Sunday, July 13, 2008

Four to go

One more overnight intern call left. Three short calls. 31 in-house calls left in my career. 21 more days of intern year left.

But who's counting?

Yesterday wasn't too bad. I admitted one patient that was left over, and then spent a large portion of the day cleaning up paperwork. I got ALL of my discharge summaries done (boo-ya!), including two that were left over from MAY. And pre-wrote one for tomorrow. Of course, not the one I really needed to pre-write, but, whatever. And then, of course, as is typical, the day picked up around 5pm. I did a pretty thorough consult on a woman who tried pretty hard to kill herself, and then sent her to Medicine. She's undoubtedly back, and will be on my service tomorrow. I sent another woman from my service to Medicine.

Medicine looooooved me last night, let me tell you.

I slept in my office last night instead of the call room. Peng (who's, of course, my officemate), thinks that's weird. But I slept so much better. I think it was a combination of things...the most obnoxious of which is that the concrete floor with the thin industrial carpeting over it is actually more comfortable than the call room beds. But I think it was also a bit of being in more comfortable surroundings (i.e., it was my space). And I think it also helped to be behind a locked door that not everyone has the key or the code to get into. And it was so much quieter. I think I'm going to get a sleeping bag or a camping pad and make a habit of this for the next 28 overnights.

I used to do that in medical school, when I was taking call on the NICU. I was on the Nurse Practitioner team, as opposed to the resident team. And I was pleased about that. My co-sub-I was a future pediatrician, so it made more sense that he would be on their team anyway. And, let's face it, I'm more suited to the touchy-feely NP team. It was a good experience. They gave me my own desk. It was comfortably decorated and less stark than the physician workroom. And we had these little white Christmas lights in the office (because it was December). It was a cozy, cozy place to sleep.

Mmm.

One of my friends, who's a year ahead of me, can't say enough about how good third year is. I'm just looking to get to second year.

I love my job. I can't actually say that enough, because it always sort of amazes me. Maybe I'm just not used to it, to being able to do my job, to love my work, and not constantly be fighting with the people who are supposed to be supporting me. Maybe it surprises me that I'm as happy as I am in psychiatry. Because, honestly? Back in the day, I never thought of psychiatrists as "real doctors."

Which of course, is crap. We play dumb a lot ("You've got take this patient onto your service. I mean, we're just psychiatrists, here"). In a lot of ways a good psychiatrist is more a doctor than others. Good psych nurses are the same way. We have to watch all the medical stuff, have enough of a knowledge base in general medicine, endocrinology, etc, etc, to manage the biological part of our patients' illnesses. And we need to know when we're in over our head. Like, my patient who's been going into renal failure for a week; I've been pestering Medicine to take her for about as long). And then we have to have several whole other skill sets - therapy, management of various disorders, psychopharmacology. And then we have to be able to deal with ourselves, you know? Our responses to the patients, our own issues, our sympathies for them or anger at them. Or the pieces of ourselves that they represent for us.

That gets hard some days, you know?

Nah, I don't know where I'm going with this, either.

I'm tired...

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