Fuck.

I'm just fucking sick of this already. Standardized patients' report comes in to the effect of:

-"Student was purely clinical, not personal. Came off as cold and uncaring, only smiled once at end of encounter."
-"Try to build rapport...I didn't feel like I wanted to share any extra information with you."

And my clinical evaluations always fault me for interpersonal skills (or lack thereof). Every time it's that I'm too quiet, or don't develop a good team dynamic. Well fuck. I won't sit here and say that they are wrong...they are right. But I don't know what to do with myself. I honestly believe I just have some traits/elements of Asperger's or something, because I am not able to relate to others fluently and naturally like most people.

So it is. I do what I can and get through the rotations. I'll get my passing score and move on. I'll take my shitty eval time and time again. I'll try to improve and get burned every time. "Student lacks initiative, student is quiet." I've had a number of actual patients complement me on my "bedside manner" for what its worth. I don't know what the truth is, I just think it really sucks. Just fuck it, you stop caring after awhile.

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~

Surgery Clerkship

If any of you clicked on my blog, wondering what's up, then here. I'm in 3rd year of medical school. During that year, you have to "rotate" through all the different major medical specialties...at about a rate of a different one per month. Such as my schedule would have it, all of my surgery specialties have come last in the year. And so, between now and late-May, I'll be dealing with the "worst" of third year, if not the worst of medical school.

So I'm now on surgery. My hours are very, very long, and my days start very, very early. I don't have the luxury of weekends anymore; they will be chopped in half at best. But in general, days are expected to be 12 hours long. In my case right now, this is my expected routine:

4:30am - Wake up
5:15am - Bet at hospital to help intern do scut work (dirty work, paper work)
4:30pm - Supposedly when I get out
6:00pm - Later end of when I get out

Mind you, I don't have a "safe haven" of Saturday and Sunday. I should get one of those two days off a week. This coming weekend I have a feeling I will work straight through, because my team doesn't give a shit that I'm there and they just want me there to do work while they have me.

I will be online as I can be. I'm not sure just yet how waking up at 4:30am will affect my body, but it will surely wreak some amount of havok. I can only imagine that to arrive home 13-14 hours later, I'll be dead-tired, even though it'll only be 6 or 7 in the evening. How I'll deal with sleep and how I distribute sleep is to be seen. But I put friends absolutely first, so I won't be falling out of touch w/anyone; that is my priority.

I can only say that going through this is just as much physical as mental and emotional strain. I will do my best to cope.

Isolation

Families, Health care workers, Patients, PLEASE...

Stop fucking wearing isolation gowns all over the hospital. So much for universal precautions. These gowns were designed to protect your clothes from patient pathogens, and the patient from your pathogens. If agents get on these gowns and you leave the room with them on and masquerade around the hospital like dumb-asses, then you're theoretically stirring diseases around in the general public.

I fucking hate seeing this shit.

Bull Shit

Inpatient Peds Rotation

1) I hate it when you get two different instructions from two different higher-ups (residents). Then, invariably when nobody is around to help you when you need it, you do whatever you think is safest (note-writing procedure, for example). Then you get bitched out by the resident for "doing it wrong." Now you can't argue back or they'll make you out to look like a condescending and haughty med-student.

Too many times, mis-communication. You get mixed signals or incomplete communication and you just do your best. And too many times you get bitched out by some stressed out resident who has noone better to take out their anger on than you.

It's an annoying and long rite of passage and I'm sick of stuffing my pride to bend over and take it from cheese dicks. And I hear this happening all over my institution and at other institutions. It's part of medical education and you learn to let it roll off your back.

Do it over again

3rd year here. In clinical rotations. If I were time-warped back to freshman year of college now, knowing what I know, would I do it all again? No.

I'm not sure what I'd do, but I'd try going into physics or computer science and finding my way to a reasonable job near a big city. I don't know, maybe 75K/year and I'd be plenty happy. Because in that non-medical job...I'd potentially have...

-Colleagues/Co-workers that were actually like me
-Weekends off
-Weekends off
-My 20s
-Did I mention my 20s?
-The freedom to fully explore my hobbies and interests
-An actual time to clock out and go home

I'm not saying medicine gives me no pleasure, or that I won't be a passionate physician that truly cares for his patients and his work. I can do that. But the sacrifices are so much, so great, that it is just barely, barrreeellyy worthit.

Even in medical school, hell all four years, you are asked to give up time and energy that very few your age are also giving up. There's worse...there are those soldiers who put their lives on the line for our country, who leave their families and stay abroad for months and months at a time in dangerous places for their stints. There are many who have to work many jobs to support their families in the hard economy.

So I am not saying medical students' lots in life are particularly difficult or unfortunate, not at all. I'm just saying man...we made a choice and we really do give up a lot for that choice. For the hope and promise of job security, prestige, financial security, and a great job, we go through so much.

Cuz you know what sets physicians...a "profession"...apart from "jobs"? The fact that we don't clock out and go home at 5pm. We are beyond the basic "job" where you come and do your work and go home. We are professionals...we do our jobs as doctors and care for patients. We don't watch the clock. In this profession, 60 hour work-weeks are touted as "nice", "light", "easy", and to some older docs, even as lazy. Especially when in training, a 60 hour week is considered extremely easy, and even 80 hour work weeks are considered normal and people lie about their hours to exceed even that. Weekends are never to be had off and families are rarely seen for many.

It's ridiculous. I'm getting so jaded already. I'm on an inpatient peds rotation, it's asking a lot of hours, weekends, staying until 10pm when I came in at 7am. And this is nothing compared to my up-coming surgery rotation...or actual internship.

It's so easy for kids in college to sit there and say "yeah, I want to be a doctor. I want to help people and save lives. I'll go through whatever it takes to get there, I really want to do it."

Do you really? Really? I'm amazed that as many accepted med students follow through and graduate, but I suspect a large number are disappointed, and "held hostage" by their mountain of debt, and knowledge of the time they invested.

PMnR

Doing a month elective in PM&R (it's an actual board medical specialty, look it up) this month.

I should have taken a vacation month instead, it sucks.

I'm getting up at 6:30am stuff like that and getting home at past 5:00pm.

The attendings really haven't been nice at all; I can't imagine soliciting a letter from them at all, let alone if I wanted to do this field.

Ugh, screw this shit. I should have really taken a vacay.