Category: Medical

I found out that my attending is friends with my uncle. I don’t know if it’s a good thing or a bad thing that my attending knows that. Today one lady accused me of curing her tremors with my presence. The clinic was otherwise pretty standard, the usual Alzheimer’s, neuropathies, seizures. Been getting a lot of Spanish practice which has been nice, definitely getting more comfortable.

Still not sure how I feel about the pace of the clinic. On one hand things move fast, and the day goes by fast and it kinda feels efficient, and I the volume of patients and number of students spreads out some of the pressure, especially since we don’t even really present. On the other hand, sometimes I feel like the patients need more time, if nothing else to express their concerns in general. But maybe that’s the ~beauty~ of specialty work, you don’t really concern yourself with problems that aren’t related to your specialty, you just kinda hope they have good primary care.

It was my first full day in the clinic and there were 5 of us students total. It’s a busy clinic so it actually wasn’t terrible; I don’t feel like any one of us was just sitting around the whole time. In terms of what I am seeing in the clinic, it’s about what I expected. A lot of strokes, carpal tunnel, Parkinson, seizures, headaches. Mostly pretty straightforward stuff and the attending moves very quickly. Whether its a new consult or a returning patient, he typically doesn’t spend longer than 5 minutes in the room.

Lunch was provided by a drug rep today and all us med students sat with the attending for lunch. We had a pretty interesting conversation about how to “survive” after medical school. He was giving us all these tips about maximizing our deductibles and stuff.

Neurology seems like a decent lifestyle. Pretty predictable work, good clinic hours, possibility of inpatient work. I’m just not sure yet if I like the medicine, but I haven’t ruled it out yet.

Today was the first day of neurology. The morning was jus orientation and some review lectures and then I was told to go to clinic in the afternoon. I switched into this rotation a little late so I missed some emails with info from before, but mostly I was brought up to date. Originally I was primarily supposed to work back at the county hospital, but last minute they switched me to be primarily at a site in Downey which is close to where I’m living which I thought would be a good deal because I would have lighter commute. I was told to go in after lecture at 1330. I got to the clinic and there were already 3 other medical students working there with the attending I was assigned, and that isn’t even counting the 3 other 4th year USC medical students who are supposed to be working there, but were apparently told not to come in today and have their first day on tomorrow. The clinic seemed a bit hectic and fast paced. I got to see one patient, and the expectations for presentation weren’t well laid out, but probably partially due to the fact that I came in mid day. I got to meet the other students, and sounds like I may not have to come in every day. This will definitely be an interesting experience, logistically.

Last day of surgery, and it was a call day. Thankfully it was only a day call, and actually our residents let us leave early. Overall I’m glad to have had this experience. Surgery is really its own world. Honestly if the school was less and the lifestyle was better I would definitely consider surgery, but that time is necessary to become a good surgeon. There are a lot of other things I want to do with my life which is evidenced by my performance not always befitting a future surgeon. It’s not over though, I still have my exams, but we’re almost to vacation.

3TITF
(1) People who decide to make lifestyle changes when they are already older.
(2) Quinoa salads.
(3) Vests.

Weekend swing shifts are the best. No clinic, just rounds and floor work. Get to spend time with patients without having to go to the OR. Today we discharge one of the ladies who’s been on our service for pretty much the whole time I’ve been here. She was a very sweet lady and I was happy that she was able to finally go home. There was another guy on our list who was here longer that I have who we’ve been working on getting a wheelchair. It is surprisingly hard but we finally got one and we went to go work with him to get up and try it out. It was gratifying. Almost done with ACS, thank goobness.

3TITF:
(1) Being alive in a time of video calling.
(2) Cute puppies.
(3) Cozy sweaters.

It was a crazy one, and I got the trauma case I was hoping for. The majority of the daytime was relatively chill, but after around 4 pm everything started rolling in. Had some motorcycle accidents, falls, assaults, stab wounds. The big case was a gunshot wound to the abdomen. When we were all looking into this guy’s belly, trying to figure out it injuries it was almost reminiscent of a group project. Everyone had their own thought and suggesting of what to do. Different responsibilities were getting passed around and everyone was joking around despite the gravity of the situation. It was good kind of group project.

Another thing I thought about though was how many resources were pouring into saving this guy life. 4 people with 6 figure salaries, 1 student with 100k debt, countless (actually carefully counted) disposable and plastics just being consumed with reckless abandon. And I get it, we are trying to save this man’s life, so maybe it makes me a little psychopathic, but that’s just where my mind went.

It was a super cool surgery and glad I got to be a part of it. Overall it was a busy night in trauma, we didn’t even get a chance to rest our heads for a teeny tiny bit. Cheers to the last 28-hour call of the rotation (maybe of my life).

3TITF
(1) PIZZA
(2) Ethics discussions
(3) Layers

Pre-call day is always nice an chill. Though this morning I got to see a pretty interesting case. I didn’t get to scrub in because I guess it was a pretty difficult case so there was 3 attendings, 1 fellow, and a 3rd year resident all scrubbed in. They were placing an interpositional graft for a patient who had their carotid artery transected by a bullet. This was my first time seeing a thoracotomy and a thus a beating heart inside a living person’s chest. It was very cool (though I still think maybe the kidney transplant was a little cooler/ more interesting to me. That said this was probably a pretty rare case, also given that the patient had some unusual anatomy, an aberrant right subclavian artery.

Also later today I went to Target to get some deodorant and this older gentleman started talking to me asking if Old Spice was a good brand. We talked about deo for a while and then started talking about life and stuff, very nice guy, but also just a very random encounter (at first wasn’t sure if he was trying to sell me something or something).

Also got a chance to get dinner with my line, always nice to see them and catch up.

3TITF
(1) The consistent ones.
(2) Random shopping encounters with strangers.
(3) Cheesy fries.

Today was my first pre-call shift. The pre-call schedule is relatively chill. We start the morning as usual; getting numbers, pre-rounding, rounding, pass-on. Then our team goes to do the surgeries that are scheduled for the ACS teams, split into either trauma or non-trauma, with note-writing and orders and other various tasks sprinkled through.

On the non-trauma side there was an appendectomy. On the trauma side, we had a pretty gnarly leg wound debridement. I remember seeing the patient in the ED when we were on call just 3 days ago. She came in with super severe leg pain with imaging and labs concerning for a bad infection. I guess they debrided it the text day, and today she was scheduled for us to clean it out again. She had 3 big openings (made by the surgeons) going down the lateral aspect of her right thigh, each at least 6 inches apart, and 1 opening on the upper medial part of her thigh. Each one of these openings communicated with each other.

During the surgery I was able to feel the tense fascia that runs down the lateral leg (aka the fasciae latae) and was able to touch my finger coming in from one of the other openings. We had to clean out any developing clots from old blood that was collecting in there and also look for pockets of pus/ infection.

This poor women, must have been suffering for a long time for it to have gotten as bad as it was before coming in, and the recovery is not going to be easy, with her likely needing to return to the OR before going home.

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TTITF:
(1) You
(2) High-quality sunscreen
(3) The learning opportunities I get every day in the hospital and the residents, fellows, and attending who go out of their way to teach me something even if it means taking a little more time to do a task.

It wasn’t too crazy of a call shift thankfully, and I actually got to leave the hospital a tiny bit early because we had teaching that morning, but I am still counting it at the next day because (1) it literally involves the next day and (2) I spend more time in the hospital on my call days than I spent over multiple days on other services.

We had a sub-intern join us on service today. Seemed like a nice guy. He was from Loyola Medical School in Chicago. During some of our downtime there was some discussion about matching into residencies and all that. In our own school, admin has been preparing us to for what 4th year is going to look like. All this has just been making me a bit worried about matching for residency. I’m not sure how competitive of an applicant I am at this point. Definitely want to use these coming month to step up my game for Step 2, no pun intended.

3 things I’m grateful for:
Staff at places who are extraordinarily friendly, like you have no reason to be as smiley and friendly as you are being, but I am here for it.
Old rattley cars that still get the job done.
Banana split Dippin’ Dots only.