Slow, Deep Breaths

Tomorrow I start my four-week rotation through the ICU. I am somewhat anxious about it, as I am going to be the senior resident on the service (ha!) with some poor medicine intern to help/hinder me. Every 3rd day will be a 27-hour work day, after which I will go home, try to enjoy part of the day, work a normal 8-hour day the day after that, and then show up for another 27 hours. Repeat this about nine times. No actual calendar days where I am not physically in the hospital at least for some part of the day.

The ICU is not my favorite place. It is where we keep all of the actively dying people. Many times, their loved ones are completely unaware of just how sick they are. Sure, there are people that recover, sometimes miraculously, but often it seems to be a slow, steady decline. A decline over days and weeks, in which one gets to know a patient's family. I remember the rotation from medical school as being a month of terminal weans from ventilators.

It is also a good rotation for learning. There are a lot of bedside procedures to be done, and I am definitely going to be challenged to make quick decisions and know my own limits. There will be an attending physician on call at night, but they aren't even in the hospital.

I was talking with one of our chief residents about his experiences the other day and he said, "Well, you are either really going to learn a lot, or there's going to be a lot of people dying and you won't have a clue why." Great, I can't wait to get started.

Performance Anxiety

Tonight I go back to the department. I am extremely anxious about it. I have finally finished all of my off-service rotations and now will be in either the Adult or Pediatric Emergency Department for the rest of the year. I really like our attendings and our residents, so it will be good to be around some familiar faces. However, at the same time, now I will be around long enough for them to figure out just how dumb I am. What if I hate it? So far this year, I have been flying under the radar. I have had good evaluations and no incidents with administration. In many ways, I kind of feel like the invisible intern. While my colleagues have been having confrontations with the staff, most of them don't even know who I am! I guess I will just have to step it up a notch. Maybe the desire to not look like a complete idiot will be a better motivator to keep up with my reading.

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In other news, my younger brother was in a car accident over the weekend. He has about 6 months left in Kenya as part of his Peace Corps mission. Apparently two jeeps were passing each other on a mountain curve and his got knocked hard enough to roll it over twice. Luckily he was on the inside part, so they didn't roll down the side of the mountain. He ended up needing some x-rays and stitches and now has to take HIV prophylaxis meds for the next month as they weren't sure that all of the blood on his face was his. Between this and losing 40 pounds that he didn't have to spare from bacterial dysentery, he has had quite an adventure over there. He's done some good things too, like constructing a subterranean dam, solar-powered water heaters, and is trying to get a windmill project off the ground before he leaves. I am sure it is an environmental engineer's paradise, but I can't wait to see him. At least now he probably won't be such a picky eater.

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As for running, I did 6 miles on Saturday, and rewarded myself with ice cream on Sunday.