Student evaluations

I'm not sure if I get to evaluate the students on my service. If I do, I'm going to be in a boatload of trouble. One of them will be incredibly easy to evaluate. She was a better student than me, and I'm the sub-intern. The other two students were fine. They did a good job. The last student... that's where the trouble lies. She did okay, but she didn't correct some things that I specifically asked her to correct. She didn't see her patients before rounds. She was late a lot. She didn't bother to attend rounds today. And our service is so light, I'm not sure how this is in any way excusable.

I thought a lot about what I did as a 3rd year student. I came in on my day off to personally calculate the QTc on one of my patients on a med that prolongs QT. The nursing staff was confused. Why wasn't I wearing a tie? I tracked down results of tests and curbsided attendings left and right. I often knew my patients much better than my interns. Not that I was showing them up. I just made their life a million times easier. I knew the labs. I knew the test results. I knew the schedule for the OR.

On the first full day of surgery, I didn't see all of my patients, and my resident asked me to present on one of the patients I hadn't seen. I told him that I had not seen the patient. "And...?" he said, expecting an excuse. I was late. I didn't know where she was. I couldn't find the chart. I didn't know what I was doing. I was tracking down another problem. Some sort of excuse.

My reply: "And it'll never happen again." And it never did. My resident was impressed by my response. Truth be told, all anyone looks for in a med student is effort, the willingness to do the work. One of my students didn't care at all for medicine, but I asked him to see his patients and write his notes on time, and he did. I asked him to list the meds for me. He did. He wasn't stellar, but he was earnest and put in the time. I can't ask for much more.

So my problem remains. I keep thinking that it's not my place to criticize. I think that I'm holding this one student to a standard that is too high. But the reality of the situation is that she did not put in the work. The bottom line is that I could not trust her.

Discarded dreams

I threw away my dream journal. That was an odd moment. The last few dreams in it were not dreams that I wanted to remember. Oh, they weren't nightmares or anything like that. They were dreams I had when I was feeling suicidal. I read through them again and I can feel the pain there. It's like an old wound, and you can run your fingers across the scar tissue, and the raw nerve endings fire up, and if you tweak it just right, you can feel the same pain all over again.

So I tossed my dream journal. I'd only been keeping it for a few years. Most of my other dreams are in my diary and stuff like that. I wish I remembered more of my dreams, because I'm sure there must be happy ones. Everyone has some happy dreams every now and then. I wish I could remember those.

Hospital codes are a spectator sport

I get left alone to fend for the service quite often. Granted, my team had good reasons not to be there in the afternoon, but I know that if I wasn't there, someone would have to stick around. In any case, I got some stuff done, and I'm feeling better about my eventual transition into residency.

But the thing about being in the hospital for a protracted period of time is that you realize a lot of people die in the hospital. I mean a lot. And it's from all sorts of reasons. There are ICU patients that just are straight up dying. But there are patients on the floors too that die for one reason or another. And it gets you down after a while.

And you can only care so much. It doesn't matter if you're a bleeding heart or you're stone cold, there's only so much you can care before you find yourself cracking jokes or simply blowing things off. It's self protection. You can only handle so much before you're overcome. The human creature was only designed to tolerate so much suffering. After a while, you compartmentalize and shield yourself to the horror of it all.

And in this respect, my life has come to mirror my hospital reality. I'm slowly but deliberately shielding myself from reality. I've adopted a policy of avoidance and ignorance. I've turned a blind eye to the world around me, because to look at it, to think about it, it'd be too much: too frustrating, too disappointing, too depressing. I'd rather not think about it at all.

But on the plus side, I've got a friend in the hospital, and M is cool beans. We've been hanging out a lot in house, and it's so much fun. You know, I realize now what people mean when they say that the other residents you work with are what define your residency experience. It's nice to have a friend in the hospital, if only to have someone to lean on.

We've had a storied history in the hospital. We took call a lot together on medicine. We were there when a classmate was diagnosed with a serious illness. We saw a lot of codes together. On surgery, we were always running around together. We were like peas in a pod. I think, of all the things I'll miss about medical school, I'll miss our time in the hospital, because she single-handedly made 3rd and 4th year of med school a fun time.

And I should note that it took my attending 3 weeks, but he finally noticed my tremor. I guess he did better than my neurology attendings who didn't notice at all. My tremor, if you're curious, is exacerbated by stress, fatigue, caffeine, and anxiety, to name a few things. However, I tend to mask with creative use of hands (pockets, behind back, pen twirling, etc).

My senior resident noticed on my 2nd day on service.

You'll probably never read this, but...

Hey, you'll probably never read this, but I think you're the coolest person I know. I think that you're amazing in ways that I can't ever capture in words. Your heart is always in the right place, and your tone is always gentle and compassionate. You've always got time for people who need you, and you've been an amazing friend to me. You think your life is a big jumble, but I look at what you've accomplished and think that I'd be lucky to be in your shoes. You'll probably never read this, and it's just as well, but I just wanted to say that I could spend the rest of my life looking, and I'd never find a person that's as wonderful as you. And one day, I'll tell you that.

Crushes have nothing to do with love

I've known a lot of girls in my lifetime, and I have gotten my silly heart hung up on a whole bunch of them. And it seems like all the girls in my life, the ones that matter anyway, have fallen into two columns.

There are girls that I've had sickening, maddening crushes on. They are attractive to me in every sense. In their presence, I feel woozy and trip over my words. I never know what to say or how to say it. I admire everything they do or say. I find myself mildly obsessed with their lives. This is, for the most part, entirely unhealthy.

Then there are girls I'm so comfortable with that it's like we were joined at the hip. We get along like milk and cookies. We talk every day as if we haven't spoken in 15 years. And uniformly, I've been entirely uninterested in these girls, save one. It's not that they are unattractive, and it's not that they haven't been interested in me. It's just that I had my mind on other things, I guess.

I often gripe that a lot of women I know are interested in everything about me, but not me. There is nothing so annoying as having a girl describe her ideal mate, and she describes you down to what color boxers you're wearing. But you know that if she was presented with the choice between you and being locked in a foot locker full of spiders, she'd have to think about it.

I've had a pretty pitiful love life, and I have a whole list of people and situations that I enjoy blaming. But maybe it's because I've been trying after the wrong girls all along. Maybe it's because the women that are right for me are not the ones that I've been chasing after. Maybe I'm just as guilty of chasing after something I don't really want. And maybe I need to rethink the last ten years of my life.