Island Med Student

I’ve been contemplating writing this blog post for a few days now. I wanted to write it, but thought I should wait until I had calmed down a bit, so that it didn’t sound like a huge ranting session. I guess I might as well just tell the story. I think it might help release some of the stress.

Let me begin with some background. I have no idea how to say this without sounding conceited, so I’ll just say it anyway. Echoing the thoughts of Jeff Wonoprabowo in his recent post, I have also always struggled to be the best. I have always maintained a very high GPA. I have always excelled in my exams. I am a bit of a perfectionist. I am a natural leader, and I always try to do everything to the best of my ability. I am generally not lazy, and I am good at “getting things done.” Okay, I hope I don’t sound too full of myself. I am certainly “not good” at many things (singing is an excellent example), but there are some things that I’m really good at, and making good grades has always been one of those things (as is common with most med students).

I did very well during the basic science years of medical school. I maintained a high GPA and performed well on both written and oral exams. I also did very well during my first two clinical rotations. My third and fourth clinical rotations, however, have been a bit different.

Okay, so now I’m going to come right out and say what I’ve been beating around the bush about. I received a “B” in my surgery rotation. Now, I know there are probably many people out there who are thinking, “seriously, SERIOUSLY, she’s complaining about getting a ‘B?!’ What’s wrong with this girl?!” But I’m hoping that many of you are still reading, and maybe there are even a few of you out there thinking, “hey, I understand!”

Here’s the thing. My surgery rotation was very tough. The hours were grueling, and the work was at times quite challenging. But I rose to the challenges. I stayed late when no one else would. I offered to do consults and other non-required tasks. I scrubbed in when no one else wanted to. I went out of my way to help my patients. I spent more time with them then I had to. I got along well with “most” of the nurses, residents, and attendings. I always did what my residents asked of me, and tried to always go above and beyond their expectations. I also did comparatively well on all the exams and quizzes. I can honestly say that I think I deserved an “A.”

I think the main problem with the surgery rotation was that we were never really told how we were being evaluated. Unlike my first two rotations, which provided clear guidelines on how students were graded, we were basically in the dark. When I got my grade, I didn’t even know who actually gave it to me. I also don’t know what I could have done better to earn an “A.” I certainly can’t think of anything shy of actually performing the surgeries myself.

Unfortunately, my current internal medicine rotation seems to be going similarly. I don’t really feel like I know what is expected of me. And this time, I really don’t know if I’m even doing a good job because I’m not sure what a good job is!

So, that’s my rant. I know it seems like such a silly thing to be upset about, but I just don’t like the feeling of “not knowing,” I guess.

I’m wondering if this lack of information about expectations has to do with the hospital, or the rotations, or the attendings, or something else. I’m actually very interested to know if anyone out there has experienced anything similar. Do you always know how you’re being graded during your clinical rotations? Or have any of you also experienced what I’m going through? Also, have you ever received a grade on a rotation that you thought was not a true reflection of your performance?

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Many photos were taken during my recent vacation, but I have to find a card reader, and stalk my friends to steal their photos.

In the meantime, please enjoy this pic of me and Laura, and a card that I received from Nate.

I love you all sooooo much!

Okay, vacations actually don’t suck. I just had a very awesome one where I got to see my family and my lovely friends. What did suck was coming into the hospital today. I was having this awesome dream this morning where I had every super power possible and was going around and saving the world. And then my stinking alarm clock woke me up and I realized that I had no super powers, and that I had to get out of my warm bed and walk in the cold to the hospital where I didn’t want to be. I am truly hating this internal medicine rotation!

Bindi and I are going to drink the Kool-Aid together.

“We all move on the fringes of eternity and are sometimes granted vistas through the fabric of illusion.”

-Ansel Adams

• the motley resident
  (tags: blog)

• The Uninsured Overwhelm Emergency Rooms – NYTimes.com
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• Doctor and Patient – Where Have All the Doctors Gone? – NYTimes.com
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The words “should old acquaintance be forgotten” are ones that most people instinctively associate with the new year. I never really thought much about them until recently, when I learned that the title of the song is “Auld Lang Syne,” and that it has an interesting and long history. Read more about the song on wikipedia.

So it got me thinking…should old acquaintances be forgotton? What does that even MEAN? Well, it can mean a lot of things, and reading about the history and interpretations of the song, I realized that it means a lot of things to a lot of people.

For me, it means should old “people I’ve known” be forgotten. This is something that I think about a lot. I have a lot of friends. I have a lot of acquaintances. I have met many people. I make friends easily, so I always find myself somewhat overwhelmed by my number of contacts. I only have so much time in the day to spend with other people, so I constantly find myself making decisions as to who makes the cut.

I wish I had the time and ability to hang out with many people, all the time, but it just never seems to work out this way. I know I’m not alone on this issue. Everyone has to make the same choices every day.

I once read the quote (can’t remember where):

“How you spend your days is how you spend your life.”

How very true that is. And you can extrapolate that phrase to:

“Who you spend your days with is who you spend your life with.”

Something to think about.

I’m so glad that I have so many absolutely amazing people to spend my life with.

Note: To find a pic to go with this post, I went to my photo archives and found the very first photo I had electronically with me and other people in it. I guess this photo is some 8 years old!

Micah and I took Scope and Molly to the park on Friday, during the big snowfall we had here. They found a playmate, “Charlie” and had an absolute blast chasing snowballs and romping around. Unfortunately, the snow was coming down too hard to get any photos, but we did get a very short video clip. We just took them to the park again today and they had fun playing in the slush!

While rounding today, I auscultated a patient’s heart and then reported my findings to the resident. Luckily, I was correct in my diagnosis of aortic stenosis, based on the murmur I heard. My resident applauded my findings and then said something which offended me a little bit. He said, “see, now that’s the difference between a doctor and a nurse… You were able to diagnose aortic stenosis based on a clinical finding. A nurse would have to read the echocardiogram report to make the diagnosis.” While I know that he was trying to give me a compliment, I felt that he was doing so at the expense of criticizing nurses.

Today was not the first time I heard a physician utter the phrase, “that’s the difference between a doctor and a nurse.” Actually, I’ve heard many doctors use the phrase to demonstrate the ways in which doctors are superior to nurses. I’m sure sometimes doctors use the statement to simply point out the differences between doctors and nurses, but I happen to feel that the words are a bit diminutive towards nurses.

I’ve never worked as a nurse, but I did work as a technician for over three years and was a part of the nursing team. While I didn’t have as many duties and responsibilities as the nurses, I did take vitals and performed other nursing types of procedures. Because of this experience, I have a good idea of what nurses go through every day. I’ve been on that side of the equation.

Now that I am a physician in training, I am on the other side of the equation. I see everything from the doctor’s perspective, and the nurses are now the ones that I ask to do things, instead of the other way around.

The conflict between doctors and nurses has been around since the beginning of both professions. Most physicians would agree that nurses can be your best friend or your worst enemy, and it’s hence a good idea to stay on their good sides. However, I’ve seen a lot of variation in the ability of physicians to interact with nurses positively.

Having been on the nursing side, I feel like I’m more hyperaware of the importance of maintaining an excellent working relationship with the nurses (and for that matter, every other member of the clinical team). I also realize that condescension and superiority complexes can lead you into precarious waters with the nurses.

Ultimately, our patients are what matter the most, and we should all be able to put aside our differences in order to provide them with the best care possible. I think it’s important to recognize and appreciate the unique contributions that each member of the team makes. I’ve seen some physicians who are quite skilled at working well with the other team members, but I’ve also seen ones who have a touch of the god complex, and can’t seem to come down from their high horse for long enough to appreciate the work of the techs and nurses, in particular.

Perhaps it would be easier if we all walked a mile in each other’s shoes. If every doctor had to spend at least a few days working as a nurse and vice versa, maybe there would be a lot more respect for each other’s jobs, and for the so-called “differences.”

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