Sucked

So I had a stint on a urology team at the most "intense" hospital on our campus. The way this month works is, I do urology for 10-12 days, then anesthesia for 12, then urology again for 12 days. Thankfully, my 2nd urology stint is at a different hospital. The children's one, even.

But seriously, that team was horrible. The hours were crap as you'd expect: show up at 5:15am to help the intern with pre-rounding scut work, then round at 6:00am until time to hit the OR, watch a bunch of operations all day, then eventually more scut work and afternoon rounds. After fighting evening traffic, I'd get home at maybe 5:30 or 6:00pm and "enjoy" my few hours before I had to think about getting some sleep before another 4:30am awakening.

Ok, fine. Expected hours for this block. I have 3+ more months of hours like this. It's the team specifically that I didn't like. Your typical surgery types: white, sporty, butch-haired males all the way from attending to intern. Even though urology is generally considered the happy-go-lucky lifestyle specialty, it's different in academics and at a huge, tertiary care hospital. It's still surgery residency, and you have residents working 80+ hour weeks and what-not.

I was pretty much blatantly ignored and treated like an uninvited pet dog. Part of it was because they are a busy, busy service. The inpatient roster was around 23-28 with 2-5 consults the whole time, and they had to round and operate and round and call consults and write orders like mad. So I get it. But I felt completely disrespected by some of them, like they didn't even bother to pull me aside 1 minute and say "hey, sorry we're so busy, but you could do this or this". No, it was just irritated glances and "do this" "do that".

I haven't been to this particular hospital at all since I started 3rd year 8+ months ago. I noticed off the bat that it was a more intense, serious place, with frankly ruder staff. It didn't help that I was on one of the busier surgical teams (probably second next to transplant). In the OR, I didn't enjoy the procedures. I would scrub in and stand there for 5 1/2 hours while they did their lymph node dissections and ileal loop thing. I get it, you're all busy, there's no time to deal with the med student. But I've had a great third year up until now, you could at least show some effort.

Anyway, whatever. I start anesthesia tomorrow at a much better place. After that, more urology at the children's hospital, then off to somewhere (I don't know yet) for 5.3 weeks of general surgery. I'll get used to the horrible hours, I only ask that where I'm placed has a bearable atmosphere.

Yukers signin off~

Residency = Crack!

So I found out some shocking information from a program that I heard on NPR's "Talk of the Nation" about Physician sleep deprivation in residency. Ever wonder just why you guys are working 80-hour weeks with no sleep? Just where did that fun "tradition" come from? I transcribed part of the program...

Spoken by Dr. Charles Seizer, director of the division of sleep medicine at Harvard Medical School.

...the Tradition dates back to 1890, and was started by a pioneer in American medicine: professor William Halstet, from Johns Hopkins, who established the first program in residency training in surgery. He really set the standard for the nation by establishing these marathon 30-hour shifts. It was only revealed this past year in an article in the New England Journal (of Medicine) just how he was able to stay awake for so long.

It turns out he was a cocaine addict.

He had just been discharged from the Butler hospital in Rhode Island where he had been an inpatient for about a year and a half trying to get rid of his cocaine addiction. They were using morphine to treat him so he ended up with a morphine and a cocaine addiction as he took over his role starting up the program.

So we're left with the same traditional schedule in which interns and residents are expected to do 24 or 30-hour shifts and are expected to perform at their best...

So there you have it! According to Dr. Seizer on NPR and his citation of the New England Journal of Medicine, all that intense residency training owes its roots to cocaine addiction! Your wife nagging at you for working such long hours in residency? "Oh honey, don't worry. I'm trying to emulate a crack-head lifestyle, that's all!" Sure, that'll work.

And so, I'm gearing up. After I finish medical school, I get to live like a bona fide crack-head, and I bet after 30 hours and no sleep, you'd probably write prescriptions like a crack-head, too. You might as well bond with that frequent-flyer in the ED and tell him to just stay up for 30 hours straight in the hospital! He'll never snort the white stuff again, and you'll have one less guy to watch over in the ED. He'll probably even go for medical school himself so one day, he too can get his fix in the hospital, just like all the medical residents partaking in the wonderful cocaine-catalyzed "tradition."

Bottom line: A tradition as crazy as medical residency could only be explained by something like a guy on crack. The funny thing? It's true. I guess it's probably not all it's cracked up to be, eh?