I'm officially half way finished (as of tomorrow) with my rotation at Harborview. Just three more short weeks and I'm off to Olympia for outpatient internal medicine. I can't believe that it's already half way done and how much (and how little) I've learned. I say how much and how little because despite learning TONS of stuff everyday, I know that I am merely scratching at the surface and that there is SOOO much more to learn!
I did my first night shift this week. It was interesting to be there for more than 30 hours and to see the whole spectrum of hospital medicine. This was my home for the sleeping hours of the night:
During the night my team was responsible for the "code pager" which means if there is a code blue in the hospital, it is the job of my team to respond to the page and "run the code". You never want to have a code because that means someone's life is in imminent danger. Sadly, we did have a code while I was on shift. I've been involved in a number of codes in the past when I worked at Tacoma General, but at that time I was safely behind my little laptop, transcribing the events. This time, I was panting for air (see the next paragraph for why), standing in line to trade off to give compressions. It felt surreal to be "on the other side" of the laptop and of the whole health care process. As I reflected back on the code the next morning it made me think ahead to when I will be the one calling the shots, maybe not for a code, but for a patient's care. And that is a heavy piece of knowledge that I already had but it was the first of many times that the brevity of that thought really set in for me.
Also, the code brought about another tidbit of knowledge for me-- I am out of shape! It turns out that 6 weeks of sitting at a desk studying for the boards followed by three intense weeks in the hospital where exercise is sadly minimal, I have deconditioned significantly! We were on the third floor when the code pager went off and the code was on the 9th floor. After sprinting up the 6 flights we were all so winded that we joked after the fact that we were all worried that we too, were going to 'code'. So, I counted that as a bonus for me that I got a quick anaerobic work-out in before bed. And when I left work, I was feeling the need for a shower and I got what I asked for! It was DUMPING rain as I walked from the hospital back to the truck. As my family said-I was just double tasking: showering AND getting back to my vehicle simultaneously :). White coat or rain coat?
Oh- and speaking of being deconditioned after studying for so long, I got my boards score back and never passed along the news to you all. I got a 231. Last year the average score for US students was a 228. And, to put it in perspective further, there are certain cut-off scores for whether or not you will be considered for a residency and from the numbers last year it seems that even the most competitive residencies have a requirement that you score a minimum of 220. Since I'm decently above that level it (theoretically) means that I have a shot at whatever I want to do. Unlike my MCAT score that closed the door for many schools, this score doesn't shut a single one! (It may only be open just a crack, but it's not closed). The national average for this year's tests wont come out until October I think, but I'm relieved, However, (as usual) I always wish I could have done better (a 240 sounded really good before I opened the email with my score) :).
But I can rest a little easier now that I know what the score is and continue to focus on the daily tasks of my clerkship as well as the "shelf exam" - the exam I have to take at the end of the 12 week rotation in order to pass the clerkship. I'm not worried about passing the clerkship, but now it begins a sort 'grading' unlike my pass/fail of med school course work. You can earn a pass, high pass or honors (oh, and fail is an option too I suppose). You are graded based on your clinical performance as well as the score on the final test. So, I'll keep cruising and keep learning as the year progresses. I am not focusing on the grade, rather focusing on making every day a little better than the day before and trying to look up 1-2 things each night that I don't know or recognize (looking all of them up would take a lifetime--which is what I'm headed for!) in addition to trying to spend about an hour a night studying for the shelf exam.
I got to see Kristi a few days ago too, and it was so wonderful to catch up, have dinner together and go shopping! What a wonderful (albeit) short lived good time!
In other news (since this is a blog called "tom and deanna" after all), Tom is doing really well in Atlanta. His work at the SEC is going fantastically well and he's getting rave reviews by everyone he works with. He's already been offered the option to come back and work (I think for money this time) next summer in addition to multiple offers by attorney's to make some calls and nail down jobs at big-time firms around the country. Selfishly, I'm hoping for a firm in Seattle, but one day at a time. He is done with the internship on August 1st and will start the road trip back to Seattle on August 2nd with a potential home-arrival date of August 6th. I told him he could take longer than that on the way home but he's insistent that 4 days is all he needs. He'll be stopping by Kansas to visit our good friends Allison and Gentry, then staying somewhere in the middle of nowhere in Wyoming or something for a night and then making his last stop before arriving home at the Gibson Mansion :).Perhaps by the time he gets back our condo unit will be fully sided instead of just half-covered in tar paper and half in insulation?
We also have some other big news-- Paul Glassman was found to have a mass on his right kidney a few weeks ago and yesterday he underwent robotic surgery to remove the mass. They weren't sure how it was going to go, but I am so pleased to report that it went better than expected and they were able to remove the entire mass with good margins and still save 80% of the kidney! So, now we wait for 3-4 days for the pathology report to let us know whether or not the mass is benign or malignant. If it's benign, then that's all for now. If it's malignant, then he will need re-imaging on a regular basis to ensure that there is no recurrence. We are wishing Paul, Ann and Julia all the best in the next few weeks as Paul recovers. I know the goal for everyone is for this to be benign and for Paul to feel well enough to return to Missoula at the end of August to finish his final term at UM.
Both me and my garden are soaking in the sun and hoping for the best!
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