This weekend was one of the better weekends that I've had in a while. Ask me why sometime.

Today I diagnosed atrial fibrillation. The nurse called me because a patient was feeling heart palpatations and her pulse was 140. So I ordered an EKG (that's right everybody- Jackie's ordering her own diagnostic tests- no hesitation or anything) and read it, and sure enough- atrial fib. Not only was this a triumph for me because I was able to recognize that she needed an EKG, it was also great because atrial fibrillation is one of the few things that I can read definitively. Like, there was no question. Diagnosis- atrial fib.

It was the greatest day ever. I'm a superstar.

Okay so it wasn't that great. In fact, this is quite a small thing to deal with in medicine and any idiot with two years of medical school could have done it (and clearly, they did.) But you know, let me have my moment for today.

Up until this year, I've found that it has been fairly easy for me to define my "role". For a long time I was a student, which meant that my day-to-day jobs were fairly self evident. I was responsible for turning up for class, taking notes, reading whatever books they wanted me to read, preparing whatever assignments they wanted me to prepare, and write whatever exams were scheduled for me. Done. I could do that. I could feel comfortable doing that.

But NOW, all of a sudden, I am totally out of my element at all times. Not only do I not know the answers to most questions people ask me, I am also totally unfamiliar with hospital procedure, I don't know what I'm supposed to be doing at most times, and I never know what to do whever anyone asks me anything. People keep asking me questions about low urine output and high potassium levels and expect me to have answers for them. While theoretically I've learned about all these things in class, not only is my recall not lightning-fast, I have no idea how most of this "book knowledge" translates over into real life. I also have no idea whether what forms to fill out for anything, how to admit someone nor how to discharge someone, and I am never sure about medication doses.

So basically I wander around the hospital looking like a complete idiot most of the time. I'm not pleased about this. It certainly motivates me to study, but a lot of this stuff can't be studied. I just have to be an idiot for a while until i figure it out.

I entered a few of the photos I took in India and Thailand in a contest at school. Here they are. If I win they might be in a calender or something.

Today I saw a woman who had miscarried. Before i went into the room to see her, I was freaking out a bit because I was unfamiliar with Spontaneous Abortion and I wasn't sure about what sorts of questions I should be asking her. My mind was racing because I didn't want to miss anything- should I be asking her about her family history right away, and did I need to get into a contraceptive history??

Then I walked into the room and she was visibly upset and i felt like an asshole, because, oh yeah, this interview really ISN'T ABOUT ME. Its funny- for the past two years in class they kept stressing how important it is to maintain your humanity and view your patients as people and such, and everyone kept thinking that this was a bit of an inane viewpoint- of COURSE we would treat our patients as people. Who are we- insensitive jerks??

But then now, when I'm actually doing it, my mind is so preoccupied with not missing anything and making sure I am thorough that its easy to see why we get these lectures. Because its easy to be preoccupied with the scientific aspects of stuff and ignore the social side of medicine. Hmm. Who would have thought?

So I've been reading this guy's blog- he's a med student doing his Obs/Gyn rotation as well. Its pretty hillarious perspective.

Um, okay, so I had a good night I think. Some things were sorted out. Um, yeah.

Bizarre, BIZARRE session today. We spent an hour with the fertility clinic doc- because we're doing obs/gyn. We get to his clinic and there's sushi and water waiting for us- FRICKIN SUSHI! Usually if we get free food as students its pizza- and even then we'll gladly take what we can get. It turns out this treat was supplied by a drug rep, which was weird. Usually the reps only latch onto doctors, not students. (Although our free textbook last year was pretty sweet...)

So here I am feeling guilty about eating drug-rep sushi (I had the whole debate with myself as to whether I should eat it or not- I know that drug reps are evil and everything, but there isn't a lot that is going to stop me from eating free sushi.) And then the doc gets into his talk- which has nothing to do with fertility, and everything to do with how not to get screwed by your partners, and how to optimize OR time while making sure that someone cleans your house. The take-home message was that as doctors, we're supposed to pay people to clean our houses and stuff and not feel guilty about it.

I know this man meant really well- and I really like him a lot- he's a very sweet guy, who just wants to give medical students some direction. You can tell that some of these incidents have come straight out of his own life- like telling us not to fight with our spouse over housecleaning and stuff- also I guess that OR thing was probably pretty personal.

But it was really, REALLY weird to be talking about all of the money that we're going to be making, and how to optimize our practice and stuff, when clearly we are very VERY far away from that point. He was talking about how to get into a big call group so that you don't have to take call more than 1 in 8, and here I am trying to get through my first rotation without looking like a complete idiot.

There is also this unwritten rule as a med student that you're not supposed to talk about the money. I mean, we all know that we are going to do well (at least moderately well) when we finish school. But you're not really supposed to talk about it. To mention the money is kind of like selling your soul to the devil- you're not supposed to ENJOY the money we're going to get, its more like, compensation for the long hours and dedication and what-not. And you're definitely not supposed to ADMIT to liking the money. So it was strange to have this guy talk about it right up front- the first thing he said to us was "you guys are going to make a lot of money." Um, okay. Glad we cleared that up. Now let me go buy my yacht and get it over with.

I had my second night of call. The whole day/night I was at the hospital was ridiculously long- I got there at 7am on Monday morning, and left at 9am on Tuesday. (I did sleep for about 4 hours in there though- so don't think that I'm especially hard-core.)

Call was sort of fun- during the day when there are a lot of people around, I don't get to do a whole lot, because all the work gets passed to the residents. But at night when there's only a couple of us, I can be more involved in what's going on. Last night I saw a couple of vaginal deliveries, 2 C-sections, as well as assessed a few patients in triage. (Not by myself, of course- I saw the patients, then my intern saw them, and then the resident saw them. And then sometimes the resident calls the attending on call- see, there's a lot of backup.)

I got home at 10am and slept until 2pm- it was sort of a weird day- I was at home during the day with not a lot to do, and I saw still really tired.

Also- Rea's mom was one of the nurses working the overnight shift and I was really excited to see her! She was really nice and gave me a big hug and helped me out with lots of stuff.