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 !