I'm a PGY-2!

I finished MICU in June with no further difficulties. Had a relatively laid-back time and found after the Dublin ordeal, I was able to have much more collected thoughts and I'm glad I went for that sense of closure. Unfortunately, I had a case that I'll remember for the rest of my life where one of my patients, a young lady, died from the dreaded Swine Flu (she was immunocompromised as she had just delivered a baby). She developed ARDS, pneumomediastinum requiring bilateral chest tube placement, we placed her on a rotaprone bed with nitrous oxide therapy and at one point were considering ECMO. But it became more and more futile, which was of course very hard for the family to accept. And one of my nights on call, she became very bradycardic which we managed to resus for a few hours, before she coded. I had to call all the family to tell them to rush in, and try to get it into their heads that there was not going to be a miracle, and ask them to let her go peacefully. It was absolutely heart-wrenching, but interesting from a personal standpoint how to think of ways to get them to understand that we had done everything and have the mother sign the DNR. I think eventually what made them understand was that I explained we were not treating her, but treating numbers. I nearly cried at several points, but people seemed to think I was being very strong. But I was also really angry that I was the INTERN who should NOT have the responsibility of doing this. It should have been the senior residents. But, c'est la vie.

This last month was my trauma month in Harlem. I think it was a pretty good month for me, I don't know what I've missed because I didn't get any TICU exposure, but I got a couple chest tubes and some intubations, so I'm happy. Hopefully I'll get more when I go back for my regular ER month in April. I enjoyed it, which I'm pleased about because it's been awhile since I've really enjoyed my ER job. I was worried (and still am) that I have made the wrong career choice, and I still do feel to some degree that I've reached this goal and now I'm bored of it and want something else. But I think maybe as an attending, perhaps I'll be able to do my clinical shifts and who knows, make some money doing something completely different (ie. more creative)? We'll see. I don't think I want to do more than 14-16 shifts a month, but what made it better was that people seemed to value my work at Harlem (patients and attendings alike) and that sense of reward is satisfying. I'm just wary that I fell into this job because I happen to be good at it, not because I have a passion for it.

Summer has really not been summer yet, there have been a couple hot days but many more cold very thundery drizzly days. But I managed to catch a great warm weekend and spent it learning how to sail. The doing is not as difficult as figuring out where your point of sail is, and in that I need much more practice. If it wasn't so expensive I'd be continuing it a bit more this summer, but I need to save more and maybe I'll sign up for the dinghy class later. It was liberating though, although I probably enjoy rowing more. Cycling there gave me a chance to explore a new bike path adjacent to the hudson river though, which was pretty awesome.

I also recently went on my first "date" via match.com, which finally paired me with an attractive intelligent guy instead of a definitely-not-my-type 60 year old....we went the Coffee shop in union square and it was absolutely downpouring. He seems quite interesting, so we'll see where it goes !

Argh.

Well, I typed out a description of the rest of the services and my impromptu trip to Ireland, but something in blogspot messed up and I lost the post. I don't have the energy to retype it. Maybe I will later. Suffice it to say that two months after the incident, words still fail to describe all the emotions and details.

Continued

Oh, here it is.

I don't really feel like writing down every last detail, but I'll remember June 1st 2009 for the rest of my life.

The Butler's reception afterwards was simply amazing, and extremely detailed to dot what would have been Aisling's last I's. The next day in Dublin, it was the Trinity service. Many of us in the class met in the Pav together so we could go en masse to the Chapel, and again it was nice to have strength in numbers. The music I thought was quite somber, so it was very emotional. But Gra and Fergal gave fantastic speeches about the girls, there were professors there that we had not seen for awhile, and representatives of Air France, Brazil and France, and the President of Ireland were there. There was a nice reception in the Dining Hall afterwards, then headed to the Bailey for a commemorative drink for the girls, then the Deasy's had an absolutely lovely reception at their house afterwards as well. I mean, this was just so heartening to see people pulled together. At the Deasy's, a lot of the professors were there and it was nice catching up as well.

Had a couple days respite and just got to hang out with my rowing friends for a few days, which was really nice. I'm really glad I have friends outside of medicine to connect me to my second home. But being back made me really wish I had never left, and although I will never want to work for the HSE again, I loved living in Europe.

That Sunday was Eithne's service in Belfast, and at the reception afterwards there was a really lovely slideshow of photos.

That's all I'll say about that now. It's been two months since it happened, and words still fail to describe all the emotions and details. I'm not a very good descriptive writer, though. The only good thing to come out of this trip besides being with everyone again was a terrific amount of drinking. Peter and I went to a lovely tapas bar on the Friday night (very late as he got out of work late) and drank a hell of a lot of wine and cocktails. Then saturday night, I took him to this really fancy extraordinarily expensive dinner at Shanahans on Stephens Green where the decor is absolutely amazing.