26-hour call

The ACGME rules are changing this July and interns will no longer be allowed to work more than 16 hours.  I'm not sure of all of the particulars of the rule change, but I know that at least as an intern (and I think as a resident), I won't be asked to take call for 24 hours.  But currently, I am.

I do okay being up for about 20 hours, but then I just get so tired.  I know that there is debate as to whether or not the limitations on residents is a good or bad thing with questions surrounding whether or not it is safer for patients and do we need to extend the years of residency training because of the limitations on hours.  I think the arguments for both sides of regulation are compelling and it is beyond my pay-grade to decide what rules and regulations are best for training of residents.

Nonetheless, this Friday I was on-call from 7am until about 9am on Saturday (yes, that is 26 hours).  As I was working on notes at 2am, I was wondering if I would have been tough enough to go to medical school twenty years ago.  They don't make doctors like they used to.  I've talked to doctors who said during residency they started their shifts at 6am on Friday morning and got off at Monday afternoon.  Obviously, they got to sleep in the hospital, but from what I can tell no one sleeps too much when they are on call.  I don't think I am that tough, but then again you never know what you can do until you try.

When I was working on notes at 2am Saturday morning, a nurse came up to me and asked how long I'd been there.  I said I arrived at 7am, but I woke up about 5:15am and he told me I really needed to try and sleep before going home because he was worried I wouldn't make it home okay.  I did manage to sleep for 45-60 minutes, which was surprisingly refreshing.  I am fortunate that I take the train rather than drive, because I know I could not have safely driven myself home.  I was capable of staying alert and awake for the train ride, but that is a different level of alert and awake than driving a car is.

I think the worse part of the overnight call is that I am so tired, but by the time I get home, I wake up again and then wonder if I should just go about my day.  Usually I come home, take a shower, eat something and force myself to bed, even though I have a second-wind by then.  Then generally, I sleep soundly until the early evening and I get up for a few hours then go back to bed (to try and keep my schedule on track).  I didn't sleep as well yesterday as I usually do, but I think it is because it was so sunny and beautiful in New York and the light was pouring into my room.  I really wanted to be outside taking a walk and enjoying the spring-like day, but I knew I had to stay in bed because my head was pounding and my body ached.

I have two more 24-hour calls to do in this surgery elective.  I really don't mind the work, but about 2am or 3am, I am so tired that just want it over with.  There have been a few nights, when other students have been on call, that have had multiple emergency surgeries and other major problems.  The two 24-hour calls that I have had this month, have been busy, but there have been no major emergencies.  I hope that my next two 24-hours calls will be relatively painless without any major emergencies.

Dinner Date

I was on call last Sunday and I will be on call next Friday, so Farley and I went out on a date this weekend.  I have been trying to get him to go to Max Brenner for months and we finally went.  He has been giving me a hard time about going there, but after we went out shopping on Saturday we were in the area.  There was only a 20-25 minute wait and he agreed to stay.  After a couple minutes, a waiter was carrying a giant hamburger and Farley was a bit more excited to be at Max Brenner.  We ordered and had a great dinner, but you don't really go to Max Brenner for dinner: you go for dessert.  We were debating what to order, but Farley wanted to try one of the chocolate drinks, "Suckao."  The Suckao is super intense hot chocolate.  The cup is  sitting over a candle with some warm milk and you melt chocolate chunks into the milk.  It is a cross between a fondue and hot chocolate--it was too much for me so I decided to get a milk chocolate hot chocolate.  It was probably the best hot chocolate, other than my Mom's, that I've ever had.  It was so good.  Max Brenner is a chain so if you are in a town with one, you should try it, even if only for the dessert...the chocolate is so good.

I don't want to be a surgeon when I grow up!

I don't want to be a surgeon when I grow up.  I thought I didn't like surgery because I just had a yucky core rotation, but I realized that I just don't like surgery that much.  I don't dislike it, but I think you really have to love whatever specialty you choose.  I don't love surgery.  I can handle doing this for one more month, but that is about it.  I am just not going to be a surgeon.

I saw a commercial for New York--Presbyterian Hospital.  It was about a little girl who had a tumor in her belly the size of a baseball and how this surgeon took our her organs, removed the tumor, then put her organs back in.  When I saw this commercial, I was reminded why I wanted to go to medical school in the first place: I want to cure cancer.  Now, if I got to see this cool surgery that was described on this commercial, I'd probably love surgery.  Actually, this commercial made me wonder why anyone would want to do anything but cure childhood cancer.

Pediatric Infectious Disease is Finished, Surgery Elective Begins

I am sad to say that my Pediatric Infectious Disease rotation is completed.  I am really sad to be done with it because I loved it so much.  I got to see some interesting infectious diseases in New York City.  I saw things that I had previously only read about and didn't anticipate seeing unless I went on a medical mission.  I loved working with the children, residents and the attending physicians during my rotation and I am excited to return to this hospital in April to complete my Pediatric Pulmonary rotation.

On Saturday, Farley and I went to downtown New York to find my next hospital.  I am not as excited to do my surgery elective, as I didn't enjoy my surgery core rotation as much as I enjoyed my other core rotations.  However, I anticipate that I will enjoy this rotation.  Elective rotations are usually a bit more laid back than the core rotations and it is only 4.6 weeks (the core is 12 weeks) so even if I don't love it, it will be over quickly and I'll be back to pediatrics.  I am nervous to start tomorrow because it is a new hospital (to me).  I hope that I learned enough in my core rotation and that I am up to the standards that they expect for an elective student.

Weather

The weather around New York has been rather bipolar lately.  It was 60 degrees on the 18th then on the 21st, it was snowing.  I took this picture from my bedroom window on the 21st. when I had the day off for President's Day.  As I type this one week later, all of the snow has melted and it is back into the mid 50s, but I hear it is going to start snowing again.  I hope that March really is in like a lion and out like a lamb.  I am ready for spring!

Valentines Day

I am posting this a little late, but Farley and I went out for a great dinner for Valentine's Day. We decided to go out for restaurant week. We made reservations at a steak house in the theater district for the 17th--A.J. Maxwell's. We got all dressed up (but I forgot to take pictures!). We had a super great dinner. I had salad, ravioli with beef and chocolate lava cake. I also had a red wine, and it was a grape that I had never heard of and I can't remember the name of it now! It was a great glass of wine. Overall, my favorite part of the meal was the chocolate lava cake. Farley had the beef barley soup, a steak and the cheesecake--his meal was wonderful too!!

It was fun to go to an expensive New York Steak House, but honestly, this place starts at $50.00 per plate (when you are not getting the NYC Restaurant Week prices). I think the food at Clinkerdagger in Spokane is better. Also, I went to Smith and Wollensky in Miami Beach for a talk on Meningococcal vaccinations during my internal medicine rotation and the food there was much better than A.J. Maxwell's. There is a Smith and Wollensky in New York too, but I didn't think to check and see if they participated in restaurant week (I doubt it). I went to another supposedly amazing steak place in Miami Beach, The Forge. Like A.J. Maxwell's, I thought The Forge was good and the location, atmosphere and service was superb, but I just didn't think it was worth the price (unlike Smith and Wollensky or Clinkerdagger).

Nonetheless, Farley and I had an amazing time. It was really fun to get dressed up and go to this fancy dancy restaurant. I did find it interesting that Farley and I were better dressed than many of the rich people in the restaurant. I guess it was an exciting night out for us and for them it was just like any other day going out to dinner.

"Hi Doctor!"

I was walking down the hall last week.  A cute little girl was sitting outside of a pediatrician's office in the hospital's doctor's building.  She saw me walking down the hall and loudly said "Hello Doctor!"  At first I wasn't sure who she was talking to, but since I was the only person around and in a white coat, I assumed she was talking to me (and I didn't think it was worth correcting her).  I said hello and told her that I loved her bright pink hat.  She got a huge smile on her face and said "I LOVE your hair!"

Why everyone doesn't want to do pediatrics is besides me. Those children are so cute and fun to be around and besides, they have much more interesting pathology than adults.  I'll take pediatrics any day!