Best and Worst

Peds Surgery
Best: Procedures! There is something really gratifying about draining abscesses.
Worst: There were some really stressful times that I didn't necessarily feel comfortable about, luckily the nurse practitioner jumped in to save me.

Internal Medicine (Adult Medicine)
Best: I worked with some awesome residents. For some reason they trusted me. I got to run a code because I showed interest. Getting a hug from a patient on their discharge day who had previously been frustrated with her care and requested me to my senior IM resident, her family gave me hugs too.
Worst: Adults. Not feeling like I knew what I was doing. Long hours. So many drunks and drug overdoses.

Clinic
Best: Quote from my quarterly eval- "best intern ever". I get praised by my attendings every Wednesday that I'm there.
Worst: Some feelings of animosity directed toward me by some of the other residents at my clinic.

Work peeps
Best: Wine nights. Birthday party planning. Rocco's Tacos.
Worst: There aren't any. These people are awesome. One of our residents lost her dad last week and it was amazing to see how we all jumped in to support her.

Other
Best: Being so close to one of my best friends and helping her wedding plan. Random trips to the beach whenever I want. It's October and I'm in shorts and a t-shirt.
Worst: Always wish I had more time to spend with Lexie. Thank goodness for hour restrictions.

Florida Month 1

Well it has been about a month of this doctoring business. So far nobody has died on my watch. The perks of having to stay up all night and having to talk about consistency of a kid's bowel movements at 3am is that at least I am getting paid now. Yes, my life is that exciting.

I am currently on general outpatient peds. Lots and lots of well child visits. There is no shortage of newborn baby visits so lots of snuggling fresh little humans. There is also the freaking out when they aren't gaining weight or have turned yellow. All in all, it has been really good. So much so that it has me considering general peds as a backup plan which is pretty big because I was adamant that I would only do peds ED. I will be at this clinic for another full week and then once a week for the rest of my residency. They have had me generate a list of patients that they are going to try to schedule on my clinic day so I will get to watch this little babies grow up during my three years here.

My time to explore my new surroundings has been rather limited. This is the first weekend I have had off since I started. There is a complete lack of food in my house because of that which is making for a great diet. I also signed up to take my last set of general boards at the end of August. Can't wait to have that behind me. My very last month of general adult medicine is in September and after that it's the under 18 crowd from here on out.

Back to studying. Keep your fingers crossed no hurricanes head our way.

-Pasty Girl in the Land of Tan

The Cat

For over a week now, there is a grey and white cat that perches itself outside my front door and incessantly meows. I am not a cat person, never have been and this little beast is doing nothing to endear me to the genus. I'm not quite sure why it picked my house of all places to set up its nightly terrorizing. There is no food out that would draw it close, I definitely have not gone out to pet it, and it didn't get the hint when I tried to shoo the thing away. So a friend and I came to the conclusion that karma, Mother Nature, Buddha, God, Mohammad, or some being/force out there is trying to drop the clue of my impending cat lady status. And based off the last three guys I have dated, I may as well go adopt some more puppies cause that seems like a far better option than being attached to one of them for any length of time.

So guy #1, he was maybe my best lesson in why it isn't always a great idea to date a friend of a friend. There was no set up though. We met on a float trip and within hours of returning home, I had a friend request waiting along with a message from him. After a couple weeks, I finally broke down and agreed to go out on a date with him. For starters, the guy was probably in a no win situation as my expectations are more on the unachievable level but I didn't think he would crash and burn as badly as he did. He did get points because he drove 2 hrs just to take me out but that's about where the point earning stopped. During the first hour we were together, I learned in no certain order that he had gone to jail for a DUI and had to pay $25k in fines, that he "didn't feel bad for me because I got myself into this" when I was discussing having to do call right after a day shift which meant working for about 30 hrs, and the icing on the cake was that he may or may not have a kid but he didn't want to find out cause he didn't want to pay child support. I pondered whether my friends were playing a joke on me. I was half way convinced it was a ruse when I asked my friend about the potential kid and they knew nothing about it. Regretfully, I allowed my friends to convince me to continue seeing him beyond that first date but eventually came to my senses. The major problem with dating friends of your friend is that you have to see them at different events throughout the year. Can't wait for the awkwardness of this year's float trip.

Then there is the waiter who got my number when my "friend" (same one who decided this cat showing up was a sign I'm destined for cat ladiness) wrote it on a receipt. And besides the story about how things started, there wasn't a whole lot bad about guy #2. His only major fault was his lack of understanding and patience. My internal medicine rotation killed this relationship. When you have to be at the hospital at 4:30am and he gets off at 11pm, it doesn't allow for much time to see each other. It was a great lesson though that I can't trust my friends with paper and pens. This same friend decided to sign me up for an unknown number of dating websites for my 28th birthday but the funny thing about the present was that I didn't get to know about it until about three months later.

And to round it out, guy #3. He was a random encounter right before I left for audition rotations which meant we spent about four months communicating before we actually went out. It seemed promising but didn't live up to expectations. Prior to this date I had been sick for about a week and not able to stomach much. I ended up not being able to eat very much nor drink the bottle of wine that he insisted against my attempts to graciously decline. So he took it upon himself to drink the whole bottle of wine minus the 3-4 oz that were in my wine glass. He also ate all of the bread as he continued to drink and at the end of the night I nearly vomited after he decided to point out that he must have backwashed into his glass because of the remnants at the bottom. Okay piece of advice for potential backwashers, this is not something you draw attention to. You try to hide this and the embarrassment on your face so your date doesn't think you are totally disgusting. Through dinner it was becoming more evident that the wine was having an effect on him (the other option is that he just had horrible manners). He went from sitting square on to having to lean against the wall perpendicular to me. Our conversation was limited to sports and family. While I love talking about both of those topics, I was doing about 80% of the talking and he would interject with things like "my parents are going to love you" or his plans to teach me how to shoot a gun. I don't deal well when people try to push me to do things and there were already multiple times he struck that nerve. And I definitely get the instinct to turn and run when I get the clinger vibe. To end the night, he had to drive me home. My question regarding whether or not he wanted me to drive didn't go over so well and also distracted him enough to cause him to lose balance and trip off a curb. Looking back, I should have gotten a taxi though I'm not sure if we even have those in Jeff City. My knuckles were blanched the whole ride home as he almost took out a group of pedestrians and ran up on a sidewalk. There was definitely no second date and I regretted that he knew where I lived especially after I received some guilt tripping texts and the fact he was an ex-Marine. And my attending ripped into me about letting him drive me home after he had the whole bottle of wine. I now have the number for my own personal white Subaru taxi courtesy of Dr. A.

Hopefully the next won't be nearly as bad as #1 and #3 or my random checking of the dog adoption listings may turn into actual calling. But right now as I sit here watching Lexie trying to paw at a ball with another toy in her mouth, I love it being just us two. Definitely no cats are needed.

Student Doctor Status: Complete

48 hrs and 14 hrs until it is seriously official but I AM DONE!!!! I walked out of my very last rotation yesterday at 6pm. It was a very odd feeling knowing the next patient I see will be as Dr. Raney with no "student" attached to the front of the introduction. And I came home to celebrate by catching up on my Thursday night dramas and watching one of my favorite movies, The Last of the Mohicans, with Lexie curled up beside me. There was no crazy party or heavy drinking, just a latte in hand and a protein bar for dinner. It was a sign of how exhausting this process has been and now it is over. I have one set of generic boards to just pass (I don't even have to do well on them) and my peds boards in three years.

So here is where I thank everyone. There have been so many people standing beside me as I made this journey and I couldn't have done it without you all. And all the people that brought doubt into my life, thank you too. You only kept my fire burning and pushed me not to give up, to prove you wrong. e

O Ye of Little Faith

Call me a pessimist. I went in to Match day expecting the absolute worst and I prepared all the documents I would need to send to programs that had available spots. It was terrifying. I was also trying to do everything I could to keep it together for the sake of my roommate who was in a worse situation than I was with very few programs willing to support his visa process. In the end, I came out  feeling like a winner but had to suppress my joy and excitement while I attempted to help my roommate scramble for a spot.

The next three years are looking sunny and warm. I will be training in polo country, specifically West Palm Beach, FL (my #1 choice). It was my first choice program and I am so honored that I was one of their top choices. I had the privilege of rotating there in October, originally scheduled as a fun out-rotation to see if I actually liked peds ER as a potential career path and it was also close to one of my best friends so I could spend time with her. It was #3 on my original rank list prior to going on auditions. Even if West Virginia and Michigan had lived up to my expectations, Florida so far exceeded my list of program wants that it jumped to the top of the list. The group of residents were supportive and attendings respected them. There was an atmosphere supporting education but also allowing for you to have fun and have a life outside of the program. I looked at the third year residents who were at the end of their training and had nothing but respect for them along with a comfort that they had been well trained and were capable of competently practicing on their own.

At the end of the day on Monday, all four of us at the Jeff City site had contracts on the table. Two were going in to internal medicine in Michigan and Florida. My roommate scrambled in to a spot in Washington, D.C. Overall as a class, things went fairly well for those of us that did the DO Match. An AWESOME outcome- there were six people so far that have matched in to general surgery, all six are female. We have some bad ass chicks in our class. Next month will be the final match (MD) with the other portion of our class finding out what the future holds for them. Best of luck to all of them. Can't wait to celebrate with everyone at graduation in three short months.

Giant Ball of Stress

Well, we are nine days out from (residency) Match. I thought the whole process of applying to med school would be the most stressful hurdle in this whole adventure but boy was I wrong. This point far surpasses anything I have gone through thus far. It seems like there are too many things working against me. For one, there are more people graduating from med school this year than ever before. Couple that with fewer residency positions open, especially in pediatrics and the numbers don't add up. It is estimated that at least 500 of us won't even get in to a traditional rotating internship position (this is a back up for a lot of people if they don't match into their first choice).

And then there were the things that I could have controlled and let myself down. I am my own tough critic picking apart my application each day thinking if I had just studied that extra hour rather than watching Grey's Anatomy how much better I could have done. But it is too late to make corrections and there are no do overs. Lists for both students and programs were turned in last week. Nine more excruciating days of waiting.

My stress is effecting all aspects of my life. My sleep, eating, how I treat people, tolerance level, and especially my emotions. So I apologize to anyone that has been on the receiving end of me blowing them off or a nasty glare or awful comment. There have also been disappointments to add to all of that as well. Expectations that didn't hold up. Some with people I barely knew and I take responsibility in building them up to fail and others with those I count closest to me. I'm holding back a rant right now as I am still digesting the hurt feelings and trying to come to a place of understanding.

So to my fellow 4th years going through these painstaking following nine days till the DO match, best of luck and if I could provide you Xanax or Ativan, I would. To those waiting on the MD match in March, good luck as well and I hope those announcing their happy match news next week don't drive you over the edge.

105 days till graduation!!!!

Wrapping it up

It's been a while. A bunch has happened in the past four months so here is a quick synopsis of the highlights. I had three audition rotation spread out around the eastern half of the US which I spent many hours in my car venturing around.

September: I spent the month in Charleston, WV working in the Women's and Children's Hospital. I spent my first two weeks in the pediatric ICU with a bunch of kids that had the lovely enterovirus D68. This was also where I encountered my youngest victim of child abuse. It is a situation I have long feared and knew it was only a matter of time until I came face to face with a perpetrator but the scenario I had gone through in my head did not fully prepare me for how I would feel. The image of seeing a little four month old baby in a coma with electrodes connected to her head and an intubation tube sticking out of her mouth. Later seeing the images of her brain bleed and the damage to both of her retinas not knowing whether this little girl would ever return to baseline despite all our efforts was hard to deal with. After she was extubated, I spent hours working with her to correct her sucking reflex as she continued to choke on her spit and feedings and the fear was she would have to be reintubated. I will never know what happened to LP but I would have gladly taken that little peanut with me.
My last two weeks in West Virginia was spent on Infectious Disease service. I saw lots and lots of bone infections. My experience over the last two weeks was very different than my first two. I wasn't allowed to really do anything but observe and my initiative to come in early and round on patients on my own was not appreciated. This was a very tough time as it was the beginning of interview season and I was with the program director so I would overhear him talking to staff about offering people interviews. My last day, he shook my hand and wished me luck in my future...that was it. I never received an offer to come back and interview. It stung at the time but reflecting now, I would be very upset if I were to match to Charleston. The program didn't offer what I wanted and I don't think I would have thrived there.

October: Glorious October. I was able to spend it in warm, sunny West Palm Beach, FL. I was so excited just going in to this rotation as I would be spending it in the pediatric ER which is a potential goal for my career direction. And it didn't disappoint in the least. I saw some crazy diagnoses, worked with some of the best pediatricians I have encountered, and interacted with a fantastic group of residents. During my third week there, one of the physicians I worked with sent an email on my behalf to the head of the peds program, the overall residency director, and director of medicine of the hospital system recommending me as a future resident. This started the ball rolling which would have me moved to the pediatric floor of the hospital to take care of my own patients and by the end of the third week I was interviewing for a residency spot. I had been warned that the peds residency director was intense but he was like that with all interviewees and residents. Well I must have caught him on a really good day because I had a fantastic interview. I have talked with the assistant residency director since and had very positive feedback. I am crossing my fingers, toes, arms, and legs crossed (I have been instructed it is not safe to work or drive with my eyes crossed so for safety purposes, they will remain uncrossed).

November: I made the huge climate change up to Detroit to spend the month at Children's Hospital of Michigan. Holy cow is it a huge hospital. I was still trying to get my bearings at the end of week four.  We had a hefty patient load that never provided a reprieve. It was an insane month. I don't think I have ever worked so hard in my life. Short shifts were 11-13 hour days with night and long shifts being 14-16 hours. It was slightly different as I was working as a sub intern which meant I had all the responsibilities of a first year resident but I just had to get all my orders and prescriptions entered by my senior residents as I didn't have that capability. And it was freaking cold. There was a record cold streak that went through, the same one that dumped 6 feet of snow on Buffalo. It was the perfect timing for the heat to go out at my friend's house. This made having to stay at the hospital where there the inside temperature was above 60 degrees slightly more enjoyable. All the hours I was putting in didn't go unnoticed, at least by the senior residents I was working with. I received a great deal of praise from my attendings, chief residents, interns, 3rd year students, as well as patients. Unfortunately, this didn't result in an interview at this program. Of the two programs I did a rotation at, this was the most upsetting not to get an interview. I am still dwelling on it and remain frustrated. I don't think I could have done any more than I did while on the rotation so at least I have no regrets in that aspect.

December: I got the chance to return home for the month to do a rotation in physiatry. It has been so nice to be home and the rotation was so relaxed compared to what I had endured over the past three months. It was tough going from all my patients being under the age of 18 to rarely seeing anyone under the age of 50 who didn't have a work related injury with an open L&I claim. I had a hard time not resenting patients who came in complaining of 10 out of 10 pain who were able to walk in to the exam room and were able to smile during the history taking and denied having any disruption in their sleep when I had just come from caring for kids riddled with cancer in their bones who were unable to walk more than 10 steps. I definitely think I am going in the right direction as far as my preferred patient age bracket.

Residency outlook: I have finished up interviews and am currently putting my rank list together. I have been trying not to get too attached to a program going in to the last month before results come out but it has been very hard. My mind set starting out was that I would make the most out of wherever I ended up but coming out of rotations it is more apparent how important it is for it to be a mutual match. February 9th is when all will be revealed. The waiting is excruciating and I'm sure the next month will only be that much harder. Think warm happy thoughts.

Only 14 weeks left of rotations and less than 5 months till graduation.