Geriatrics, The Beginning

Most people dread the required Geriatrics rotation. Not me, I'm looking forward to dealing with this segment of the population. It's primary care to its core, with patient interactions largely occurring in nursing homes or home visits. You'd think the orientation would basically be this shoo-shee froo-froo type affair, telling us how great old people are. But no, they get hardcore immediately.

"Do you any of you have allergies? Because some of these patients have, like, thirty cats. And if the cat dander doesn't kill you, your mold allergies will."

Even better, the clerkship coordinator gives us several safety tips for our home visits:

• Always travel in groups.
• Never offer transportation to the patient or their family members.
• Mace doesn't work.
• If attacked, yell "Fire!" instead of "Help!" or "Police!"
• There is some evidence that supports the fact that medical care workers are granted some amount of amnesty when traveling through unsafe neighborhoods, so wear your identification badge prominently.

The speaker concludes cheerfully,"We haven't lost a student yet, and we don't plan to..." Still, I'd feel a little better if they had standard issue body armor for this rotation.

MICU, Day #25

Sike!!!

Like the day after Match Day we would actually be expected to show up to our rotations. Yeah, right. No, this day is for taking analgesics and rehydration.

And?....

Philadelphia!!!!!!!!!!!

w00t!

One Day More

At noon tomorrow we get to open our envelopes. I don't think I'm going to be able to sleep tonight.

MICU, Day #21

A better day in the MICU today - I felt more like part of the team. But...the better news is:

MICU, Day #18

My first unenjoyable day in the MICU. Happenings at the VA Hospital seem to occur in slow motion. The MICU is no exception - patients get admitted, taking their time to heal (if they can). It's a rather low-capacity intensive care unit - due to staffing cutbacks, there can be no more than six patients in this unit at any one time. Since I've been here, the admissions to the unit have been few and far between. I myself have only admitted one patient, and it was a patient that really didn't have to be in the unit in the first place. We booted him back to the general medicine floor pretty quickly. The other patient I had been following got better while I was out of town, so when I returned, I had nobody to follow.

The team of residents and interns has turned over completely, so nobody remains of the original MICU team. That team spoiled me - the original residents were particularly good at making sure I was getting the most out of the rotation. They gave me lectures, papers, and invaluable clinical pearls. The new team...not so much. The new resident didn't even bother to meet me today, just looking in my direction as if I'd passed gas - loudly - in the middle of rounds. The residents and interns pretty much just talk amongst themselves and leave me out of the discussion.

My first feeling was one of paranoia - what had I done (or not done) to now be excluded from the rest of the team? Did I fail to engage them enough intellectually? Am I asking stupid questions? Did I run an inappropriate plan for the patients? I've come to the conclusion that the reason is far simpler: They simply have no interest in teaching medical students. At least not this one.

So, I got my work done before noon. I ate lunch. I sat around for an hour studying or following up on the patients. Mercifully, one of the interns sent me home in the early afternoon.

*******

Six days until Match Day!

Match Day Invades My Dreams

Day-to-day, I am experiencing relatively no anxiety as Match Day approaches. I'm pretty certain I'll match somewhere, and I'll be happy with the result.

"Not so fast!" my sub-conscious interjects, and Of course, my sub-conscious has a different opinion, as demonstrated by a recent dream...

I'm wearing a suit - not the standard issue funeral-like garb medical applicants wear when on interviews. Out of the corner of my eye I see a board with numbered lines on it - apparently Match Day is going to go down like Draft Day. Names that I don't recognize, yet which don't sound entirely unfamiliar, are announced, and these names start taking up the available residency spots on the draft board. Alas, my name is not among those selected for my #1 ranked residency program. The next event is a blur. I find myself now in a different room, holding an envelope. It feels both thick and thin in my hands. Intuitively, I know that my match results are contained within. I open the envelope and unfold the paper. It reads:

"Congratulations! You have matched at your 17th-ranked residency program."

The dream ends.

Very funny, Mr. Sub-Conscious. I only ranked 13 places...

*******

9 days until Match Day!

MICU, Day #13

ALS sucks.