Life is Hard.

I'm averaging 70-80 hours a week. I never see B. My patient who came in with abdominal pain reported child abuse and then I had to report it to CPS. Another patient had a very high ammonia overnight which we only found out about this morning, for various reasons. I've been exhausted for two months straight. I talked back to my very sweet attending on rounds today because I was so frustrated, and then he forgave me, which was really heaping coals of fire. I then sent him a letter of apology. I have three discharge summaries to dictate, it's nearly eleven, and I'll have to get up early. I've been reflecting on what I learned this year and I think I'm dumber and less knowledgeable than when I started. Nurses are grumpy and the hospital is full. Why is it that the less ill children seem to have the more demanding parents? It's a hospital, not the Hilton. The new interns are coming in July and I'll have to be a senior. I'm so tired, and everything that's been hard all along has become too hard all at once. Tears.

What It's Like to Be an Intern -- Or, I'm Back!!

I have missed this blog. And I simply cannot keep a diary online in my own name. So, in short, I came back! And it feels really, really nice to be back. But there's a small difference, which you might notice in the header. I'm no longer a future doctor lady, but an actual doctor. And that's a scary thought. And given that residency is the equivalent of two full-time jobs, I likely won't be able to write often, but I do want to write. It's been amazing. Very intense, very frightening and at times, incredibly sad, but amazing. It turns out that my dream program really was my dream program.

So how does intern year work? You rotate through various areas of the hospital for a month. Child neurology is two years of general pediatrics, one harrowing year of adult neurology, and then two years of being the child neurology "fellow", meaning senior resident who is called by everyone in the middle of the night for pediatric neurology consultation (ie is this child having a stroke?). Yes, children have strokes.

I am currently rotating through the emergency department. It varies from very slow to really quite insanely busy with a lot of very serious disease. In just day for example, we had one patient with newly diagnosed cancer and one baby with pyloric stenosis, a girl with ovarian torsion, four suicidal patients (boys and girls), and multiple appendicitis scares with a couple of true cases, multiple fractures, children with bad cuts needing stitching, some concussion, and one case of possible abuse. That does not include all the children with asthma attacks, bad viral illness, and croup. It was a busy night. But I have to say, putting a fingertip and nail bed back together is a pretty interesting skill to have :) I don't like as much the heartbreaking conversations with the suicidal patient and her family centered around her gender identity. What I told her is that obviously I can't decide who she is for her, but being true to her values and treating those around her with honesty and kindness will get her through the really tough times. But honestly, what do I know, especially at three in the morning? Luckily there are really great resources for her that will do her more good than I possibly can in the emergency department in the middle of the night.

One thing I really like about the new hospital system where I work is that people don't seem to be quite as sarcastic or angry, even to the medical students :) I appreciate that. I'm thinking maybe having all the children around help the culture -- most people don't want to curse in front of a four year old. The absolute cutest moment of my current rotation this far: I'm discharging a patient home with her parents and they tell her, "Ok, sweetie, say thank you!" And this three year old says "Thank you!" to me and to her nurse, since we were standing together. Then, as she reaches the door, she turns around, bats her eyelashes at me, and says, "Bye-bye, Dr. Nia!"

Melt, darn it.