Honeymoon over

So I was loving pediatrics. Not that anything has actually changed, but, like I've said before, even if you like doing something, doing it too much can kinda kill the joy.

The last two weeks have been busy, with long hours. Most regular days have been about 13 hours long. Sometimes 12, on one occasion, 11. Calls have been busy, hard, intense. On my last call I admitted 5 patients between 9 PM and 3 AM. What doesn't help the feeling of pediatric saturation is the fact that my precious golden weekend was almost entirely spent on my bathroom floor barfing, and the following several days I was barely strong enough to stand.

Last week: Monday: 16 hours, Tuesday: 12, Wednesday: 11 (woo!), Thursday: 14, Friday/Sat: 32. Grand total of 85 hours (correct me if my math is off).

The good news is, I have found something awesome for my few hours of spare time here and there. Randomly, I ran into a girl in my building who has a horse and not enough time to ride it. And, hey! I'm a rider without a horse! It was an arrangement that met both our needs. Total mutual awesomeness. I can't even begin to emphasize what a great coincidence it was that I ran into her. I had just happened to get on the elevator wearing a horse shirt and it all just... happened. The horse's name is Shiloh and she's kept out in Gig Harbor (a 20 minute drive and $3 toll bridge). She's a adorable, very sweet, good ground manners, speedy as all get-out and pictured at left (took that with my phone today). My goal is to try and get out and ride her on the 11 and 12 hour days, when I have a few hours before having to go to bed. It really is making my 80+ work weeks a little more bearable. It's better than drugs, therapy, massages, beaches and just about anything except a day off to do it even more.

Today, sadly, was my last day off for two weeks. I grocery shopped, rode Shiloh, took out the trash, did my laundry and cooked like a fiend. I made hummus, black bean soup and lasagna to hopefully last the two weeks. Now, I buckle down and watch time fly... hopefully.

Oh, and as an aside. Also a random coincidence. As soon as I find out about Shiloh we start admitting kids with organ damage (lacerations of livers, spleens and kidneys) from horse accidents. No kidding. We've had three in the last week. Thankfully, aside from being a bit grouchy when it comes to cinching the girth, Shiloh has been a perfect doll!

A Week in the Life

Monday: Finish orthopedic surgery/sports medicine. AM at the army base, PM in sports med clinic. Done by 6 PM. Get sign-out on the patients I'm picking up in the hospital tomorrow for new rotation. Some are really sick kiddos. Finished with sign-out/chit-chat at 8 PM. Realize I have to go to bed in 30 minutes to get 8 hours sleep. All in all, just about a 10 hour day (not including sign-out).

Tuesday: First day on new rotation. In-patient pediatrics. Get there at 6 to start rounding. Round until 7, then it's morning report where I hear about new kids that arrived overnight. Then round until 9:30. Finished seeing my 7 spanking new (to me) patients just in time. Then round again with the whole team until 12:30. Then do floor work until 5 PM (discharge about 5 patients). Sign out to the person on call and get out before 6. 11-ish hour day (doing really well so far!)

Wednesday: At work by 6ish. Similar deal. Finish rounding around 12:30. Have required conference until 1:30, back to work to finish floor work. On call, take sign-out for other services. Admit only two patients. Am signing out by around 9 PM (night float is overnight Su-Thu for those confused about overnight vs. non-overnight calls). Home just before 10. Finish preparing a presentation I have to do the next day. Bed by midnight. 15 hour work day (not including presentation stuffs).

Thursday: At work at 7 AM. Round until 1 PM. Floor work until 2-something. Get to go to about an hour and a half of didactics (didactics from 12:45-5 on Thursdays). Give my presentation at 3:50. Run back to hospital for sign out. Am exhausted and leaving between 5 and 6 PM. Go for a walk at point defiance to enjoy rhododendron garden (see pics). Have DQ for dinner. Somehow end up not going to bed until 9:30-10 PM. Excited to sleep. Am sick and decide not to take Nyquil for some reason. 11-hour work day.

Paged at 12 AM.

Friday: Up at 12 AM due to page about a patient in labor. Can't go back to sleep because I'm coughing so much. Paged again at 2 AM. Go into hospital. Glad I didn't take Nyquil. Manage her labor until 6 AM when she actually starts pushing. No sleep in interim. Deliver baby around 7 AM. Sew up her lacerations for a half hour. Paperwork and examine baby for next half hour. Frantically round before 9:30. Round with attending until 12. More frantic floor work until 1:00. Try to nap from 1-1:15 but get paged three times. Cry a little out of frustration that I CAN'T SLEEP! Then stuff face with lunch and go to clinic from 1:30-5 (manage to brush my teeth too). Of all the days, I have my a one-on-one with an attending observing me to critique my clinical skills. On two hours sleep no less. Thankfully it randomly is the attending that was my back-up for the delivery so he gets where I'm coming from and is wicked tired himself. We are punchy, loopy and totally out of it but manage to rock through clinic. Leave around 5:30 after convincing people I am okay to drive home. Walk out of door holding car keys in hand yet immediately forget I drove to work and walk home. Get to my apartment and wonder why I have my car keys out. Figure it out and shrug. Let myself in, eat, make a couple calls, watch a little TV, go to bed at 8 PM. About an 18-hour work day.

Saturday: OFF! Wake at 9 AM - a good 13 hours after crashing. Grocery shop, laundry, go get my car. Am groggy most the day and forget about both a friend's daughter's birthday party and an R1 outing. But am grateful to catch up on sleep. Go to bed around 8:30 with some cough syrup bedside.

Sunday: On call. A measly 14 hours of work. But insane nonetheless. The night was full moon worthy. But I was relatively well rested (thanks to my cough syrup with codeine).

This week was just about 80 hours. Not too bad considering the crazy delivery that mucked everything up.

The good news is that all the work I've been doing has been pretty nice. I have enjoyed the week overall. I hope that feeling sticks! It probably also helps that it's been sunny. And check out the size of that uprooted tree! HUGE, eh?

Nose, meet grindstone

Back from vacation and now it's on to four consecutive months of 80-hour work weeks with the usual four days off a month.

Please allow me to heave a huge sigh of self-pity.

*sigh*

On the bright side, I'm getting one the of most dreaded, dangerous rotations of second year out of the way right out of the gate. By dangerous I don't mean the rotation is performing prostate exams on sky-divers. I mean the well-being of pregnant women and unborn children at Tacoma General will depend primarily on little old me every fourth night all of July and August. Translation: every single delivery, tragedy, ER case, c-section, pre-eclamptic seizure, preterm labor rule-out, everything, anything, that could possibly happen to anyone pregnant at Tacoma General is my responsibility. There are exceptions for private doctor's patients but, really, until that private doc comes in from, say, Gig Harbor, to see his or her patient I'm the back-up. Also, it is true that there will be at least two attendings available to help me. At least one of them in-house. And there is another resident in the hospital doing night float that I can call for help in dire situations. Despite all that, I can't help but feel that this is a risky way to go about bringing life into this world. However, it's not my call and it's been done like this for a long time without any truly adverse events (that I know about). I'll be sure to let you all know what it's really like when I'm in the thick of it.

As for the two months before that. These remaining 7-ish weeks of internship I will be rotating on in-patient pediatrics. I think the last time I did that was October of 2005. So wish me luck on that.

The bad thing about this stretch is that I will not be able to take advantage of the NW's supposedly gorgeous summer - the reward we get for enduring the abysmal weather of the last 6-7 months. The silver lining is that at least in my 80 hour weeks I will get to still see some daylight. Even if it's just during my trip from hospital to bed. The other silverer lining (wordsmith = Liz) is that the dreaded two consecutive months of R2 OB will be o.v.e.r. and I will begin to have a better idea if I want to pursue OB as part of my future practice. (photo I took of tree in Wright's Park).

I feel like I should include a brief summary of my vacation. It was rather nice. I got to see lots of friends, spend some QT with family and even got to finish reading a book. I went for a few runs in a park, walked around Detroit (took photo at left of Spirit of Detroit), saw a ball game, and spent part of a day in Grand Rapids and ate awesome Indian food at a friend of a friend's Hindu celebration/ceremony. I relaxed, I rested, I ate a TON of ice cream. It was good and I actually feel pretty refreshed (despite the nasty cold I caught somewhere along the way).