Summary of the rest of 2007

Haven't posted in a long time - that's what being an intern does to you...sucks up your time and your life. But hey, the money's alright!!

So since the last post, I completed my surgical rotations of my intern year. Orthopaedics in St. James's and General Surgery in Ballinasloe, Co. Galway (Portiuncula Hospital) . I am definitely a surgery person. I like the independence and responsibility given to junior staff, and the no-nonsense direct approach to stuff.

But anyway, Orthopaedics was a bit mad. Ortho wards are like human zoos ... half of the patients are old folks who go nuts on the analgesia and anaesthetic meds. Another quarter are the drunks and druggies who demand a lot of attention. And the other quarter are those suffering from MOLS (miserable old lady syndrome) who block beds while you wait for suitable nursing homes for them. I came to work one day and found a whole ward dancing in each other's arms to some imaginary music which one of the patients had dreamed up. We were like..."what the hell?!?!" but hey, they were happy and weren't screaming like usual so we let them.

I loved Ortho. My consultants and registrars were awesome. The only thing I hate dealing with are the social issues, but other than that...i like tools, I like the in-and-out of patients, and I like the gratification you get from getting them back on their feet. A couple patients gave me presents...which was really nice and touching. Sure, there were a couple awful days when I questioned my sanity in choosing to become a doctor, but on the whole, I loved it. The worst day for me was in my first week, when there was a difficult case we had post-bilateral calcaneal fractures. Part of a vac dressing had adhered to a portion of the posterior tibial artery which sheared when his dressing was changed. Blood and screaming everywhere, which then set off all the other patients screaming, then the mother came in and started screaming at everyone about lawsuits and shit like that, and meanwhile the patient was taken to theatre like 3 times and had maxed out on pain meds because the tolerance was quite high (a nurse actually found some unprescribed "medications" in his drawer, if you get what i mean...) . and then right after the operation this patient goes for a smoke. GD it. That was a hairy day. And other awful day was only awful (regarding the same patient) because I was post-call and a miscommunication between the nursing staff, plastics and myself meant that I was there til 8 pm post-call. That was the closest I came to losing my temper at a nurse.

The thing that made SJH surgery hell was call. I hate call with a passion. Here, there are still no capped call hours. I've been working for 38 hours with no sleep before. My avg # of hours during Ortho was 85 hrs. per week...one week, I reached 102. Call is so irritating and you get called for all this stupid shit. I was absolutely furious at one of the most stupid ones I've gotten. I got urgently serial bleeped to review a patient for thyrotoxic crisis. So I rush up from A&E thinking "oh crap, what dose of beta blocker, which one, etc." and find the patient sitting in bed, reading a magazine. His only complaint was swollen hands (note: it was warm in the room, as it was summer). No tremors, no jitteriness, no feeling unwell whatsover. So I asked the nurse, "why did you call me to review this patient?" Her reply: "well, I thought swollen hands were part of a thyroid problem. Me: "Um... no." Her: "Well, could it be a paracetamol overdose or something?" Me: "Um...he's on 1g qds, which is normal. Also, you must have been a nurse for 20 years. In those 20 years, have you ever seen swollen hands from paracetamol." Her: "Umm..." Me: "Don't call me again." (and I was also thinking, "Go back to nursing school.") which is very mean of me, but come on.

Anyway, then moved to Portiuncula Hospital for General Surgery. At first I really didn't like it because it's quite remote, and lonely. But I made fast friends with the two UCD interns that were there, and we managed to have some fun. The best thing about it was that call was so easy compared to the big Dublin hospitals. the whole surgical population equaled one ward of SJH. Our bleeps worked from home so we could watch tv or clean up the house while doing rounds, and only got called maybe 3 or 4 times to do stuff. The nurses were fun too, but it's quite different there in that the nurses really run the hospitals since the doctors change every 6 months or so. My Consultant was lovely, and I got along with my team. I didn't ever go into theatre because I wasn't too interested in gen surg (not an abdomen person), and had other stuff to do (applying to ERAS, etc.) but it was interesting to go to a peripheral hospital.

In the first two weeks of December, I went back home to do interviews. I applied mainly for EM so had an interview in NY, then a prelim interview in NY as well, then a TY interview in Georgia. My number of interviews isn't great statistically, so I'm skeptical about Matching. But we shall see I guess. I interviewed at Metropolitan for EM, and I really liked it. But they treat interviews like informal chats sometimes, and everyone gets along well so it's hard to gauge where you stand.

I ended the year by being on call Christmas and stephen's days. Christmas day was grand (I was invited over to the main gynecologist's house for dinner because I knew his daughter, who's a physio there) and it was lovely. It only got really busy at like 11:30 pm and I didn't leave til 1 am, and then Stephen's day was busy but that's ok. Then I got like 6 days off afterwards because the teams treat the Christmas season as every day on call.

so for New Years, I went up to Letterkenny (Northwest Ireland) to visit a good friend of mine for a couple days, and it was absolutely lovely. She's an Olympic hopeful so spent a couple hours in the gym to kickstart my year off well (after a night of getting absolutely hammered), and her parents are lovely too. They treated us to this massive carvery for dinner one day and stuffed ourselves, and then went for a really nice drive to see some scenery. We didn't go out New Years Eve because we wanted to start this year off right, this being a big year for her, and I thought that we could go get smashed any night, but there are very few times we can actually just spend the night relaxing by a fire. It was a brilliant New Years :)