Okay okay okay!

So today my friend Rob posted this on my FB page, "I feel like the blog is circling the drain.. like an end stage nephro patient. Write more stuff!!!" 

Which is fair enough. I've had a lot of posts or snippets of posts floating through my head since I started residency but for a number of reasons I feel like I can't write them. 

For one, I live in a pretty small town and I have an ever-increasing paranoia that I am violating patient confidentiality by writing about things that happen at work. Also, for some reason I feel slightly more duty-bound to pretend that everything is fantastic because SHAZAMMMM! I am done medical school and am actually a doctor now - i.e. life goal has been realized and therefore I should be rolling through a field of tulips with an ecstatic expression on my face. 

Truth is, I am actually not that happy. But I mean really, the cards are stacked a little against happiness right now. 

I just moved to a new town and have no friends. I just started a new job which is always stressful. The herniated disc in my back is unrelentingly painful and restricting my activity (thus quality of life). I am broke as a joke. My boyfriend still lives two time zones away because Canadian immigration moves slower than maple water in an ice storm and his permanent visa has yet to be granted. This town is ROUGH. I could go on and continue to list another dozen first world problems but I will stop myself there. 

I am a positive person, I really am. I always try to find the silver lining in things. I try to think that everything happens for a reason and that the universe puts me where I need to be. But I just can't seem to go there in my mind right now. I am not a person of regret usually but right now I regret so many things. I regret studying abroad and the financial repercussions as well as the professional ones. I don't want to be here. Am I allowed to say that? I can't wait for the end of the day (or night) when I can be home watching "Parks and Recreation" reruns in the quiet darkness of my curtain drawn living room. 

Transitions are hard, and I know that. I remember being nauseated and sleepless before every shift when I first became a nurse, and gradually that faded. I just suppose that I am frustrated too that I didn't anticipate these growing pains. I (erroneously) believed that I knew what I was getting into, coming into medicine from a nursing perspective. But I realize now, more than ever, that every stage of life brings with it some joys and some sorrows, some stimulation and some tedium. Becoming a doctor hasn't allowed me to transcend that reality. It's just given me more waking hours to experience all of it.

What apps?

Hello world.

I am keen for some suggestions on apps that people find indispensable. Recall that I am doing rural medicine which means I need all specialties, all drugs, and all procedures, at all times. 

I was hoping that PEPID would answer this call since it has the ambulatory medicine suite and the EM suite - it's ok. But the interface looks like something from the 80's and it keeps crashing on my iphone. Boo.

I am mostly using Medscape and Pedi-STAT (and PEPID when it works and while I am still enjoying a free trial).  

Also, actual books that people found useful in residency would be welcomed. Currently I only bring my "Bugs and Drugs" with me. I'm just that hardcore.

Annnnnnnnnd GO!

Multi-tasking

I picked up the kid's chart. It wasn't a simple consultation as he had been referred to the pediatric clinic for ongoing investigations of chest pain and palpitations. It was a busy clinic and so I was trying to juggle reading referral letters, getting histories, and writing notes all at the same time.

I was sifting though the documentation while a sweet, round faced lad swung his legs against the examination table - non stop kid-style stream of consciousness monologue pouring forth. So while I'm seeing ECG's and prescription refills and trying to elucidate the history from his mom, ignore the chatter and read through a holter monitor report from the cardiologist he says, "Excuse me, excuse me..." I realise that I am not emulating the appropriate 'doctor/patient/parent' interaction so I stop mid sentence in the specialist report and say, "Yes?"

"Did you know that lemurs have opposable thumbs?"

No kid. No I didn't. I'll just add that to the seemingly countless other things I do not know in this world. I laughed and made a mental note to start dropping more non sequiturs into conversation.

Now back to that pediatric cardiology referral.

At the end of the consultation I told him he was one sharp kid and he agreed adding, "and a curious one too".

Yes indeed. 

Orientation to Nursery Discussion

"How far are you from the hospital?"
"6 minutes."
"Ok so....pretty far....get the OB nurses to call you in early then for c-sections".
"Ok."

Gotta love the rural perspective on 'long commutes'.

Blood spurting!! Life saving!! Code calling!!

No. That wasn't at all how my first day went.

It was all very dimly lit and civilized. It was all about how to fill out forms for vacation requests and travel, how to submit log books, finding computer passwords and parking instructions.

I still have a few days of orientation ahead of me. Today I purchased a propane tank, a Co-Op membership, and maple syrup. I am feeling very 'rural Canadian'.

These transitions are tough. Tonight while I was making homemade ketchup I was thinking that it has been a long time since I've been a new person in a new town. There has always been a safety net of friends or well known colleagues in my previous nooks and crannies. I know I'll be on my feet soon but I know I am stress-condiment-making (I am not a baker, so I cannot stress-bake).

Right now I am melting in the >30 degree heat, in my house that has no AC.

Next Tuesday is my actual first day on the job. Eeeep! For now, I will bask in the paperwork.