| I'm a Pediatrician in training... |
[Sep. 2nd, 2009|01:50 pm] |
Working on my second intern year here in NJ. I'm not gonna lie, another intern year absolutely sucks. But on a brighter note, I'm more calm and collected than last year. I matched at a university program in NJ. Love it! My fellow interns are awesome. However, I am only one of two married couples in our group. Younger fresher crowd. Once I stopped comparing my old program to this one.... things have gotten better. The grass looks green on the other side.
Ken recently got a job in NY. A bit of a commute but in today's economy, we're glad something worked out!
Been married for a year now. Went to VA for a mini vacation. A much needed getaway.
Aunty moved out, finally. She and Dad are not exactly on speaking terms. Unfortunate that it came to this there's something called karma.
Ash just had her first major breakup. I hate to see her so devastated. I like this other guy for her but I don't know how he feels about her.
I woke up at 1pm. Felt wonderful. Have the day off. :) |
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| Superbowl and Pneumonia |
[Feb. 2nd, 2009|05:04 pm] |
The Steelers won the Superbowl. I don't follow football. Nor do I care. But the people here in Pittsburgh are so passionate about their team. It's amusing.
Intern year is almost over. I'm applying for Peds. Done with interviews. Mixed feelings where I want to go next year. The places I least expected to like, I found a "cozy" feeling. Rank lists are due soon, so I just have to make up my mind and submit.
I had to take off from work today because I have a pretty nasty pneumonia. Failed the Zpack and ongoing fevers. I sucked it up and went to work. Then when I called to take off, they gave me the run around. I hate the working world. Sometimes I think I should go back to school for something else. Is it bad to rethink your career even though you have a 6 digit loan to pay off? Do I not want this enough?
People give you such a hard time- whether it be your attendings,seniors, nurses, PATIENTS?! And all I'm trying to do is a honest day/night's job and survive. A 52 yo female with uncontrolled diabetes and hypertension, with a below knee amputation ended up on dialysis in January. She realized she didn't want to do this anymore and wanted to be made home hospice. She died last week. Mixed feelings about that.
I've come to realize that I don't deal with death well at all. I've cried more in these last 6 months than I have my entire life.
Ken's been awesome taking care of stuff since I've been ill. I love him more with every passing day. He can be pretty dense sometimes...Men are from Mars, Women are from Venus... but it's in the little things he does for me that I find very romantic. I hope this doesn't change. We still laugh about how the priest at our wedding was talking about divorce.
Let me go hydrate. Happy 2009. |
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| 3rd Peds Interview |
[Nov. 13th, 2008|05:07 pm] |
So, reading back on some of the past entries, ehh... 5 months into internship, being a real doctor. Ocean of emotions and experiences over these past few months. Getting yelled at by attendings, pronouncing someone dead, feeling so incredibly tired- literally falling asleep in a chair waiting for a call back, running around like a headless chicken with stashes of paper in my pockets, stethoscope locked in place to a code, BLAH "free" meals. Still learning how to cope with this death business. I think as students we are so protected in our training and never really put out there on the limb and then residency strikes and you have to learn to deal with all this stuff.
Being married helps. I can come home and vent. Keni is such an amazing person. I fall more and more in love with him the more I know him. Yes, his OBLIVIOUS ways puzzle my type A personality but that's why opposites attract.
Going to a Preinterview dinner in a few hours. I hate these kinda of social gathering where people put on a act of being super nice. Every program sugarcoats what they have to offer. At the end of the day, all taht matters is you're with a bunch of residents who are EASY to get along with and you have attendings who want to teach and you to learn so when you see a case again, you know how to deal with it. I've been on two interviews. It's different as an intern compared to a 4th med student. I hope I don't come off as cocky but I'm trying to up-play the fact taht I have this year of training.
You know, there are some days, I still reconsider my career. What else would I do with my life? How in the world do I pay back a 6 digit loan do anything else? That was the running joke our dean used to tell us in med school. I think one of the best things that happened to me is, sitting down with my mentor Dr. Ritz and having him just help me identify what's I'm looking for in life. I think he can relate to me because he redirected his career with more at stake...
I'm just babbling. Waiting for Keni to come home so I can take the care.
Going home for Faroo's wedding in 2 weeks! Can't wait to see the gang! Wantd to put on a funny skit, slideshow for him but haven't heard back from anyone else yet. So not sure where that's going.
I'm on ICU for the next 4 weeks with Eli and Amy. Totally excited! 1. It's such a controlled atmosphere. People are sedated, on a ventilator 80% of the time. 2.Will learn how to talk to family members about death, code status all that stuff. 3. Seeing the sickest of the sick. Mind you our hospital pt population that lands up in the ICU is often 60 years and plus. Not sure how I'll feel abut it when my pts are on the younger spectrum.
I need to study more. I just dont have a learning atmosphere at home though. We come home from work and then jsut chat. And before we know it, its time for bed... and the day starts all over again... Golden weekend! NO CALL SAT or SUN! Wohooo!
Let me get my stuff ready to go.. |
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| Done with Nights |
[Aug. 24th, 2008|12:47 am] |
These past few weeks have been exhausting. Nights from 8:30pm to ~8am. Wow. Being one of two people doing crosscover calls, admissions, and codes....OVERWHELMING. Fortunately, my seniors were really chill and it was bearable. Doing newborn/peds next month. Which I'm actually really excited about!
Things are getting better. Not the best but better. I guess a lot of things happened so suddenly that I just didn't know how to deal with it.
Ken's with me now. It feels so good to finally be together. Doing the SMALLEST things! We're trying to figure out where we'll be. I actually like it here in Pitt and wouldn't mind staying.
We had our first dinner guests today. Manimamma and family came over. We made sambar, aloo&gobi, chicken kababs, rice. Then we went out for a movie. Ken's fast asleep. I guess being on nights, my circadian rhythm is completely off.
I want to go to church tomorrow then hiking. We looked up a few trails. I think the weather will be nice!
Ash moved to NY. I wish we were closer. Maybe I should look into residency up there so we can chill with her when she needs a break. |
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| Life and Death |
[Jul. 17th, 2008|08:44 pm] |
I think I hate being a doctor. I hate seeing such sick people. I hate how medicine is treated as a business. I hate the politics and policies. I feel like I know absolutely nothing. What the hell did I do for 4 years in medical school, digging my way into a six figure debt....
I feel stressed all the time. Can't taste food. Not sleeping right. Tired? Alone.
So removed..
Ammachi's funeral date has not been decided. Her eldest soninlaw decided to accompany his wife. I hate him because he's going there to stir up trouble, I know. It should have just been our moms. Dealing with Ammachi's death is more than enough and he's going to bring up shit like her will/property... He caused her enough grief when she was alive and I have no idea why he feels the need to... Well, there's something called karma. In addition to, SHIT HAPPENS.
So as I'm in the process of trying to decide what I want to be when I grow up. I learned that I need definitive answers. I need to go into an area of medicine where I get answers. No shades of grey. Black or white. Is that even possible?
I think I hate being a doctor. I want to go back to school for something else... |
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| RIP AMMACHI- You will be forever remembered |
[Jul. 15th, 2008|07:45 pm] |
My grandmother, my mom's mother passed away today. In India, 07-16-08 around 3am or so. Freaklishly enough, this is my grandfather's death anniversary as well.
I feel numb. When I hugged her for the last time in Kerala... I knew I'd never see her again. My heart broke when she looked at me and didn't even know who I was or asked me to go away. Amma was unfortunately not there when all this happened. In Bangalore settling house stuff.
Ammachi developed some SOB. They took her to the hospital, CXR showed pulmonary edema, fluid in her lungs. She had an MI. They declared her brain dead soon after she was intubated but since all her kids wanted to be there, they kep her on the ventilator. Her heart gave way. And she passed.
I'm trying to stay objective as a physician. But as a grand-daughter, I can't even put into words how I feel right now. Sad in the loss of such an inspirational woman in my life. Despite her limited schooling, she always encouraged me to study and to work towards my goals. Never discriminated my female gender or undermined what I could do, unlike the other grandmom. Angry, that I did nothing for her. That I live here so comfortably and she lives alone in a house that is literally falling apart. Remini, her caretaker is a Godsent. Happy in that she didn't have to physically suffer for long. All this happened in less than 12 hours.
I miss you Ammachi. When we went to India in 2004, was fortunate enough to spend time with her. And she spoiled us rotten, like only grandmothers can. Little did I know, that was the last time we'd see her like that. Over the years, our conversations dwindled down. I loved and how she would speak to us so emotionally, not ashamed to tel us how much she missed us and how she ended every phone call with "Ammachi's sweet kiss!"
She raised me. I was in Kerala for the first two years of my life. And she took care of me. She used to tell me this "Baby chick" story. It's how I loved a baby chick so much that I squeezed it to death. And how she had to explain that it was gone... I wish I had taped the way she narrated it.
When I was younger, I thought she was dark because she drank coffee. My other grandmom is fair which i attribute to her tea intake. SO I used to drink it proportionally. Ammachi loved Maalox. I'm not sure what she thought it did for her. But I saw her gulp it down every night before we went to bed. Or the time, I discovered her dentures. I didn't know how my granny lost all her teeth overnight. Her love for gingerELLY aka gingerale.
I will always remember the way she would turn the lights off and pray with us. When I was younger I believed a lot more than I do now. I would tell her if something was bothering me, or if I had a test... and we would pray. She tearfully prayed for all her daughters and grandchildren. Somewhere, somehow, some divine intervention has brought us all the blessings we have now. And I think it's because she prayed for us.
Unfortunately, I think that her love was never recipricated. She loved us all so uncondtionally.
A widow for over 30 years.
I miss you Ammachi. I will always remember your birthday, every New Years. I came to terms in parting with her when I left her in June. "The lights are on, but nobody's home" is a cruel way of saying it... I knew then...
Our moms are all reaching Kerala and not sure when the funeral is. I don't think I could go to her funeral. I couldn't bear to see her alive the way she became...
Mental health is so overlooked. Just cause someone gets old, they don't automatically get demented. I wonder waht she really had.
OnCall in the ICU tomorrow. Then 24 hour call inthe ICU come Saturday. Being around dying/very sick people is not going to help me cope with this. |
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| "Do something that you're good at." |
[Jul. 12th, 2008|12:18 pm] |
Yesterday was a strange day for me. Also carried the code pager around today. No codes. Sigh of relief. The last one, the lady died. I hated seeing her pale, limp body. Just a body. Where did her soul go?
Anyways, there's this Tamilian Resident, who I was call R2; he's a surgical 2nd year resident. We're following the same pt. My metastatic lung cancer woman who had a percutaneous chole tube placed. SOoo... after I handed off the code pager, I went down to the library to check some stuff out. And then he comes by. We talk about our pt and then just start talking about random thing. He was really into Pysch but then realized that he was good at surgery... ended up doing a Prelim yr at UPENN and then matched into th PGY2 spot here. So I asked him a lot of questions. About medicine as a career, clarification of some of my intern feelings.
I want to know, how can I choose a residency and like it for the rest of my life. How do I know I'm gonna like it 10 years down the line... And he reassured me that if I go with LIKES, then I'm doomed to fail. I have to choose an area that I'm good at and I will be sure to succeed. Then what he said next is what really helped me: You have to aspire something above an beyond... and everyday, everything you do should be working towards this.
I've always wanted to do International Health. I know, eventually.. Ken and I will move back to India. About 10 years down the line or after a good chunk of my loans are taken care of. I'm not sure if he was trying to recruit me or what. I asked what would me a good residency to field work, underserved areas. I don't quite agree with what he said though. He's like India needs Intensivists. Meaning physicians who manage ICU care. He's planning on going into transplant surgery and is talking to some hospitals in India who can start building the facilities for what he wants to do. Fo someone who hates such sick acute patients.. I was like, but I like to talk to my patients. And he's like, you can talk to them when they leave...
So randome conversation for 2 hours. I think I found a mentor? He was brutally honest. And wasn't a d*head like most surgeons are. He hands me an ICU book and tells me to read it. So here I am, reading the ICU BOOK by PAUL MARINO.
I told him how I was reading other resident's blogs. And he's like, don't do that. You have no idea who those people are... whether they're good docs or bad docs or just plain impostors... Right now, that I should be seeking real people and asking not virtual people. I won't read such blogs anymore because then it only justifies my negative feelings. Right now, I need to learn and read to make myself a more knowledgeable compassionate doc. I feel insecure because I don't know enough. That's as simple as I can put it.
And instead of complaining about this..I'm going to take control. That's the whole purpose of this training program. I hope I run into R2 again. I need pep talks like this every so often. I think he could relate to how I was feeling cause he went through all this in the last two years.
I'm keeping this blog not as a bitter doctor. Well, taht's not how I want to come off. I want to keep this as a Memoir. My personal and professional growth.
Also, on a brighter note... I told Ken everything that was bothering me. Every nitty gritty detail. And we both feel good. It sucks to be married and still do this long distance. Note to self, when our kids get married, leave them alone. Give them time to be wth each other. I'm just surprised at how chill my dad's been with me. He just stepped back after the wedding. Didn't drag us or demand that we meet all these relatives like Ken's parents did. The man I hated so much while I was growing up because he was such a tyrant. Up until now, it's like I've alwys been trying to prove to him that I am independent. He's hurt us a lot. Bt on the whole, he's been a good father. I miss him. And he actually said, for the first time ever.. that I looked beautiful on my wedding day.. right before we went down the aisle. |
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| Another day.. |
[Jul. 10th, 2008|09:37 pm] |
Another day... had the code pager. Praying that it wouldn't go off. I hate seeing people so sick and trying to resuscitate them. And then they get transferred to the ICU. I don't know how I feel about medicine anymore. Do I feel this way just because of the added responsibilities? After I put in an order, I think of a zillions reasons why I should reconsider. After I come home, I worry about them. I worry because I feel I don't know enough.
I don't lke the way our service runs. Our senior is nice but she's so busy doing so many other things that she doesn't really have the time to run thru our individual patients. It's frustrating. And most of them are private attendings who round whenever they want.. So we're basically hording the charts. And when one of them comes looking for it, we try to get some learning in.
I have this weekend off. My "golden." Wanted to go home but my family has other plans. I feel so F* lonely. Actually looked up tix to go to TX and hang with Nina for a bit. It's too much. I'm married but I don't even feel like it. Half the time I forget. When I wash my hands, the ring slips off my finger.. and then I remember. Might I add, a ring that i don't even like.
Why am I so unhappy with the way things are?
Does it get better? |
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| Acute Cholecystitis |
[Jul. 8th, 2008|09:57 pm] |
My pt keeps going from bad to worse. Her masses have all enlarged. She actually has an inflamed GB. Which in a way is good, might account her altered mental status. We felt her WBC's were going up secondary to malignancy... r/o UTI. Surgery was consulted yesterday. They put in a percutaneous chole tube to help drain it.
The PCP talked the the grand-daughter about end of life issues with this woman. She did an awesome job explaining it. I'm glad that wasn't left to me. At least, now I know how to model the talk. I don't know why I feel more emotional than I have ever felt. Is it cause of the changes in my life recently? She has a living will and she is a DNR/DNI. Her grand-daughter is the POA, makign some decisions. I need to talk to my parents about this. I do not want to make these kinda calls. I guess couples should also talk about it.
She's dying. Dumb cancer.
This is why it's so hard for me to understand God. We say bad thigns happen so we can appreciate the good things. Stuff to help us become stronger. Why is there so much pain and suffering in the world. I guess when I thought of medicine it was more like, problem..let's fix it. And it got fixed. Nay... our hospital's census is predom geriatric population. I can't emotionally deal with it. So many comorbities.
treReading abotu EKG's now by Dubing. Break over.
I'm not looking up her labs. She's prob being transfused right now. I know this isn't healthy. |
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| Metstatic Lung Ca |
[Jul. 7th, 2008|10:07 pm] |
So I've been following this 85 yr old female with Metastatic Lung Ca since my first day. She was admitted for a fall.. r/o seizure vs syncope. Low and behold we do a CT of her head and it shows a mass in her right cerebellum. She just had her third round of radiation today. Her mental status has deteriorated a lot since the 7/3. I thought it was secondary to an infection since her WBC's are climbing. No UTI. Her CXR looks fine. I go to see her today and she complains of abdominal pain. So, I was hoping it would be her gallbladder. But nada. BTW, she has mets to her liver and GB.
This woman's cancer from her lung is taking over her. I ordered a repeat CT of head after speaking with neuro. I hope it's not a CVA. I hope it hasn't spread more.
I hate geriatric medicine. Especially when they are terminally ill. Cause you know that watver you're doing for them is to keep them comfortable, not to cure them. Which makes me want to work with younger people all the more. Met an ID doctor who let me ramble a little bit about myself. His wife was a pediatrician and now in Psych. A part of me wants to do Neuro/Psych. I hate inpatient medicine. I hate seeing people this sick coming in. Sometimes I think this way, because maybe I don't know enough? I come home and read. I read so I know what to say when a family member asks what's going on.
I've decided I want look up my pt's CT till tomorrow. I don't want to feel bad tonight. Then we're gonna start talking about hospice/palliative care and such with the family. Aghk.
I hope I can figure out why her mentation has changed so much. |
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