that I feel perhaps I suffered from a head trauma after graduation which would logically explain my complete memory loss. So now I must cram every fact I can get my ears on, into my brain.

Additionally, we all realized that residents, though they provide cheap labor that real live doctors would rather not do; are still dispensable and can be fired. I worked very hard to get a job which is going to be quite likely a hellish journey, that will make me question my sanity at every turn, but will in the end be what I always dreamed of doing - a whole lot of paperwork and sometimes making someone feel a little bit better.

Day 20: The Stay At Home

Me: "I wish I had a stay-at-home husband who would be glad to cook and clean for me, and fill my car up with gas and wash it too. And maybe sometimes drive me around."

Friend: "That's called a maid."

Me: "You have to pay a maid; also never mind, I want to be a stay at home person without all that housework."

The things we say when we are deliriously tired.

Day 19: Camera Shyness Explained

I am not photogenic; during one brief 2 year period in the past I was photo-adequate; as in people were ok with sharing pictures with me and did not feel like I ruined that memory. That was in the past; post-puberty and pre-super stress life.

Unfortunately, those years are behind me and also unfortunately this lack of photogenicity is only amplified a million times on I.D card pictures. In fact it is so ridiculous that I usually don’t even look like the real life me on my ID cards. Once, a customs official looked back and forth at my picture and me for a solid minute before deciding that it must have just been a bad day and I was indeed the same person.

In my defense, on the Canadian passport picture we are not allowed to smile and instead must maintain a neutral expression. I’m not sure what a neutral expression is, but whatever I interpreted it as, has me captured in film looking like a constipated criminal.

I was hoping I could surmount this rather awful lack of photo talent on my hospital I.D badge, after all I would be wearing this on my lapel for the next 3 years and as you all know during residency things in the looks department only go downhill.

People should be able to look at my I.D badge and think, “Man, at one point this was a regular looking person, maybe things have just been really rough and that explains her current status.”

I really wish there were do-overs in life, I would use that pass on that fateful day I had my I.D picture taken. The I.D picture was taken the same day the ‘pee fiasco’ occurred, read here for more details. So, in summary on my I.D I look vampire pale, and for some reason my cheeks are super flushed and my mouth is inexplicably garishly red. I’m glad I never have to look at it, and in a few months when everyone knows my name I’m going to flip it over.

Day 18: Lists are for Losers

I have many compulsive tendencies, unfortunately remembering what groceries/toiletries I need is not one of them. And so this is how I find myself wandering around those really cheap mega stores that are a giant conglomeration across this nation - for an hour or more every other week. Lists are for losers who can't remember the insides of their own fridge - I am better than that! I got this!

These are my sentiments, until I find myself moments later aimlessly going up and down aisles with more toothpaste because I have forgotten how fat the tube was at home, clutching more milk when the carton at home probably has another 2 weeks left. And worst of all - collecting useless things that seem like they would make an amazing improvement in my life, and everything would start falling into place because, I now have that one thing that I never knew existed until now; but will surely organize my life into some sort of zen haven.

And this is how I end up lugging a number of heavy bags of groceries on one arm while clutching a giant plastic organizing contraption under the other, up 3 flights of stairs; I know if I just focus hard enough, I will not crush all the bread against my side and there is no need to make 2 trips to the car.

Day 17: Confessions of a Dork

I can’t afford a TV, which is rather unfortunate because now when I come home from work I am forced to sleep for lack of more entertaining things to do in my post-work stupor.

Additionally, my internet is weak since I didn’t opt for 'Roadrunner ultimate super duper speed' and instead got the 'Road kill Roadrunner Speed'. And so watching TV online is not a good option unless I want buffering to drive me insane.

These are the circumstances which caused me to sign up for Netflix yesterday. Drum roll for the revelation of the exciting DVD I chose to watch first – Mythbusters. Yes, friends I am a tremendous dork.

If this in itself was not attestation to my dorkiness, I will reveal another secret – although, I am not a Star Wars fan I believe I do a good Jar Jar Binks impression.

Day 16: Laundry Underworld

Today, I decided to go down to the laundry room to get some scrubs since next month I’ll be doing night shifts when we are allowed to walk around in scrubs like the lazy surgeons do. The laundry was not what I expected, first of all the walk down there was basically eerie. There was a grimey staircase that smelled like an alley people pee in that led to a long, wide hallway which was poorly lit and lined in unfinished cement. The hallway became progressively hotter until you finally ended at a boiler room; which looked like something out of one of those action movies where in the final scene there is an epic battle in a room with pipes and smoke and boilers.

The laundry “room” to the left was more of a laundry stadium. The temperature and air down there is as I would imagine hell to be, if such a place existed. It was the kind of heat that sucks the air out of your chest and makes you question if you will ever breathe again. The room was filled with these extraordinary machines clumping, and slamming and screeching. Gigantic machines whirring away spitting out flattened coats and scrubs and sheets and pillowcases.

The most extraordinary thing in the place was the people working there. I imagine they are on their feet all day, likely get paid a minimum wage, work in sweltering heat and go completely unnoticed by the world upstairs no one realizing when they ask for a pillow or a towel just how much hard work and toil went into cleaning it.

I think I have never expected gratitude from patients but there have been occasions when a difficult patient who argues, complains and fights and in the end is completely noncompliant has aggravated me. But in all honesty, I think even that I will now take in a stride; because at the end of the day I am pretty fortunate to have the job that I do; especially when I consider all the people living and working in such difficult anonymity just below the surface.

Day 15: Wind vs. Water

Whenever any of us gets sick or feels unwell at home, my mom’s diagnosis is always, “you have gas.” Whether you have a headache or pain in your shoulder the root cause as per my mom is flatulence. I, on the other hand attribute most common ailments to dehydration. Instinctively, if someone is dizzy, fatigued, has the flu or a cold, has a headache I attribute some of the symptoms to dehydration.

Nothing, a bottle of Gatorade probably couldn’t fix, prophylax or alleviate at least somewhat.

Today, during rounds while we walked towards a patient room, my parched attending walked into a wall. We all bit back laughter and she was fine. But I’m sure if she had been hydrated she would have been more alert.

And for our sake I am glad it was not the alternative –gas.