T.S. Eliot is famous for declairing that "April is the crulest month". As a medical resident however, no one argues about the fact that July, not April, is the crulest of the months. This is because July is when new interns start. "July 1st" is often whispered around the hospital in tones that make you feel like you are in 1962 Florida during the Cuban Missile Crisis. I'm pretty sure that most seasoned hospital employees would rather have a vacation week in early July than they would over the Christmas holiday.
Just about one year ago I was among the throng of deer-in-the-headlights residents starting their new patient care responsibilities. All things considered, I actually think I had it pretty easy. I started on Neurosurgery. On the surface, this may seem like a bad way to kick things off, but the service I was on did mostly scheduled spinal surgeries. The trauma and other really really bad stuff mostly went to a different team.
I did have one bad night however. I had been a resident for 3 days and I was taking overnight call. I got paged around 1:30 in the morning from the ER, telling me that a guy who had had a spinal surgery a few days ago was now back with what looked like an infected surgical site. Surgical site infections are never a good thing, but they are particularly bad when they are that close to the spinal cord. In addition, this guy was starting to show signs of septic shock. I rushed in to see the guy. I fumbled my way through admission orders (I didn't have a very good idea of how to use the electronic medical record yet), started antibiotics, forgot to take blood and wound cultures and just prayed that he would make it until morning. Fortunaly for everyone he did great. His blood pressure stabilized on the antibiotics and we took him to the OR the next morning to clean things out. He did well after this and I am happy to say he went home in good shape. It was however, a long night...
Because of the huge volume of knowlege we are expected to know in medicine, it gets very easy sometimes to feel like you are not learning anything. Because you are perpetually feeling like you don't know enough, it is easy to overlook the things that you have learned. I think it is helpful, if nothing else, to have a yearly reminder (July 1st) of just how much I have changed. That, of course, does not excuse me from needing to learn more and there is SO MUCH that I still need to learn, but it is kind of fun to look back at July 2010 Eric and see what a differeance a year can make....
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