Saturday, November 19, 2016

The Lost Tribes Can Lose Themselves in a Black Hole as Far as i'm Concerned

I worked from 11:00 p.m. Thursday to 8:00 a.m. Friday then went for a meeting for my semi- review. I was given approximately 45 minutes' notice prior to my review. I was under the assumption that these meetings were to be scheduled so that the subjects of the reviews could be adequately prepared as opposed to literally running down the block from whatever hospital at which we had worked overnight shifts wearing bled-on scrubs and barfed-on white coats with uncombed hair. One review panel member, whom I had never met or even seen in my life,  had the gall to comment on my disheveled appearance. The dean of my program was the only person present with whom I was acquainted. She, it would seem, did not do much of a job in advocating for me to the rest of the panel.

The questioners weren't especially cordial or reassuring. I would be very afraid of the results of the review had I not been given a copy of the review form as I was leaving from work this morning. I received maximum scores on all scored items. In the "comments" sections, absolutely nothing was written. I cannot help feeling that this absence of verbiage will be interpreted as  writing between the lines by potential internship and residency programs. I am afraid of the results, just not very afraid.

Following my interview, I was asked to wait outside the interview room while the panel talked about me in the event that they had additional questions. They apparently forgot that they told me to wait, so I sat there patiently for seventy minutes. I could have slept after working all night but was afraid they might have considered me unprofessional had someone come in to summon me and found me asleep. Instead, I poured water from the water cooler into a cup and splashed it onto my face in order to refresh myself. i sent  text to someone and brushed up on material I though might be covered on the test i was to take shortly. After seventy minutes. it was five minutes before my exam was to begin in another building. It was difficult for me to do this, but I approached the door to the conference room. I knocked softly. No one responded. I knocked harder, and still no one responded. i opened the door to find the room empty. The entire panel apparently left out a door at the other end of the room without bothering to tell me that I was excused.

Following my interview. I had to literally sprint from one building to another down the road to take the exam for internal medicine. I'm dealing with kidney stone issues, and the run combined with the kidney stone caused me to have to throw up in the bushes beside the building I was entering to take the test. An exam follows each clerkship. The problem is that the exam is supposed to follow the clerkship. My schedule,  because of complications of my potential HIV exposure and the treatment that followed it, have me three weeks behind the others in this rotation. Those in power decided that, because they did not want to risk anyone giving me the answers or the questions to the exam, and they did not want to go to the trouble of making a new exam for me (each rotation gets a new exam to minimize the possibility of sharing information) it would be my problem that I was three weeks shy of completion of the rotation. i took the exam along with those who were finishing the rotation. I'm sure I did fine. That's not really the point. Had it been may students other than I, they would not have done fine. I suppose that is not my problem.

I stayed awake to speak with a friend, but our wires crossed and we never made contact. I eventually fell asleep at five, and was up, dressed, and at work at 10:50, which was five minutes lates than I would have liked to have been there, but te minutes beofre i was required to be. The shift went without incident. no one did any field sobriety checks in me last night. i wonder why they were so painstaking about it the nght before without even asking a single question about it the last night, but in the end, it's up to me to ensure that i'm fit to deal with patients on a given night. i don't have enough authority to do anything to harm a patient, but still, it's up to me to be in an unimpaired state. I don't know what would happen if I showed up and told them i'd needed to take too many drugs or was too sick to work. Depending upon who was my direct supervisor for the evening, I would either be sent home or told to drink coffee to sober up and to barf in a trash can and to pass out in low-traffic areas. with last night's crew, the latter would have been the more likely scenario.

Most med students were off as of yesterday morning following any shelf exams. Because i missed time due to the HIV exposure thing, I'm expected to work at least through Tuesday and possibly Wednesday as well.  I was scheduled to have this weekend off.

as I was leaving this morning, the fourth year med school student who has no real clout but just enough authority to make my life miserable on occasion, told me that I would be expected to work 11 p.m. to 7:30 a.m. shifts Saturday and Sunday nights. She's going to be gone. ll the med school students ae going to be gone. she did this just to be mean to me. On monday morning, I'm expected to make it to work in the office at 7:45 and work the full day after getting off  at 7:30. There's no time for breakfast or to shower or to change clothing. I like to wear nice clothes and look decent when I work in the office, but it's out of the question on Monday morning. I'm pretty sure this is against state regulations, but I've called and texted my preceptor. she's not taking my calls or returning my texts.

I'm not liking medical school very much right now. Those who have the authority to pull rank do so just because they can. Those who should be high enough on the food chain that they should no longer get their jollies from pulling rank are still doing so, perhaps out of habit or perhaps out of sheer meanness. People in the profession who should advocate for defenseless students are not stepping up to the plate and doing so. I  could take a few classes and be a fully credentialed math and science teacher. Then again, I'd be dealing with obnoxious adolescents, and i don't know that I'm sufficiently masochistic to dothat to myself.  Perhaps I'll just go to work for my father. I could complete a PhD in pathology. It would take me approximately three semesters -- three far easier semesters than the ones I'm currently facing. That is starting to look better and better.

Please excuse me while I barf. I'm having a tough time keeping anything down. That will make it easier to barf all over the E.R. when I show up for my shift tonight.


  1. Sounds absolutely miserable. I hope it gets better soon.

    1. It is miserable. I, too , hope it gets better soon.

  2. This is all part of the gruellling apprenticeship. It does help yo sort out those not dedicated or lacking the necessary physical stamina needed for certain areas of medical practice.

    We worked a 36 hour -day/overnight/day every 5 days for six months. If your last night of a rotation fell into the first night of new placement no accommodations were allowed. I unscrubbed from one such during a vascular surgery rotation to immediately begin an ER rotation.

    One girl in my cohort, a diabetic, was unable to handle this without detriment to her health., so made the decision after 3 Rd year to withdraw. She became a dietician and did very well. Hard decision, but pragmatic and ultimately the right one.

    No one can decide but you if it is becoming too much, but these years are only a brief part then you can adapt work hours and specialty demands to you.

    Wishing you better days.

    1. In my dad's day, for interns it was one 36-hour shift every four days, but they did get 12 hours off immediately following a thirty-six-hour shift. Even then, those who supervise such things were forced (I think by a U.S. congressional subcommittee) to restructure things not because it was inhumane to physicians-in-training but because patients were being seriously harmed by fatigue-induced human error. It's still rough, but not as rough as it was in the day. I understand that a large part of this year, in addition to learning the actual practice of medicine, is about vetting those who cannot withstand the rigors of internship. Residents still have it rough, but supposedly nothing is as bad as that first year out of medical school. If absolutely necessary, I could get medical clearance (in the U.S.; I'm considering Canada for my internship as well, as I have dual U.S./Canadian citizenship, for my internship. I have no idea what provisions are in place there for those who fall under the umbrella of medically fragile, which I barely but technically do here in the U.S.) to stretch my internship into two years, though that is not my first choice. I'd rather tough it out, get it over with, and be a licensed physician at the age of 24. Then I can explore options for residencies. In a worst-case scenario, I can complete my residency with my dad. He has a ten-slot (residency, not internship) program for residents and two-slot program for fellows. He isn't really part of the match system, though in name he does participate. In actuality, he recruits and hand-picks. Training under him would not be my first choice, especially as it would limit my specialty choices to hematology, oncology, or pathology. None of those are among my first choices, though I could live with pathology.

      I suspect it will work out, but if not, I always have the PHD option, though from this point on, almost every day I spend in med school is a waste of time if I intend to switch to a PhD program.