Blog-orrhea

So when I left off I was in the first half of one of the tougher years of my life. Baby on the way, my wife and I were both fresh interns, and the uncertainty of what the heck would I be doing with my life this time next year was driving me crazy. You see, you don't just get a job as a doctor when you graduate medical school. You first have to complete a residency of 3-5+ years, not including any time spent in a fellowship. My one year spot in the grand scheme of this process was essentially useless as far as getting me towards "attending physician" status. It also sucked having to go over my situation no less than 3 times each day when people asked the inevitable "What's your plan?"

While internally moping and probably being a big baby much of the time, I outwardly put my nose to the grind stone when I was at work. I responded to most request with an attitude of, "I may not know but I'll make it happen." The funny thing is that residents are quickly labeled as being either "good" or "bad" by everyone in the hospital. Here are a few examples of how you can earn the designation as "good" by various hospital roles...

Nurses

• Return pages promptly
• If they are concerned, come see the patient. It shows that you respect their assessment of the situation and are handling it.
• Don't be a jerk. Unfortunately, it is too easy to snap when the pager won't stop going off and you're in the middle of ten things. Just don't do it.
• If you have an issue, talk to the nurse privately and again, don't be a jerk about it
• Stand up for them. They are stuck spending more time with the difficult patients/families than we have to and most nurses do their best to diffuse things before giving us a call.
• If you happen to be passing by and see a couple nurses moving a large patient or untangling thousands of IV lines or doing any of the other thousands of things they do, give them a hand. It really goes a long way.
• And anything else I have probably left off this quick list

Fellow Residents

• Don't leave shit (post op checks especially) for the team coming on to do that you should've done yourself. Everyone hates that guy.
• Help when you can, no matter what your level. We're all very busy and a little help goes a long way and helps us all get home to our families.
• Best put by one attending I really liked, "You are either a lion or a gazelle. Gazelles graze in the grass and wait for things to happen. A lion chases his food down and takes it." If every resident was a lion, the work load per resident would drop significantly.
• Be someone your seniors can assign jobs to with knowing that it will get done fast and well. This makes your service look slick, your chief look good, and attendings happy. All of which are good things.

Attendings

• Be honest. This would seem to go without saying but be honest even when your actions hurt one of their patients.
• Be efficient.
• Be available to do whatever whenever
• Show that you are learning, teachable, and interested.
• Keep them in the loop.

Ok enough of that stuff. I tried my best to do all that despite a growing hatred for the rectal exam (you do a lot of those in general surgery world it turns out),  and knowledge that all this extra effort may not pay off one bit.

But it turns out that it did. I became known as a "good" resident. I made friends with residents in other specialties as well. One such friend happened to be a neurosurgery resident, and due to certain things going on, he recommended that I move my schedule around to rotate with them and see if I liked it and wanted to throw my hat in with them as well.

I thought sure what the heck. At this point I had to stay in the current city to be with my wife and ever approaching baby and was only applying to ortho and general surgery this time around. So in December of 2012 I rotated on the neurosurgery service and I FREAKING LOVED IT.

The work was intense sure, but these are the people that operate on your BRAIN when there is a problem. And they quickly integrated me in to their system and it wasn't long before I was drilling holes in people's heads.

Cranial Access Kit

(or trephination kit if you want to sound cool)

 

 

Performed centuries ago to release demons, trephination and my new exposure to neurosurgery caused a ray of light to break my negative funk and bring hope back to the table. I saw people brought back from the brink on a day to day basis and I even got to help in that process. This was all done while operating on one of (maybe the most if you ask us) unforgiving and sensitive organs in the body. In my first post I mentioned the initial terror I felt when starting out that my actions may be the ones that hurt or help someone in their time of need.

 

Turns out, I now FREAKING LOVE THAT TOO.

 

So I rotated, worked hard, came early, stayed late, got my hands on procedures whenever possible. They took notice and in March 2013, almost one month after my son was born (yes of course way more important but you can go to my Facebook page or look at my phone to see/hear me talk about the most amazing little person in the world) I got the news that I matched and would therefore begin training officially as a neurosurgery resident in July 2013.

 

 



 

 

That is the majority of the first year. I now had the "categorical" spot. I had a place. I had a new son. I still had my beautiful wife who was a rock through it all. I'll likely post more significant stuff from that time if I think about it but it is nice just to move on.

 

Thus began the even more crazy but infinitely happier times.Bl