It's 645pm. I'm sitting in my apartment in complete darkness. I still have my jacket on with my hood over my head. I got home less than 10 mins ago and i'm trying to decompress. I left my apartment at about 630am. I wouldn't say i accomplished a whole lot in the MICU today but i still feel guilty because i left. I ditched the team and did not follow the Attending and two Interns to go watch the bronchoscopy the Attending was about to do. My guilt comes not because i left but because i was "caught" in the act of leaving. I didn't expect the attending to still be standing in front of the elevators and when i saw his reflection in the huge windows my heart skipped a bit and i hesitated for a second, but i figured he already saw me, so i chopped liver and kept on walking, smiled and waved goodbye to him and the two interns, all the while wishing i could disappear.
As a med student, rule number 101 is you never ask to leave. You have to wait until someone takes pity on you and dismisses you. Sometimes you are forgotten, so you have to subtly asked to be dismissed by asking if there's anything else for you to do. On this rotation, i have asked to leave a couple of times, i have also left without asking anyone on many occasions, like today. I've had enough of the eye service. If i'm not doing anything, I refuse to sit idly waiting for someone to take pity on my and send me home. I'm completely over the bullshit. I am perfectly okay with a pass in this rotation, they can keep the honors and high pass.
I didn't go in yesterday because I had a few appointments in the afternoon, so i just decided to take a mental health day. I told the Fellow i wouldn't be coming in, he didn't ask why, he just said okay. Between yesterday morning and this morning when i went back in, two out of my three patients died. The one i had been really worried about, i found out when i got out of bed at 8am and checked his chart. I was shocked to see a warning telling me i was opening the chart of a deceased person. My reaction was actually quite comical. Like i jumped back in my seat and clutched my chest in shock. Even though he was really sick and everyone on the team knew he was not going to make it, i had hoped he would be there when i got there today. I just watched this man die. The whole process, one organ after another. It bothered me a lot. I just kept thinking about his wife. The other patient, i didn't even find out until this morning when i looked at a note on the board. I had actually ditched that patient after admitting her cos i felt she wasn't as interesting. There really was no indication that she was going to pass away soon. My last patient is also at death's door. I'm like what the hell?
The craziest thing is when we rounded this morning, no mention was made of the "expired" patient. The team has already moved on. I'm still trying to wrap my head around that. I think being in medicine you are thrown into difficult situations and expected to somehow deal with it. I'm not different from any other person out there. First it's dissecting cadavers your very first semester of medical school, which you become desensitized to pretty quickly. On your first day, you think i can never eat meat again, or how i'm i going to use these hands to eat. In a couple of weeks, you are dissecting and thinking about what you are going to eat for dinner or people are talking about how certain parts of the body look like steak or whatever food.
It took seeing a black cadaver towards the end of the semester for it to hit me that we were actually dissecting human beings because after the first week or two, i "forgot". When i had to do a rotation in anatomy this past december, i didn't give it a second thought, somewhere along the line my brain has accepted dissecting cadavers as normal.
In second year, as part of pathology we went to the medical examiners office and helped with autopsies. This time we were dealing with newly dead bodies, most less than 24hrs dead. Once again, i was just an ordinary girl who happened to be in med school. Why was it assumed that i will be able to deal with seeing a body with half its head blown off still dripping fresh blood or watching how undigested noodles was emptied out of someone's stomach? But hey, i was a medical student, i signed up for this so somehow i should be able to cope. I pretty much this last week just watched someone deteriorate and die. I was just putting ice chips in his mouth less than a week ago after he was intubated. I talked to this man everyday before he was intubated and even after he was intubated he would make hand gestures in response to my questions. He didn't come in at death's door but now he's dead. We don't talk about it anymore, we just move on and are expected to be okay. I'm struggling with this.
Every morning when we round, sometimes all i see is a bunch of sheep following the shepherd around. We are all properly dressed for that role with our white coats, some long and some short. You have to always present a picture of interest and enthusiasm even when you are bored out of your mind and cursing the attending who insists on rounding for four hours twice a day. Sometimes they forget to tell you they are heading to the restroom and like brainless sheep, you almost follow them in. They are the leaders and the little minions just follow around. Recently, we all took this israelities journey to get to a patients room when we could have just cut across the hall and gotten there in 2 seconds simply because we were following the leader who did not bother telling us where our next destination was. Sometimes i wonder how all this facilitates learning and if i couldn't spend my time in more productive ways.
The MICU is interesting. I see different things i want to learn more about but by the time i get home everyday, all i want to do is sleep because i'm physically exhausted by the insane amount of hours i spend on my feet. I want to be the enthusiastic student who would never pass up the opportunity to observe a bronch especially since i've never seen one, but i'm tired and just want to get home to my warm apartment, and my tee shirt and sweat pants. I'm pretty sure i can watch a broncoscopy on youtube and i'm keeping my fingers crossed that this attending doesn't fail me.
LOL Or Not?
4 hours ago