Tuesday, February 24, 2009


Residency is full of challenges and we all know how fun it can be to grin and bear it through everything. This week has been a week full of challenges. I have had to grin and bear it through difficult patients, difficult social situations, difficult nurses, difficult bureaucracy, and difficult diagnoses.

Example of today: Patient A has abdominal pain and chest pain, for which we are literally doing nothing but refusing to let him eat. He has been infinitely patient, but we continue to challenge him. We poke him repeatedly for blood and got none. We lost his belongings, including his house keys and his wallet. Yet, he continues to tell me, "Doctor, I just want to get better." At the end of the day, literally as I have my keys in my hand, his blood gets drawn and he gets a critical lab value - and I put my keys back in my pocket and proceed to poke and prod him further. To add to it, I get calls from physical therapy and social work that there are issues with him - even though I had consulted them early in the day, knowing that he would be discharged.

Patient B is incarcerated and presents with chest pain and weakness. We rule him out for any real cardiac pain. We rule him out for a stroke. Yet, he says he has continual chest pain. Convinces the nurse, as he is about to go back to jail, that he has the classic substernal chest pain radiating down the arm to the jaw and feels like an elephant sitting on his chest. So, there I am, again with keys in hand and they go back in the pocket, as I sit and wait for an EKG - which arrives an hour later. Nice to know "stat" means something resembling "in the next lifetime."

And of course, this does not include the dozens and dozens of pages I get a day. Half the time, they're worth it. Half the time, I answer them and sit on hold for 5, 6, or 10 minutes until someone answers the phone and then is disappointed that I'm not the person they're looking for.

This week has been challenging, to say the least. I guess it's all a part of my life that is intern year. That doesn't make it any easier, especially knowing that intern year is almost over, meaning that I will be a second year with twice as much responsibility.

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