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Friday, December 21, 2012

Happy Christmahanakwanzika!

Rotation life has been all over the place since my last post, so let me break it down for you like a fraction: 


November, Part I: Lungs with a PCOM Legend


During my first year, I was introduced to the PCOM Pulmonary Pack (kinda like the Rat Pack, except they didn't sing and dance (I wish), but equally as famous in PCOM circles). These guys went to PCOM together, trained together, and now practice together. After being knocked down and kicked in the chest from learning the intricacies of the kidneys, these doctors were a beacon of hope for a passing grade. They made the lungs easy to understand, and their lighthearted classes were full of anecdotes. So, when presented with the opportunity to enter a lottery to rotate with one of them for my elective, I jumped on the chance, and boy, did I strike gold--I got Frank Sinatra himself. Throw in that his children and I share an alma mater, and it was a match made in heaven. 

Over the next two weeks, I arrived at the hospital at 0545, read chest x-rays and CTs until my eyes bled, finally got to hear the differences between rales and rhonchi, and learned how to manipulate ventilator settings. It was a lot of fun, and I wished the rotation could have been longer. Then, on my last day, I looked at him and said, "And now, the end is near, and so I face the final curtain..." 


November, Part II: Home Is Where the (Patient's) Heart Is

To be honest, I was sort of dreading the thought of living with my parents for the last two weeks of my elective. Since it's an empty nest, showing my face every day would give my mother the perfect opportunity to ask me details about my life, nag me to run errands, and, of course, bring out any anxiety I had about applying for residency. Thankfully, it wasn't too bad since it was right before Thanksgiving, and she was more worried about my sister, who is a first-year law student (did you know that they actually have to come to class prepared?! And then have to speak?! I'd rather do a dozen DREs). 

As for the rotation, it was inpatient cardiology (mostly consults) with a little bit of interventional (cardiac catheterization and stent placement). The heart was, is, and always will be a weak area for me (see #2 on my previous post), and since I haven't had internal medicine yet, I had to work a little bit to get up the speed. One of the highlights of the rotation was my attending, an outstanding teacher and diagnostician. I was thankful that he broke down cardiac pathologies into the simplest analogies, because even though it made me feel like an idiot, it cleared up a lot of confusion. Not only was a he a good teacher, but he was also a cardio Sherlock Holmes. When called to the ER for a consult, he would read the abbreviated triage history, check some lab values (rarely imaging), turn to me and tell me his diagnosis. Then we would go see the patient, and a majority of the time, he was spot-on. I asked him how he could diagnose so quickly before seeing the patient, and he told me that all the clues were there; we just had to recognize them and figure them out. It gave me a new appreciation for Internal Medicine (one of my possible career paths) because while a patient may be admitted with a certain diagnosis, it is up to the IMED docs to get to the root of the problem.




December, Part I: The Rorschach of Shadows

This month, the 22 third-years in rotation group six reunited for a scintillating month of radiology, introduction to surgery, and a mess of other things. The first two weeks were spent in a dark room, looking at x-rays, CTs, and ultrasounds until we started convincing ourselves that the smallest shadow was cancer.  At first, you might think, "Ugh, radiology? Sounds awful," but think about this: PCOM is the only school that sits you down for two weeks and says, "This is how to read an x-ray/CT/US." Most schools (so I hear) have "radi-holiday," where you rotate with a radiologist, but the actual didactic portion is small. So yeah, sitting in a dark, cold room for 7 hours a day isn't the most exciting, but if someone were to hand me an abdominal film and said, "Go," I wouldn't be as scared as I was a few months ago. 


December, Part II: Lecture Grab Bag

After we emerged from radiologic abyss, we had a series of random lectures/sessions: introduction to surgery (how to insert a chest tube, gown/glove, tie surgical knots), surgical simulations, ACLS certification, and the always fun day-long medical ethics discussion. Since I'm not interested in surgery, those parts weren't terribly exciting, but what I did have fun with was the ACLS course, especially the simulated megacodes. Even though it was just a dummy, and even though I clearly had no idea what I was doing until right before the test, I felt a little rush as team leader. Running a code is, at best, an intricate, choreographed dance (at worst, complete chaos), and as team leader, you have to make sure that all the team members are working together and doing the right things to save the patient's life. So, who knows, maybe I'll be giving the Emergency Medicine route a second look. My friends said that they could see me in that field, but I think it was their polite way of saying, "...because you are loud, easily distracted, and not afraid to shout orders." 

Well, that was the calm before the surgery storm. Next month, I expect to be hating my life and putting a pox on anyone whose appendix/gallbladder/hernia gave him problems. I hope you have a great holiday, and a happy new year!