this-is-mdness

[this-is-mdness]

When a nurse says they think a patient is seeing multiple people, it's important to clarify if they mean hallucinations, or romantically

[this-is-mdness]

Right when I started working in the ER, there was an absolute legend of a patient in my pod that was complemented by a legend of an ER doc. I was scrolling through Epic seeing what's what and I see a chief complaint of "Penis Injury". I thought "Oh boy, what's that all about!"---I clicked.

"Patient states that he was using a mechanical penis extension device and that since using it one hour ago, he has no sensation in his penis whatsoever"

I read that and thought "Huh. Wow crazy." (Working in an ER is like working at a Waffle House.)

The situation itself isn't what was making me cry from trying to hold in laughter. It was the ER phsyician who was nonchallantly referring to the patient as "Penis Guy" over and over again in a conversation with is resident.

"What we're thinking with penis guy is..."

"The problem with situations like penis guy is that..."

"Yeah, penis guy will most likely be fine in the end..."

"When you're a full blown doctor, people like penis guy can really..."

"Hey, did you read penis guy's chart yet?"

"I have a plan for what to do about penis guy!"

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(going through the process of becoming a medical doctor) who could’ve guessed that this would be hard

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06.24.2025

Today was a happy cry day.

My patient today was 13 and had the same nickname as me (relatively uncommon name). He and his parents were such a lovely family. We bonded over the names and that his parents were also from California. It was cute.

I did my first double lumen tube today and it went so smooth! Hell yeah!! When the regional team came in the do their block, I was suturing in my arterial line. The attending told me that I was more fun now than at the start of the rotation. I pretended to be offended, and he told me that I had been so nervous at the start he had been scared to make jokes around me, and that it was nice to see me now having fun and sassing him back while taking care of my patient. Honestly, it was really really sweet. And it hit, because I know that confidence is something that I struggle with. It always has been, and it's always been noticeable to those around me. I'm not good at hiding it.

Yesterday I had my end of rotation feedback session with the rotation directors, and they just kept reading me positive reviews from attendings. Some of them I felt like were just lies, but there were some real fucking compliments in there. Two I hope to remember when I doubt myself: "would love to have her as a colleague" and "I can't wait to see her as a CA3." I may not be perfect, but I'm also not as useless as I sometimes make myself believe.

I can't even remember what I stress cried about last month. I remember working with a snarky attending, feeling like I couldn't do a damn thing right, and being so tired of being at the whims of whatever plan my attending came up with. Guess who was my attending today? But now I know how to handle his snark; I know how to match his energy and give it back. Today was a good day.

I listened to music I love on the way home. Happy tears started welling up on the way home as I reflected on the day, and I realized I was driving the same stretch I was sad crying on last time. Life is funny like that.

I still don't think I want to do a peds fellowship, but I have learned to appreciate the simplicity and fun of healthy kids. Exception: older teenagers can go be someone else's problem, must you be so sweet when awake but such a monster waking up?

So happy and proud of my growth today. I fucking love my job.

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ranking the best things I have heard surgeons say mid-surgery:

1. "Five second rule!" while scrubbed, after dropping a sterile scalpel on the floor (no they did NOT pick it up again but I swear everyone's buttholes puckered)

2. (spoken during the closing of a particularly long and difficult case) "Nurse - my tunes." :heavy metal starts blasting:

3. Gently to a fretful patient, pre-anaesthesia: "It's going to be okay. I promise, I've dealt with worse." As soon as the patient is unconscious: "This is literally the worst thing I've ever seen."

4. [okay this one was a med student] "Wowwww, that's so gross!!" Reg: "Please remember that [patient] is awake for this procedure." Student to patient: "Oh my god. I am so sorry, that was really unprofessional - " Patient, cheerfully, also engrossed with what's happening inside them on the screen: "Nah - it's, like, super gross, right?"

5. [another procedure where the patient couldn't be put under GA] Patient: *starts singing country roads midway through the procedure* Surgeon: *shrugs and joins in with surprisingly good harmony*

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06.12.2025

Hey, guess what? Peds anesthesia got better.

In my last month of it now. Feeling more comfortable. Not calling for every little thing. Kind of getting a feel for what blood pressures are okay. Working with attendings I like, getting to know their quirks.

Had a great moment today where we had a nervous 16yo, attending brought her back and started getting her at ease. We cracked jokes, I drew her a cat, we had a good time. Apparently the cath lab team commented to him that they liked me??? Which I don't understand because I genuinely just sat in the corner and did nothing all day, but I will take it?

Working with the fellowship director tomorrow...who I dislike working with. She's particular but also overly friendly in a mothering way and we just don't vibe. But we got through the staffing phone call and she told me I did well and that she's proud of me, which I feel like she tells anyone who demonstrates a modicum of effort, but whatever. At least she doesn't hate me.

I still hate NICU babies. I'm still not interested in pediatric fellowship (or any at all, I think). But I'm learning more about kids, and starting to enjoy the healthy ones. Things are as they should be.

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06.07.2025 - ABA Basic

Well. That was a test.

I felt like I didn't study enough but some of the questions I'm not sure I would have studied anyway. Not sure if those are hard questions or if other people are studying differently than me? Am I dumb or is the test just like this? Who knows.

Some of the questions literally could have been on Step 1...it's crazy. I do kind of appreciate how straightforward the question style is though, everything is 1-2 sentences and first order.

By far the worst part of the test is that the proctors called all of us "doctor" every time. Please....

I'm glad I took yesterday off and spent the day working on a new cross-stitch project and snacking rather than trying to last minute cram and panic. Most people pass--I should, too.

[this-is-mdness]

Reasons I Despise/Dislike Pediatric Anesthesia:

NICU babies are so tiny and why do I feel so awkward trying to pick them up but other people make it look easy?

Why is the kid crying? Are they hungry, emotional, or in pain? Am I supposed to do something? Help.

Oh my god why are you broncho/laryngospasming?

Why do I suck so much at IVs and intubations? I am useless.

Please stop having genetic syndromes I have neve heard of before.

Damn I am rusty at the arithmetic needed to calculate drug doses.

Actually, I do not know how to steer a stretcher and watch for fogging/chest rise at the same time. Especially when you keep bundling kids up in a babushka burrito to keep them warm.

I am bad at smalltalking children.

I actually do not think that babies are that cute.

Needless to say, I have no interest in pursuing a fellowship. I was so wrong.

[this-is-mdness]

05.09.2025

Well, we did it. We officially broke the streak of "did not cry because of work" this CA1 year. Made it 10 months.

Nothing major happened. I feel better after a little cry (avoided a sobfest) at home and food.

Telling myself that it is okay. Not every day is perfect. It's okay to have a bad day. One bad day is not necessarily the start of a downwards spiral.

But damn, do I wish I had a shoulder to cry into. I am so tired of the pressure I feel (self-inflicted?) to be "okay."

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04.30.2025

Am I the only one who feels like I've been lied to about laryngoscope blades? Specifically, the idea that straight blades should be used to scoop the epiglottis and pin it up? In a newborn, yes. In most of the children I've intubated? Ends up in the vallecula and works just fine??

[this-is-mdness]

at the euthanasia party everyone gets a sip of the forbidden lean

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04.10.2025

Did my first caudals today! 1 ultrasound, 1 blind.

Baby sacrococcygeal ligaments are smooth like butter. So cool!

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04.08.2025

I did it. I survived my first day alone as a resident on my pediatric anesthesia rotation.

Did I have a giant stress stomachache all morning? Yes. Did I call my attending multiple times to ask if a blood pressure was okay? Yes. Did the surgeon get kind of annoyed at me? Did I keep forgetting stuff in my setup? Did I miss an intubation? Yes and yes and yes.

But did I and all my patients survive? Also yes.

I'm still exhausted, I still hate this, I still wish for this rotation to be over as fast as possible. That's okay. We (and our patients!) keep on surviving.

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04.05.2025

I asked to do my pediatric rotation early because I thought I might have some interest in it. Oh, how wrong I was. It's week one of a three month rotation, I keep trying to tell myself that I have to wait a month before a really hate it, but god I cannot see myself doing this.

Kids make me so medically nervous. I feel like I can never relax. I don't know what normal vital signs are. I have to think seven times and reference a handout before I give any medications. How do people do this during emergencies? I don't get it. I am NOT an adrenaline junkie and I don't want to be so scared all the time.

On the second day, we had a 2yo laryngospasm on emergence. Did you know that a pulse ox can go down to 2%? I didn't. I know that number isn't "real" but we all know it was Very Bad. They ended up being discharged home--it's true what they say about kids being resilient. It's crazy, but it doesn't fill me with hope. It terrifies me that any healthy kid can go downhill so fast at any time.

I thought I would feel awful the first time I made a mistake that killed a patient. I have one patient that I kind of killed; it was a mostly blameless situation and I didn't enjoy the experience, but it was surprisingly manageable. But seeing a little alien in the ICU that's been here for half their life? Reading their chart and meeting them and their parents and seeing the love, and realizing how horrendously awful I would feel if the kid died on my watch? That surprised me.

I also don't like this hospital or the fellowship director, but that's site/program specific. That's not a big deal. The root of the issue is that I am stressed and scared and exhausted, and I just don't see how I can do this.

They say it will get easier. I hope so. I can't handle this.

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Doctor: What do you see in this X-ray?

Students: *collective gasp*

Doctor: Please don’t do that in front of patients.

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[this-is-mdness]

Whoever decided to give your sinuses boner parts should be beaten