Mile 11942: Exploration - A Prelude to Part III

Above: Michigan Avenue in Chicago has to be one of my favorite streets of all time. September 2010.

IN JANUARY 2011,
WE'RE TRULY HITTING THE ROAD.

Is this something I'm truly excited about? Yes.

With me finishing up psychiatry (roundup ahead), I have two big cores left, OB/GYN and Surgery. Both are at St. Anthony Hospital in Chicago and I begin the OB half this upcoming Monday.

Now that all the bugs have been smoothed out (they were kinked for a little bit), I can tell you that I'm going on an amazing road trip. In May of this year, I went on a road trip that was independent of medicine, just to explore life without limits, and not to be a medical student for a little while. However, beginning in January, I'll be going on the road to do several rotations away from home. It's my time to explore where I might do residencies, different places to work, and even experience what it is to live in a city that's not my own.

(Please don't get me wrong, I love my hometown, the Windy City, to death. I'm just an explorer at heart.)

My current remaining schedule looks like this:
November 2010 - Obstetrics & Gynecology Core at St. Anthony Hospital, Chicago, IL
January 2011 - Family Practice Sub-Internship at Decatur Memorial Hospital, Decatur, IL.
February 2011 - Internal Medicine Sub-Internship at Wilson Medical Center, Johnson City, NY.
March 2011 - Intensive Care Unit at Grant Medical Center, Columbus, OH.
1 week break to take the ever-so-important Step 2 CS on April 1, 2011.
April 2011 - Surgery Core at St. Anthony Hospital, Chicago, IL
Planning 4 week break to take the also very-important Step 2 CK in July 2011.

After then, we're back to an abyss as to what to expect after then. I have about 16 weeks of electives remaining to schedule, as to what they are, we'll see as I have a series of sites I'm looking into and will be putting in my reservations for them soon...

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And now approaching 12,000 miles, I have ended psych. The doctor I round with in the morning and I have seen many things we never have expected to see, everything from people saying that they were "poisoned" to people who have ended up with more money in their pocket after dying. I even met someone from Bedrock (ever Meet the Flinstones?). And as crazy as these stories may seem to some people, doing a psych rotation really has put new perspective on how to look at these patients. To me, with each interview, I was getting onto a roll of taking each interview as a conversation I'd have with someone over breakfast or a cup of coffee. Each patient (from the elderly with dementia to the teenager with schizophrenia) presented with a new challenge, which was something I always welcomed. That's the way I learn: through my challenges.

Although my career interests currently don't involve psychiatry, I value now being able to see how the skills that psychiatric interviewers use to talk to their patients can be used in any setting, and it certainly helps in making any doctor's job easier. Thanks psych for a wonderful six weeks, I loved every moment of it.

So now I'm now a Fourth-Year student (by numbers of weeks of rotations)... If this past year came that fast, well... the next year is going to fly.

Mile 5998: Fritos & Coffee

Above: Roadside stands like these are available all thoughout Georgia. I get my load of honey-roasted pecans each time I pass here.

EVEN WHEN ITS ONLY FIFTY-DEGREES OUTSIDE,
MY WINDOWS ARE DOWN.

Every minute seems to blur into another, as the weeks pass by faster and faster. We're already in our third week (about to start our fourth), and it was only yesterday that I remember we were getting into the realm of things. The one thing I like about the internal medicine (IM) rotation I currently am at is that it satisfies the standards that I had set at Mile Zero on my journey very well. Doing this rotation actually makes me rather excited about IM. Our work on the floors has the quality of intensity, something I have been desiring for some time.

The following is a normal itinerary for me on a weekday.

6:00 AM - I leave home early. In Chicago, traffic accumulates with every minute lost in the morning, so this is the absolute goal for departure. Although I don't have to be at the hospital until 7:30, I'd rather do some reading in the resident's lounge than waste more time stuck in traffic. I usually get to the hospital about 6:30 AM, and when I get there, I'm loading up patient data from the computers and visiting the patients I'm following before my intern arrives.

7:30 AM - My intern arrives. The first thing he does is make coffee at the maker in the resident's lounge. On the table in front of the maker is an aluminum tray with a few juice cups and bags of snacks that the hospital delivers for the on-call team for the night. He usually isn't able to grab breakfast in the morning, so he grabs a bag of chips and opens it up for breakfast. Not leaving my resident alone with the morning ritual (even though I already had my Frosted Wheat Puffs and Ovaltine earlier this morning), I usually pull up a bag of Fritos (or Cheetos, as a viable alternate) and get a cup of coffee.

This is a superb example of a resident-recommended diet.

8:00 AM - I round with my intern, releasing the data from the labs I pull in the morning and the data I pulled on the history of the patients I'm following. These rounds are walking-intensive (involving going up and down several floors and down several wings) and can slow down whenever patient demands in the ICU or on the floor come up. I usually find myself walking around in "shadow mode" sometimes, leading myself to walk exactly in the footsteps of my intern (which could have me backing up into walls or other health care staff).

10:00 AM or thereabout - On some days, we have what they call "teaching rounds," with a senior attending physician along with our group of interns and students (about 8 in total), which involves a component of lectures, bedside patient presentations, and resident/student presentations. This is one of the lecture components provided. I believe that lectures are good to recap what's going on in the hospital. Getting lost in the demands that the rotation/residency provides is easy; we can't forget we have to learn every step of the way.

12:00 PM - We have another didactic lecture over lunch, on a hot health topic. This usually takes place in the lecture hall and makes our day more efficient, by giving us a good time to combine eating while our learning. Time management and efficiency is critical to operating and being successful in residency.

1:00 PM - I sit down and write progress notes on patients I'm following. The afternoon is usually left to admitting new patients, taking their histories/doing physical examinations, running actions/plans past my intern, and reading up on their cases. Medical education is very reliant on real cases, and that's a good thing. It's not the same reading about a topic in a book. Each medical case encompasses critical thinking skills and problem solving. Memorization won't get a physician anywhere.

5:00 PM - By this time I'm ready to leave the hospital if I did everything right. Sometimes there are exceptions, either late (or multiple) admissions, falling behind on notes, and the occasional assisting the intern, so he can get stuff done earlier. But in the end, I don't see the way I work with my intern as senior-junior, but in many ways it ends up as a team. I think that's just really cool, because that team combo has enhanced my learning experiences in medicine.

6:00 PM - After some time in traffic, I stop by one of the nearby Caribou Coffees or Starbucks and pick up a good iced coffee that powers me for the rest of the day. That night, I read up on primary literature for my cases and lectures, and I finally get to bed by about 11:00 PM.

And with that (and some occasional changes day-by-day), it's simply rinse and repeat for the next day at work. Weekends are a tad shorter (ending by 3:30 PM), but the same routine above follows. I'll be shooting out more specifics on what goes on during my internal medicine rotation, so stay tuned.