Musings
August 27th, 20208/27/2020
I had a day yesterday. One of those days where the mind doesn't want you to feel well no matter where you try to point your thoughts. Turns out doing medical school remotely is not good for the psyche. A combination of being physically separated from human contact for our overabundance of Covid-caution, taken completely away from my primary service with the exception overnight call (which I sit diligently covering now) and otherwise as alone as someone might get makes for a sour swallowed pill.
Although the efficacy varies, I usually try to treat that brand of blues with a bike ride. Much of my riding over the last month or so has been nearly at or well after dark, both because my days in the hospital were pretty long and the Philadelphia heat is oppressive, even after the sun goes down. So, last night I hopped on my bike to crush a few hills around the area and try to perk up. Fast forward and not once, but twice I toppled off my bike during the ride. Once where I hit a ledge of pavement trying to cross a small gravel bit and a second where a juniper bush caught me as I tried to avoid an oncoming pedestrian. Thankfully both were at slow speed, but my damn hip doesn't care how fast or slow it was, it still took a solid bruising. Scratched up the right knee also, but pretty minimally. Admittedly, I was pretty disappointed with the results of my intervention. At least the bike is ok, with the exception of a scuff on the back of the saddle. The call phone rings with stories of tongue injuries.
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August 24th, 20208/24/2020
We will be doing our first in-person meeting for med school small group tomorrow (or rather, later today). I'm hoping it's not too annoying to go through all the med school's version of hoops. Having been back on service for 2 months and operating within the hospital, I'm not sure how many additional steps the school will make sure we take. All I know is that the additional time may not be worth the efforts. I need to wake around an hour earlier to try to get through the first AM lecture because we need to arrive at least 30 minutes early to take some special elevator at a previously designated time. It was a lot better when all we needed to do to get into a building was walk through the front door.
My fickle friend, the summer wind8/23/2020
Like all things, so too must this summer come to an end. Since July, I've been rotating back on my primary service, OMFS, following the "first" didactic year in medical school. Our specialty is unique in the sense that at many training programs, OMFS residents bounce back and forth between their primary service, medical school and eventually other surgical services. Tomorrow (I'm writing this on Sunday night, into Monday AM), I return for the beginning of my second year of medical school, which happens to be in my second year as a categorical OMFS resident, that's also my third post-graduate year since dental school. Very clear, I know.
Unlike some other places in the world, OMFS in the US requires an individual to complete dental school then move on to residency. OMFS residency can last either 4, 5 or 6 years, depending on the curriculum structure of the program. Four year residencies conclude with an OMFS certificate only. Integrated MD programs set five and six year curricula apart. There are select few which have a five year curriculum (Case Western is a classic example). I didn't match into a residency on my first application attempt from dental school. This is where my first post-graduate year was accounted for; I was an intern on the OMFS service where I'm now a categorical resident. Although I still sign my notes as "PGY-2," I at least make a PGY-3 salary. I'm sad to return to classes, especially in the times of Covid, where they are delivered completely remotely. Traditionally, I preferred and attended class in-person; I feel the engagement of attending lecture, even just by maintaining eye contact with the speaker, provided so much more to me as a learner. Instead, I consider much of my education "YouTube Medical School." As an MS2 (medical student, year 2), I will begin some in-person small group sessions once again. Having spent my summer back on service in ORs, clinics and generally treating and interacting with patients and colleagues, I'm sad to know that the majority of my learning will again stagnate as I stare at my computer screens. My last weekend for the summer didn't consist of much, to be honest. Some futzing around the apartment, but not enough to see the difference. Lot's of videos on YouTube (I've discovered Comedy Central's Drunk History just in time to hear of its pending cancellation). A little drawing (I'll post when it's finally completed). Some riding, some running (I plan to start linking to Strava data for my daily rides/runs). Lot's of chai tea. Playing Path of Exile (new-to-me Diablo-esque game that I believe will quickly become a dangerous time sink...more to come). Welp, off to sleep for now. Cardiology begins at 8am sharp. August 20th, 20208/20/2020 Today's been a mixed bag of a day: busy in both good and bad ways and, in the end, just a long day, preventing me having much time to decompress and live a little of my life before crashing for sleep before repeating it all again tomorrow. This, the never ending plight of adult life, let alone the life of a resident physician. I still have a little shy of 5 years remaining, so I expect to run into this a lot as the next couple years pass by me.
I was given latitude to run my own sedation case today, including all aspects of monitoring and medication delivery. Easily, this was the highlight of the day. It's a big step in my mind to have earned the trust of an attending physician to be able to manage delivery of anesthesia as well as conducting a successful surgery. It went swimmingly well and it was a huge self-esteem boost, despite some other muck that I dragged my feet through today. I'm continuing to make steps forward with my training which, in light of that 5 years I mentioned above, provides me needed motivation to keep going when I might feel otherwise. Tonight, I'm hoping to add a little more to a sketch I'm working on. If nothing else, just put a pen in my hand and scribble something. How's it looking so far? August 18th, 20208/18/2020 Today's been an ebb and flow day: despite the seemingly full schedule, it's bounced between busy and dead-slow. Our first case in the OR this morning was delayed due to a faulty valve in the anesthesia equipment. Eventually the ball got rolling, but this threw a little wrench into the system and backed up the rest of the morning.
Regardless, I got to scrub for a case this morning with a couple of top notch co-residents, confirming my belief that the people make the party. I was then assigned to one of our clinic locations for the afternoon where I conducted a sedation for multiple extractions and a procedure called alveoloplasty - our fancy term for smoothening of jaw bone to promote a sound foundation for a denture or some other prosthesis. I also had a nice little struggle against a set of wisdom teeth, one with especially nasty, curved roots. In the end, we won and the teeth came out. I'm just now taking a short break on call tonight to jot down some thoughts. This evening, I sutured up some intraoral lacerations for a kiddo at the children's hospital who suffered a gunshot wound to the neck and face which our team will repair tomorrow. Although he sustained a severely comminuted fracture of his mandible (think shatter, not a simple break), amazingly he suffered no large vessel or cervical spine injuries. If there's some kind of luck involved in life, this kid got lucky. We'll see how the rest of the evening goes...only 12 hours left for my shift. On an exciting, completely unrelated note: I've rediscovered my childhood love and obsession with the Teenage Mutant Ninja Turtles. A few weeks ago I purchased an animated Batman vs TMNT movie and thought it very entertaining. Last night on my cycling trainer, I decided to search for something to watch while I busted out some miles and found a more recent animated series from 2014 on Hulu. Very entertaining so far!! I'd plan to see some TMNT sketches and swooning over the comics in the near future! Day One8/17/2020 It's been over 20 years since I last made a website (in 1998 I did a little stint with online guides for PlayStation games), so I trust this will be an evolving work-in-progress.
Despite my limited experience, I hope to utilize this space to connect with people and share my thoughts as well as the things with which I occupy my time. Most weekdays, today being no exception, have me well occupied with my training. Today, I was in charge of conducting multiple surgeries under IV sedation in one of our clinic locations. I've been told that as a resident surgeon, it's probably a good thing to enjoy doing surgery; that probably means today was a pretty reasonable day. Plan for tomorrow: OR in the AM; sedation/clinic in the PM; in-house call overnight :-/ AuthorI'm a burgeoning anesthesiologist. I like to do a lot of other things, too. My hope is to share them here. Archives
June 2023
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