Pushing Back On Pushback

I was working on writing this gigantic 4,000-word monstrosity of a post where I tried to align specialty services with the old-school Dungeons and Dragons “Lawful/Chaotic vs Good/Evil” axes for character generation, and it was exactly as complicated as it sounds.

As I worked my way through it, I realized that half of what I wrote was about convincing specialists to come down to the ER and see my patients. At large academic centers where we residents train, we are almost always calling other residents for this task – and therein lies the rub. Like us, they are overworked and underpaid a flat salary to do their jobs. When I call the surgery resident for a consult, for example, I am creating work for them.

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An ER Doc’s Primer On The COVID Vaccine

Hello! Once again it has been forever, but I don’t care. I’ve been too busy trying to prevent my head from exploding from, once again, people being stupid.

(I am a tiny bit frustrated with vaccine hesitancy, which I sort of understand, and very frustrated with COVID deniers and other conspiracy theorists, who I think should be first boarded onto a 13-hour Spirit Airlines flight and then forcibly ejected out the emergency exits at 35,000 feet.)

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The COVIDpocalypse is Here and I’m Coping By Writing Again

I would like to blame my prolonged absence again on COVID-19. To be fair, it does dominate about 95% of my work life and probably 50% of my personal life, but honestly, I’ve just gotten lazy.

The last time I published here was March 5, where I started with “it seems like we are inevitably headed for a massive, global pandemic.” For once on this blog, I get to say I WAS RIGHT ABOUT SOMETHING IN RESIDENCY! No attending or dad can correct this.

As of this writing, my area’s daily hospitalization rates look like a Space-X rocket launch. We’re out of ICU beds, regular beds, gurney, cots, sleeping bags, and patience. The worst is somehow yet to come. I am coping with this impending doom by playing with my dog and, finally, writing again.

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Second Year Is (Almost) Over

In a little more than a month, the new interns will arrive. Much like last year when I wrote “Intern Year is Over,” I greet this milestone with joy and relief – not because I am thrilled and excited for the interns to roll in, but because I am thrilled and excited to be DONE. WITH. SECOND. YEAR.

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“Why?” the interested reader/grandma may ask. After all, if intern year is when you learn the byzantine system that is medicine at two different academic centers, second year is when you focus on your actual medical knowledge. Your procedural skills. Your team-based communication. Continue reading

Not My Hill

The journey through second year of residency is an interesting one. As I’ve mentioned before, we are tasked with two major, new responsibilities: performing most procedures and seeing a much greater volume of patients. We’ve all gone through a substantial adjustment period. It’s been hard.

One of these journeys is toward two, or greater, patients per hour. I hit this milestone rather infrequently. In fact, it is about as likely for me to achieve this as I am to win a game of Oregon Trail. It is far more likely that I will die of dysentery, or make it no further than Fort Collins before my oxen quit on me. Continue reading

Discharge to Home

When you go to the ER for medical care and are discharged home, almost every ER will send you home with “discharge instructions.” In a perfect world, this would contain information that is actually relevant to the patient’s medical condition and cover what was done in the ER, the results of lab tests and imaging studies, and “return precautions” – when to come back to the ER. Continue reading

BUFF and TURF

I am now done with my ICU month. I would just like to reiterate, again, that being on 30-hour call every third day for an entire month is total and complete bullshit that ruins your body and soul and no one should have to do it.

I have also been advised by legal counsel, also known as one-half of the Bringers of Life, that in my previous post I apparently ran a small risk of getting in trouble. I am not sure why; perhaps this is because I reference in somewhat pointed terms that one of my hospital sites (the Not A Real Hospital one) is run about as efficiently as a traffic jam. Continue reading