Life Makes Me Motion Sick

Here I am at school blogging away, waiting for my friends to meet me to study. My surgery test is Friday. (Cue scary music)

I'm disgruntled today.

I'm doing outpatient psychiatry. This means I sit in a little room with my classmates, Chris and Ian, and our attending. I sit and try to stay awake as the patients tell the resident about the voices and what they are telling them to do. The patient can't see me because I'm behind a one way mirror. I didn't know that those things really existed. I feel bad for being sleepy, but it's dark and quiet in there. We're expected to write case reports on our patients, and turn them into the resident, so they can correct our punctuation (seriously). The pace is so slow in psychiatry. I will be glad to start O.B. in two weeks. I will be even happier to be back on surgery in July.

I was thinking the other day that I only have 13 months left of medical school. That might seem like a lot, but this is how my last year stacks up:

July: Sub-internship in General Surgery-- either at MCO or University of California San Francisco, start working on residency application
August: Trauma Surgery at Georgetown
September: Clinical Anatomy, study for USMLE Step 2
October: Clinical and Laboratory Hematology
November: Radiology
December: Infectious Disease/Residency interviews
January: Some rotation/Residency Interviews
February: some rotation I haven't chosen yet, Submit rank order list
March: Neurology, the "Match" for residency
April: vacation
May: vacation
June 2, 2006: Graduation

I haven't gotten my schedule, yet. I think they're supposed to show up on May 6th. That means my schedule might not look like this. These are the things I have selected. I tried to pick things that will make me a better surgery intern. I don't even know. I figured it would be a good idea for a surgeon to know how to read films, thus the radiology rotation. I chose infectious disease because I like all of the docs that run the service here. I chose a surgery sub-i to get letters and try to convince the chief of the department that I mean business, regardless of the fact that I don't have a penis.

I have been looking around in cities that I would like to live in for a house or a condo. I'm sick of renting crappy apartments, and I am probably going to get my inheritance from my grandpa during 4th year. That's my new thing. I look at places that cost 2 million dollars on realtor.net. I will never be able to afford something like that, even when I'm a bad ass doctor. It's just fun. My parents are going to finally move into their new house in June. They have been building it for about 7 years. In any case, I'm going to inherit the bed that is in the house they're living in now. I have no idea how old it is. It's a four-poster in maple. It was in my grandmother's guest room for years. My sister and I used to sleep in it when we would spend the night with her and my grandpa. It's old fashioned and slightly worn. It's classic. I'm really excited about that, too. I'm tired of springs gouging into my back. The style of it is very Sara. I love the old, classic furniture. Not fussy antiques, mind you.

I'm going to go drag myself to the lab room to study. We're doing CT and genitourinary tonight. Hearts and weenies. yay. 7:02 PM

Hiding Out
Instead of going to group therapy, where I have to either make up my feelings or share my actual feelings, I'm hiding out in the office. We don't have to go to group everyday, so it's okay that I'm not there. I don't like making feelings up because I don't want to deceive the kids. Yes, there have been times that I have been angry. Yes, there have been times where I didn't handle it the best way. Ask my sister. I could slap harder than anybody on earth when we were kids. Nowadays, I just use my sarcastic tongue to carve people up. I'm not always in control of myself either. To me, this means one of two things: we're holding these kids to an impossible standard of self control, or I need to see a therapist. I don't like to share my actual feelings in group therapy because that's self disclosure. It always makes me uncomfortable. You have to be careful what you tell people. The focus is supposed to be on the patient. You don't want an 8 year old with behavior problems to feel like she has to comfort you. She's got enough to deal with. It's a fine line.

I woke up in the middle of the night to hear thunderstorms. I love that. I snuggled down in my bed and listened to the rain. I don't even mind that it's kind of gray outside right now. We need the rain, and I have heard that there might be more storms during the day today.

I have been really pushing myself for the last few weeks. I'm studying for my surgery shelf exam. It's on the 29th. I missed the test on the day I should have taken it because I had the flu. The 29th is the earliest I could take it because they have to order me a test and it takes 3 weeks to get here. I have been studying in a group of 4. Things are going pretty well. I will be glad when it's over. This exam is really important to me because I want to be a surgeon. I'm not sure how much impact an Honors in my surgery clerkship will have, but it's still a good idea to go for it.

I could go back to sleep for a few hours right about now... 9:04 AM

Psychiatry is for Crazy People

I have been on psychiatry for about a week and a half now. I'm doing child inpatient. Maybe I'm just not getting it, but psychiatry does not strike any sort of cord with me at all. First and foremost it is a discipline of categorization. "Well, we can't call little Billy a conduct disorder unless he has actually hurt someone. Until then, he's oppositional defiant." It just seems like there's a lot of bickering about classification. There's bickering about whether a kid can be bipolar, or if it's just ADHD. Adult classifications don't work for kids. Kids are more irritable when they're depressed. The thing I'm grappling with is this: does it change treatment at all? I don't know enough to say yes or no. The only thing I do know is that I gravitiate toward the concrete. There is nothing concrete about what I'm seeing here, not if you compare it to surgery. In surgery, there is a certain amout of clinical judgement involved, but you have physical exam and laboratory studies to back you up. In psychiatry, it's all clinical judgement. Treatment decisions are based on how a kid seems to the psychiatrist. I have no doubt that the doctors are making good decisions, but I would feel uncomfortable doing that myself. I like things I can see and touch. I like it that when you operate, the secrets are most often there in front of you. I like having answers, and a more tangible treatment plan. I give people who like psychiatry a lot of credit. You have to be cerebral. You have to be willing to mess with something that is, in my mind, much more dangerous than the idea that I might take out a few healthy appendicies. You can change somebody's very sense of self with these psychotropic meds. I've seen people become totally different after their meds. It freaks me out. 8:46 AM

So, the other day I was thinking, "Isn't it amazing that I have been working in the hospital for 9 months and I haven't gotten sick?" Then, I got sick. I'm just now starting to feel somewhat normal. I had the flu. This is the real flu, as in influenza. I had a fever of 102, a cough, a headache, a runny nose, and I felt dizzy every time I stood up. I had this for 9 days. This means, I missed my shelf exam for surgery, and I have been sick for 80% of my spring break. I was supposed to go see my sister in VA, but she came here instead, and I slept the whole time. Currently, I'm having stomach issues. I won't go into the details. This bug is the gift that keeps on giving and giving. Everybody at school was sick along with me. Here's a shout out to Sheetal, who was even sicker than I was.

I'm done with most of my surgery rotation. All I have left to do is finish the test. I can't believe it's over. I can't believe I was dreading it so much, and I ended up loving every minute of it. Most of all, I can't believe I have finally settled on surgery as my chosen specialty. Maybe I'm crazy, but I miss the OR already, and the thought of doing psychiatry for the neaxt 6 weeks makes me feel very sleepy. 6:56 PM