Monday, July 26, 2010

Back and Recharged.

So last night was redemption night. After 3 days off to recharge, so to speak with 3 very active kids and a baby, I worked last night in the ED.
Not only did I ensure that I was very proactive and wanting to show that I am a hard worker but I also wanted to gauge from the residents whether or not what the attending said had any merit. I have come to the conclusion that no. I do belong in the ED and I do work hard and I am very proactive.

Everyone asks me how I can do it with 4 children at home. And while I work very hard at medical school and try to spend time with everyone, I have to give all of the credit to my wonderful wife. She is like a single mother when I am either studying for boards or when I am on my rotation.

I try to spend time with everyone as much as possible. And I try to do it in a fun way and not feel that I am obligated, because I really want to spend time with my children since in the next blink the house will be empty, but I want them to feel that I WANT to be there. So the other day, when I was off I set up my laptop and had my photo program and my itunes open so that each girl can have a "photo shoot" with the music of their choice. Then we looked at all of the pictures together and put stories to them and even played music in the background to them. And while the whole thing took about an hour, they loved it and I will always cherish it.

You can spend all day with your children and if all you are doing is watching television or are on the computer, it will not matter because that is not quality time. I believe in quality and not quantity. Sure when I am done with school it will be a little more and when I finish residency it will be even more, but my girls will not stay 9, 6, and 4 until I am done. The above pictures are only 3 of the many we took during the "photo shoot".

Saturday, July 24, 2010

3 weeks into my EM rotation

So it has been a couple of weeks since I started in the Emergency Room. During that time, I have had the pleasure of seeing all kinds of things. Of course, the complaint that I have seen the most is Abdominal Pain, which is what has always been the highest complaint in the ED.

I have also seen a couple of traumas. One was a man who was shot by his wife and the other was a little girl who was hit by a car. I learned a lot from those 2 situations. First of all, the main role that the emergency room has in those situations is to stabilize. The man who was shot, the most important thing to check is to ensure that his airway is stable, he can breath without any problems, and that his circulation is intact and is able to maintain a blood pressure. The whole thing took about 1 hour and he was completely stable and sent home with the bullets still in him. We do not take bullets out because it causes more problems than if you left them in.

The little girl had a broken leg and was transferred to a children's hospital.

Most of the other issues were medically related. I was able to drain a few infections and start numerous IVs. However, I did not do some other things such as central lines or arterial blood gasses.

I did learn several things so far. First and foremost, I need to be more confident. This is where I am lacking. I know my material and I do a decent job getting a good history, I just need to be more confident and with years of leadership experience, I should be able to do this more easily. However, this being my first EM rotation I think it just takes a little bit of time. Second, I need to realize that I am only to focus on the cause of the patient being here and if that is going to threaten their lives. If I happen to notice something else and it is not imminent they can follow up with their regular doctor.

Now after 3 days off and a recharge I am going back into the trenches tomorrow and show what I am really able to do. This rotation also exposed me to the inner city emergency room. Next week I start at the community hospital. Let's see what happens next.

Tuesday, July 6, 2010

Day 1 in the ER

So today was the first day of my 4th year rotations and also my first day of my first Audition Rotation in the Emergency Department. All I have to say is WOW!!!!! I love it. In a matter of 30 minutes, the ED went from having 1 patient to about 15-20. Today I saw Dental Pathology, Palpitations, musculoskeletal chest pain, high risk pregnancy with pelvic pain, sickle cell crisis, cellulitis. It took me a little bit to get my sea legs back after not seeing patients in about a month and a half while I was studying for boards. But I have to say, after each patient I was getting better and better. A couple of times I was nervous, I said I did not get meds and allergies when I actually did. Now that the butterflies are out of my stomach, tomorrow will be my time to shine.

Monday, July 5, 2010

Well, here I am

A little bit about me in this issue to give people some background about me.

I graduated from college in 1997 with a degree in biotechnology. this was the final degree I decided on as during my freshman year I had about 4 majors and they were all in the second semester. When I began college I was a gung-ho premed. I was in biology 101, math, english, the rest of the basic freshman classes except for chemistry because I did not want to bog myself down. I came from a high school where I was in the top 20% of the class (#81/312). I was also very good in the sciences, especially biology. So I was expecting to do really well in biology. However, there was something that I was not prepared for and it was going to come back and haunt me.

I was not prepared for how to manage my time, nor was I prepared to start doing poorly in my classes. I was used to be an A/B student and nothing lower. I would read and understand. Here I am in college and I am struggling. Not only that, but since I never attended a high school party and I was away from my parents or any authority figure I wanted people to know that I was fun to be with so I went out every weekend and got drunk. I would hand out in the campus center or my dorm room but I would not be able to focus. At the same time I was pledging so that took up my time as well. In the end, I did really poorly in my first semester including failing biology. This was my first F in my academic career ever, and I was especially devastated that it was in biology. So I convinced myself that I did not like school and that I would drop premed and try to do something else.

I went ahead and changed my declaration from biology to human ecology to environmental planning and design to Landscape Architecture. I retook my english and math and passed it and registered for Landscape Architecture classes for my sophmore year.

During the fall of my sophmore year, I had a running start. I did well in my exams and really liked what I was doing. I was convinced that this was my real calling. My roommate was a biotechnology major and I saw how he was struggling with organic and thought to myself, am I glad that I do not have to deal with that. This semester turned out better than my last 2 but I had straight C's. The worse part was that I was not accepted to the Landscape Architecture program and ran back to my apartment crying thinking that I should drop out of school.

It was then that an ambulance call came in and as an EMT, with time, I went to station and went on the call. I was back in my element and successfully treated the patient. It was then that I realized that medicine WAS my true calling and it was time I shaped up and got cracking. By this time, it was already the spring of my sophmore year and I immediately went to the Pre-med dean and had a meeting with him. After the meeting the first thing I did was to extend my graduate year by 1 and drop every single one of my classes and register for my pre-reqs. I also dropped every one of my EC's and began.

Over the next few years I took classes over the summer. I retook biology and got a B in it. But there would be a lot of problems. Ths issue was that I still did not know how I needed to study. I had tried many, many different things. The main issue was the I was able to explain things to my roommates but when it came to the exams, I would blank out.

I tried studying in silence, but my mind kept wandering. So I tried studying to Jazz, no good. Classical, no good. In the library, no good. I tried 20 minutes intense reading and 10 minutes off, nothing. Finally, at the end of my junior year I got it right. My girlfriend had a tape of a thunderstorm and I borrowed it. I went to the library and put it on. When I lifted my head for the first time, I was amazed that an hour and a half went by and I remembered everything that I read. It was at this session that I decided to outline the chapter. Finally, I found my niche. However there was something missing.

In the spring of 1996, I signed up for the MCAT. I was planning on taking it and felt that since I was taking organic chemistry and physics that I would already be studying for it, so why should I bother studying extra (I now know that this was very, very foolish but hey, I was young). My parents could not afford kaplan or TPR so they sent me to a small, no name prep course that was horrible. I would up getting a 24 (VR 9, PS 7, BS, 8 VR P).

At the time, I really had not idea what it meant to apply to medical school. It turns out my roommates' girlfriend's mother worked at a medical school and got me a meeting with dean of admissions who suggested I retake the MCAT. So I did and again, did not prepare. I did worse 20 (VR 6, PS 6, BS 8, WS S). I called the dean and she suggested I get a masters degree.

I wound up graduating and starting my life. I figured medical school was a distant memory, but maybe. I finally landed a job in a lab 1.5 years after graduation and it was here that the last peice of my studying puzzle was placed. I taped the lectures of the one class I went to. During my commute to/from work I would listen to the tapes. I would up remembering everything better and did very well on the tests and scored a B+.

Life went on and I got married and had my first kid. I would up getting a job at place where they pay 100% tuition reimbursement and my boss was asking if I would be going for a masters or a PhD. Since I could not find a part time PhD program I setteled for a masters program. I started going to school in 2001. In fact, my first day of class was supposed to be on 9/11. A year and a half later I was a sporting a 4.0 and during a trip to Tampa, Florida I told my wife that I really wanted to go to medical school and she said fine. However, we agreed that we would keep this between us.

I also learned how naive I was at the application process when I was in college in addition to how to properly prepare for the MCAT.

To date, I have a 3.4999 in graduate school with a missing grade due to my thesis, which I should be defending in March. I retook the MCAT in August of 2004 and scored a 22 (VR 7, PS 6, BS 9, VR R). I applied to 14 schools and was rejected by all. I restudied for the MCAT and scored a 29 (VR 9, PS 10, BS 10, WS Q). I reapplied to 9 schools, all DO and was accepted by 2, my top two choices.

Here I am, 3 years later and am about to start my 4th and final year of medical school. One little surprise though, our 4th daughter arrived almost 2 weeks ago. That has added the benefit of having less sleep that I did before but in a good way. Because I can bond with her while either giving her a bottle or changing her and waiting for the bottle to arrive. Either way, we get some Daddy:Amy time.

I hope you enjoy my blog and as I enter my final year of medical school and start the process of looking for a residency position I will write often. So don't be a stranger.