#intern year

[slf-cntrl]

ONE OF THE MOST ICONIC SCENES…

there’s just too much going on lol

[emgoesmed]

10/11/2024

Ambulatory block this week.

The workflow details and all the little things parents ask about feels overwhelming 90% of the time but I’ve been surviving and getting reassured by my attendings that I’m meeting expectations.

Intern year is fun, exhausting, frustrating, and rewarding at the same time. 😵‍💫

I had extra time this morning so I treated myself to my favorite breakfast sandwich from the cafe down the street: fried egg, refried beans, pico de gallo, avocado, hot sauce on a Kaiser roll. It’s the little things in life. 🥰

[whitecoatblackmarket]

When another specialty’s resident or attending is rude to you and your senior resident or attending asks for you to give them the phone

Hahaha you’re in trouble now 😂😈

[cranquis]

Wanted to send you a message - I'm from another country, but wanted to match into the US healthcare system for the longest time for several reasons. Followed you for the wisecrack insights, stayed for the soul.

I've matched into my dream Anesthesiology PGY1 spot this year <3

Thank you for all that you do.

I am so excited for you, my friend and colleague! Congratulations!!! Now keep your chin up as PGY1 year does its best to smother your dreams with scutwork and stress and lack of sleep.... this too shall pass!!!

[brighterthanthou]

first day of intern year ☝🏻

wish me luck

[a-young-doctors-journey]

The worst part about the ICU is that you get to a point where you're on a first-name basis with family.

Frederick was at bedside every day, sitting beside his wife. When he wasn't, they were on speakerphone, her work of breathing worse each day. We explained to the family that she was really really sick, and they understood that the prognosis was poor.

But when it came time to decide about intubation, they couldn't bring themselves to withdraw care... so we intubated, knowing there was no way that she would ever come off the vent.

It was after 10pm when the nurse came over to us.

"Room 7 won't make it through the night. Maybe you should call family."

My senior looked at me, and asked, "You wanna call the husband?"

"Frederick? No."

"It's important to learn how to have these conversations, you know," he said, somewhat gently.

"I know. And I have them plenty. But you asked me if I want to call him and tell him his wife is dying, and I don't. But I can, if you want me to."

He nodded and dialed the number from our 'Next of Kin' list. "Mr. Smith, I wanted to..."

Not even half an hour later, the monitor by my computer started beeping furiously. Her blood pressure, which had been dangerously low already, tanked. I ran to Room 7 as nurses from surrounding rooms crowded into the little space, code cart already in place.

She had no pulse. The ICU team really did have an intuition for this sort of thing.

We went through the motions of the code, not for a moment believing that we would get her back. But we did. A short-lived miracle... but maybe it would give Frederick just enough time to come back.

The second time her heart stopped, my senior asked me to let the family know that we had done everything we could. I stepped outside, the sounds of the active code behind me, and explained that there was nothing to be done.

"So this is it?" he asked matter-of-factly.

I nodded. "I'm very sorry, Mr. Smith." He thanked me as I walked back into the room just in time to hear the pronouncement.

"Time of death: 10:39 PM."

Gloves came off. Supplies were discarded. The code cart was wheeled unceremoniously out of the room. One of the nurses placed a fresh sheet over the patient, tucking it gently around her.

As I headed back to my workstation, a heart-wrenching sob pierced the hallway. Frederick - a stoic, quiet man who had spent countless hours with wife, ever so hopeful - was sobbing into his knuckles.

I felt the tears well into my own eyes, swallowed hard, and looked up to see the surgery resident coming towards me, no doubt seeing my watery eyes but making no comment.

"Are you taking care of...?"

And the rest of the night went on.

[iknowthisisnowhere]

I haven't seen the sunlight in over a week. I get to the hospital when it's dark. I leave when it's dark. I'm not meant for 6a-9p.

Hospitalist medicine is hard.

There's no pulm/crit team... so a fucking psych intern (me) is taking care of ICU patients. Intubated, on pressors, about-to-die ICU patients.

At least I haven't killed anyone yet.

ACGME cap is 10 patients. I've had 10 every day, plus admits.

I shouldn't be complaining. I know interns are being forced to carry more than 10, I'm sure, and we all break the 80-hour rule. We have to.

I'm struggling.

[intrainingdoc]

The next installation of our "Surviving IM/G" column by internal medicine resident & international medical graduate Dr. Gottlieb is now published to in-House, the online peer-reviewed publication for residents & fellows.

[beastwhimsy]

"I should draw Māori Miku!" I said to myself. "Just a fun sketch, it shouldn't take me long" I said to myself. Six hours later I come to with this in front of me and a wrist begging for mercy but holy fuck worth it. I love this trend this was so much fun

PLEASE DON'T REPOST ON OTHER SITES!!! ASK ME FIRST!!!!!

DISCLAIMERS AND NOTES ETC.... I'm Pākehā, meaning I am not of Māori descent. I hold so much respect for Māori people, for their values and traditions, and for the fierce pride with which kapa haka is performed. I thought if I was going to design a Māori Miku, it makes sense to dress her in a kapa haka kākahu, as her whole thing is singing and dancing!!! The moko kauae is not based off any real person's. I referenced the temporary moko kauae a lot of kapa haka performers wear!! Was tricky finding out whether or not depicting her with a moko kauae was a good idea, so I went the safe route- showing an aspect of Māori culture without stepping over any boundaries!! Brown eyed Miku is everything to me shout out brown eyed Miku.... I referenced like seven different outfits to put hers together!! I really hope this looks accurate or at least passable. Thanks to adorkastock for the pose ref!!

[p1nkshield]

Prompt idea: Danny has been attending Wayne family dinners for weeks now and he truly doesn’t know how he got this far

Danny has been without a home or a means to get food for a while because of either identity reveal gone bad or Dan timeline shenanigans. Either way he needs to eat. As a last ditch attempt Danny tries to attend/infiltrate a Wayne family dinner. He’s seen the Wayne kids around Gotham and he’s sure that he could look and act the part enough to get in the door and out with some bread rolls at least.

Was it his best idea? No.

But he sure as sugar ain’t firing on all cylinders rn.

And Bruce already has a gaggle of blue eyed, black haired children.

What’s one more?

Batfam of course notices immediately when a whole new kid shows up, grabs some miscellaneous pieces of food and then prattles off some excuse about “not being that hungry.” (Clearly a bald faced lie) And that they were “Going to the library to study for finals, bye Dad!”

1. No one skips out on family dinners. Even Jason was here.

2. Alfred sets the table for everyone ahead of time and the kid had no place to sit.

3. Nobody in this house studies anything beyond case files.

4. Nobody in this house calls Bruce Dad.

Danny thinks he is suffering from success. No matter where he is in Gotham someone picks him up and insists he’ll be late for family dinner which is unacceptable.

Alfred just wants to feed the boy.

The batkids are amused by his efforts to look as though he’s been here all along.

Bruce is drafting adoption papers as we speak.

[emgoesmed]

9/14/2024

I can’t believe it’s September. Time is flying.

Coming off a long week of nights. My first true 80hr work week as a resident. I’m sure it seems like small potatoes to the surgeons out there, but I’m definitely tired. 😅

I went on a cute lunch date with my bf and then we spent the rest of the day in the kitchen. He made homemade pho and I made a lemon olive oil loaf cake. We sipped on orange wine and watched Somebody Feed Phil on Netflix and it was such a perfect day. ❤️

[whitecoatblackmarket]

When you overhear a patient say “Nurses are the ones who really care about patients, you barely even get to see your doctor!”

Ouch that kind of hurts 🥺 I love and appreciate our RN’s so much - they certainly are empathetic and wonderful - a vast majority of the work they do for patients is something patients can see, and is at bedside. The reality is that I cannot be at bedside for long periods of time because I have a lot of patients and I need to be seeing all of them multiple times per day, putting in orders, documenting their care plan in progress notes, and operating in the OR. I can’t even count the number of times I’ve stayed late to personally follow up on a patient’s results or stayed even later to personally talk to them as soon as we had new info, I make an effort to go above and beyond when I have chances to improve patient care and make their hospital stay less stressful. I’m constantly having conversations with my team, researching treatment recommendations and possible risks to each step, fighting with insurance companies and agonizing over patient care choices, but none of this is something my patients can see. I work really really long hours - a 5am-8 or 9pm day is not unusual, and I don’t hesitate to stay longer if I can be of more comfort to my patients. Just because we cannot be at beside does not mean we don’t care, and wow does it kind of sting when patients or even other healthcare workers allude to nurses being the only ones who truly care and advocate for their patients. We are all on the same team, and just because you don’t see all our hard work doesn’t mean it isn’t happening.

[giantkillerjack]

Today my therapist introduced me to a concept surrounding disability that she called "hLep".

[plain-text version of this post can be found under the cut]

Which is when you - in this case, you are a disabled person - ask someone for help ("I can't drink almond milk so can you get me some whole milk?", or "Please call Donna and ask her to pick up the car for me."), and they say yes, and then they do something that is not what you asked for but is what they think you should have asked for ("I know you said you wanted whole, but I got you skim milk because it's better for you!", "I didn't want to ruin Donna's day by asking her that, so I spent your money on an expensive towing service!") And then if you get annoyed at them for ignoring what you actually asked for - and often it has already happened repeatedly - they get angry because they "were just helping you! You should be grateful!!"

And my therapist pointed out that this is not "help", it's "hLep".

Sure, it looks like help; it kind of sounds like help too; and if it was adjusted just a little bit, it could be help. But it's not help. It's hLep.

At its best, it is patronizing and makes a person feel unvalued and un-listened-to. Always, it reinforces the false idea that disabled people can't be trusted with our own care. And at its worst, it results in disabled people losing our freedom and control over our lives, and also being unable to actually access what we need to survive.

So please, when a disabled person asks you for help on something, don't be a hLeper, be a helper! In other words: they know better than you what they need, and the best way you can honor the trust they've put in you is to believe that!

Also, I want to be very clear that the "getting angry at a disabled person's attempts to point out harmful behavior" part of this makes the whole thing WAY worse. Like it'd be one thing if my roommate bought me some passive-aggressive skim milk, but then they heard what I had to say, and they apologized and did better in the future - our relationship could bounce back from that. But it is very much another thing to have a crying shouting match with someone who is furious at you for saying something they did was ableist. Like, Christ, Jessica, remind me to never ask for your support ever again! You make me feel like if I asked you to call 911, you'd order a pizza because you know I'll feel better once I eat something!!

Edit: crediting my therapist by name with her permission - this term was coined by Nahime Aguirre Mtanous!

Edit again: I made an optional follow-up to this post after seeing the responses. Might help somebody. CW for me frankly talking about how dangerous hLep really is.

Plain-text version:

Today my therapist introduced me to a concept surrounding disability that she called "hLep".

Which is when you - in this case, you are a disabled person - ask someone for help ("I can't drink almond milk so can you get me some whole milk?", or "Please call Donna and ask her to pick up the car for me."), and they say yes, and then they do something that is not what you asked for but is what they think you should have asked for ("I know you said you wanted whole, but I got you skim milk because it's better for you!", "I didn't want to ruin Donna's day by asking her that, so I spent your money on an expensive towing service!") And then if you get annoyed at them for ignoring what you actually asked for - and often it has already happened repeatedly - they get angry because they "were just helping you! You should be grateful!!"

And my therapist pointed out that this is not "help", it's "hLep".

Sure, it looks like help; it kind of sounds like help too; and if it was adjusted just a little bit, it could be help. But it's not help. It's hLep.

At its best, it is patronizing and makes a person feel unvalued and un-listened-to. Always, it reinforces the false idea that disabled people can't be trusted with our own care. And at its worst, it results in disabled people losing our freedom and control over our lives, and also being unable to actually access what we need to survive.

So please, when a disabled person asks you for help on something, don't be a hLeper, be a helper! In other words: they know better than you what they need, and the best way you can honor the trust they've put in you is to believe that!

P.S. Also, I want to be very clear that the "getting angry at a disabled person's attempts to point out harmful behavior" part of this makes the whole thing WAY worse. Like it'd be one thing if my roommate bought me some passive-aggressive skim milk, but then they heard what I had to say, and they apologized and did better in the future - our relationship could bounce back from that. But it is very much another thing to have a crying shouting match with someone who is furious at you for saying something they did was ableist. Like, Christ, Jessica, remind me to never ask for your support ever again! You make me feel like if I asked you to call 911, you'd order a pizza because you know I'll feel better once I eat something!!

Edit: crediting my therapist by name with her permission - this term was coined by Nahime Aguirre Mtanous!

Edit again: I made an optional follow-up to this post after seeing the responses. Might help somebody. CW for me frankly talking about how dangerous hLep really is.

[3allo32]

مفاتيح

المفاتيح الي بلاقيها في الشارع بتشتغل معايا احسن من الي اشريتها. مرة لقيت مفتاح مقطوم حطيته ف جيبي و نسيته و جربته بعد سنة لقيته فتحلي شراعة صغيرة شفت منها نفسي و انا ماشي فارد ضهري عجبني الموضوع. مرة بقى اشتريت مفتاح من ع النت زمان و دفعت فيه كتير طلع ميتيني و كان بيقع مني وينزل ف الطين و اضطر انضفه كل شوية . كنت بحبه بس كان حاد و بيعور جلدي يوميا بدون اي فايدة ولا بيفتح اي حاجة رميته ف بلاعة و نسيته. الاسبوع الي فات اتعلمت ازق باب متوراب بشياكة و ادخل من غير من استنى الاقي مفتاح. كنت فاكر ان الجدعنة انك ترزع الباب المقفول او تكسره على الي فيه عشان تبقى جامد بس اكتشفت ان الادب و الهدوء و الثقة ساعات بيخلوني ادخل من الباب من غير الحاجة لمفتاح. لكن ده لا يمنع اندهاشي الدائم بمفاجئات المفاتيح

[a-young-doctors-journey]

I’ve survived trauma. I spent most of intern year nervous about this awful month… but it came and went and I’m still alive!!!

[iknowthisisnowhere]

15 days away from being a PGY2.

Fuck.

I don't know if I'm ready for this.