Sleep strike!!!

I am, as we speak, engaging in a sleep strike.  My husband and I are staying up to watch a movie - he surprised me with what he knows is my secret weakness - a chick flic.  And he's currently making me coffee in the kitchen so I don't fall asleep during the opening credits.  We are laughing in the face of my ridiculous hours and staying up together to watch a movie!  I couldn't be happier.  I'm actually post call today and its been marvelous.  I actually got out early this morning - so more like a 27 hour shift instead of 30.  I slept and then I WENT TO THE DENTIST!!!  Its sad but I'm so excited that I actually to go to the dentist, its taken a year, but thanks again to the help of my hubby I magically got squeezed in on my only day in months that would have worked!! 

Call last night hurt.  I got approximately 34 minutes of non-consecutive sleep the entire call.  I was a total goofy giggly nutcase by the morning.  As a non-intern I've now been upgraded to taking ICU call, and last night we had a record number of patients.  But I survived and all the patients survived with me, so I count it a victory!

Well, that's all for now, coffee is ready, and since my previous debacle, coffee it is no longer allowed near the laptop.  I am off to watch a delicious movie and sip some marvelous gourmet coffee and although I'll likely pay for it in the morning, I can already tell its going to be worth it!

Nothing much new

So, I'm about a month into second year, it feels comfortable enough.  I'm on call tomorrow.  I'm doing a better job at organizing my life in general.  I have to work on some research stuff today/tonight and I hope not to suck at it.

I've become much more comfortable operating and I'm trying to find the best way to document what I'm learning so that I can do this stuff independently at some point.

Ok, so I really don't have anything interesting to say.  I just really felt like writing something.  So what follows is just a list of my random thoughts:

 I start a new rotation in a little over a week.  I'm planning my anniversary vacation trip.  I'm watching "He's Just Not That Into You" on repeat. I am becoming the family spokesperson for all things medical which isn't so bad, I feel good to be able to help when I can.  I am slightly shaken by the number of people I keep finding out are pregnant.  My house still looks like we just moved in.  And nothing much new has happened.

Sleep deprivation

I almost got my paycheck suspended because I hadn't taken my life balance quiz that residents have to take every year.  How ironic that my life was too unbalanced to allow me the time to even take the test,  the best part was reading about the perils of sleep deprivation and realizing that all of those side effects have taken control of me.  Humans were not made to sleep this little.  I am SO tired.  I am tired every morning when I drive to work bringing me nearly to tears.  My legs hurt, my feet hurt, I'm hungry and thirsty and holding pee all day.  I am reaching my limit.  My temper is short.  I am never home when I am home I'm sleepy or mean.  I have this weekend off and desperately need to go away somewhere, but that is another battle.  I need to leave, I need to separate.  I don't have much more energy left.  I feel like I seriously "reside" in the hospital.  I need someone to talk to, but I don't even know if I have the time.

Take back

In the end all works out ok, but today was a bit of a backstep from my high flying reflections of yesterday.  I got EMBARRASSED in conference this morning - totally blindsided.  Even the normally tough people were commenting about how I was getting picked on.  Later in the day I realized one of my decisions on a patient from last week was wrong, buying him 2 months of nasty wound care.  Today, I anticipated getting out at a reasonable time and getting a chance to be normal and spend time with my husband.   I left at 8pm.  Today was just a sort of crappy day.  But, at the end it doesn't feel as awful as I expected because despite my beating, there were just as many people there in my corner and encouraging me and reminding me that some people really are here to teach us and care that we become good surgeons and good doctors.  Today I am thankful for them.

Better... (the sequel)

So, this year is so much better.  I know its still new and shiny and destined to dull and fray a bit, but its better.  I shock myself daily by how much less of an idiot I am than I think.  I actually know stuff.  I often don't realize I know it until interns ask me about things that have become 2nd nature to me now.  My calls are much better.  They are hard and tiring but I feel like I'm doing something that contributes to making things work.  I feel valid.  I don't think of quitting every five seconds.  For the first time since I started, I think I can honestly SEE myself making it through this process.  I love my days.  I see my ICU patients and consult patients and get to think through their problems and discuss what I think.  People actually want me in the OR.  I have lots of thoughts and lots to say but I think thats enough for now -- I'm tired and its late.  I just wanted to drop a note just to say that things are better.

A two parter...

Part One: Terrification

Tomorrow I will be on call as the junior-in-house, meaning I take ER consult call, run traumas, take patient calls from home,  go to all surgical codes and cover cardiac surgery patients.  I was mostly calm until now, but now I'm pretty terrified.  I feel like I'm going to vomit from nervousness.  I'm terrified of the responsibility!  I know I'll have great seniors working with me tomorrow but I'm pretty scared just the same.  I've been talking out my feelings about tomorrow with my husband for the past hour and he's pretty successfully talking me off the ledge.  I need to trust myself more and realize that I know more than I think I do.  Also, on some level I should embrace the fear.  Someone once told me that the most dangerous doctor is a fearless one.  Fear implies recognition of the seriousness of my responsibility.  So, tonight I will enjoy a pre-July 4th dinner with my husband at our favorite restaurant.  Then I will go home and review and read on all the stuff I'll be responsible for tomorrow.  And Sunday will come, and I will get through this and spend a sunny summer afternoon at home.

Part Two: Double Gloving

My husband actually asked me to write this one after telling him the story.  I had my first needle stick of residency this past week.  I got stuck about 4 times by other people as a medical student, but then I always wore two pair of gloves for additional protection and none of those times were my fault.  However, after actually becoming a surgical resident and being involved in the actual operation I've pretty much stopped wearing two pairs of gloves.  Most people don't double glove.  It definitely makes your hands stiffer and hotter and more uncomfortable, so I just wear one pair of gloves.  Well, last week while operating with one of my attendings he decided to ask me out of the blue if I wore two pair of gloves.  I told him no, that I just wear one pair of thick gloves.  He then gave me a brief lecture about the benefit and added safety of double gloving.  Well, at the end of that operation, I took my gloves off and there was a tiny dot of blood at the end of my left index finger.

The patient we had operated on had no infections for me to worry about, but I got unbelievably upset.  I had to stay in the room to get the patient transferred to post-operative unit, but my initial thought was that I wanted to cry.  I wanted to cry because it happened.  I wanted to cry because I'm accountable to more than just myself, I thought how me getting infected with something could affect my husband, or could change my life.  I thought how I can be a risk to my patients.  There is still a risk of needle stick with two pair of gloves on, but less.  I've been double gloving ever since.

I don't know why this time bothered me so much.  I was married when I got stuck in medical school and didn't want to cry.  Something was different this time.   I felt alone, irresponsible and angry.

need help, please advise...

I'm over a week into my new role and in many ways its awesome!  I actually feel like I'm in training to become something.  But today I feel tired.  I have already worked 70 hours and I have a full day and a 30 hour call left in the week.  I just almost passed out at the gym today, and I'm being an emotional and snappy wife.  I got off "early" today, at 7:30, and was so excited to actually do something fun with my husband.  But we ended up not talking and not doing much of anything because I'm just tired and cranky.  So, I'm looking for help.  I just finished browsing all the resident websites, reading facebook posts of fellow surgery residents elsewhere, grasping at straws because I need someone to help me know how to do this.  How to be a present wife and invested in the way I need to be.  Again, I think of kids and how I would ever possibly be able to juggle.  One of our chiefs is pregnant and is jokingly/seriously considering retiring her scalpel post baby.  How do I do this?  I just want someone to talk to.

me