End of orientation.

What a long week.
I really hope I remember even half of the information thrown at me last week. If I just remember where the research cabinet is, and the pantry, and I always show up early for shifts I should be OK. My first shift is research. I think that’s a very good thing. I can get my bearing in the emergency department, and talk to patients in a controlled manner. I’ll have explicit instructions, and know exactly what it is I’m doing, which will be nice. My Tuesday shift is in peds I think, which will be more difficult because I’m still not sure what the boundary is regarding sharing information on minors, and the nurses and doctors aren’t sure either, so everyone’s extra cautious about volunteers there. I am excited to jump right in, as usual. I’m the one who dives into cold water before the rest of my friends, who makes the final decision when it comes to what we’ll eat, where we’ll go, and what have you. I may be indecisive by my standards, but that’s because I really appreciate directness and good decision-making skills, and leadership.
We were all given a reading list that I’m excited to get started on. There’s so much I can learn this summer. And I should take a diagnostic MCAT. I hate that a standardized test stands between me and my dream career. Well, two standardized tests actually. At least two. But in a way that’s a big part of why I chose medicine, and why it chose me. I want guidance, requirements, little boxes to check off on my to-do list. It makes me feel secure to know that the biggest factor in my success will be sheer dedication and hard work. Sure, its great to be intelligent, and creative, and have a good bedside manner, but at the end of the day there’s a list of things one must do to become a doctor, and to get through the list you just need to keep plugging away. I hope I can interact with patients. To say I’m not the best talker is an understatement. Some people can make conversation with anyone, and they never seem awkward. I am not one of those people. And I guess I don’t have to magically become sociable to excel in this internship. But I will have to meet new people every single day, and do my best to make them feel…actually I’m not even sure. Make them feel like someone cares and is looking out for them, even though they’ve been waiting for 5 hours and haven’t seen a doctor yet. Make them feel less like patients and more like people? I know that everyone, truly everyone, has something interesting to say, and I know to reserve judgment about people because I usually end up being wrong. I’m not naïve enough to think that there are some people whose lives are so far outside the scope of my experience that we won’t have anything to say to each other. At the very least I could ask those people questions. I can’t wait to meet people who challenge me and make me think. I like to hear everyone’s story. We had a speaker who ran a workshop on doing HIV testing outreach in the emergency room, and she kind of rubbed me the wrong way because she asked everyone to write down a quality we liked about ourselves. I wrote that I’m a good listener, which is true, but she made a comment that saying you’re a good listener can just be an excuse not to step out of your comfort zone and talk to patients. I have not intention of standing in a corner and watching people, much as I might want to do that. When I have HIV outreach shifts I’m going to introduce myself to every single person in the ER and give the spiel about testing, both because I think HIV testing is super important, and because I want to prove Ms. Extroverted HIV counselor wrong. Yes, I always get I for Introvert on the Meyers Briggs test, and yes, I know that most people think extroversion is an essential trait in physicians. I’m quiet but I’m passionate about medicine, and more importantly, about people.
I can’t wait to get started tomorrow.

Project Healthcare Orientation thoughts

Not sure if anyone still reads this, but that's probably for the best.

I need a place to document my experiences this summer, but I don't want to be pretentious or otherwise annoying by talking about pre-med things all the time. I know that gets old real quick. Everyone likes to talk about their interests, and I don't have many friends who are as interested in the study and practice of medicine as I am. Maybe writing about what I do at Bellevue all day will help me tone down the incessant pre-med babble. Let's hope so. I could also use a record of this internship some day soon when I have to write a personal statement for my applications, and in general, it will help me remember bits of potentially useful information. For example, the Principle Investigator for NYUSoM's minor/moderate head trauma study is also the CEO of the school! Helping with his research is yet another connection between me and NYU. I need all the connections I can get.

Today we picked an anesthesiologist's brain regarding how he deals with the stress and emotions associated with being a doctor. He talked about dissociation, saying, "If you see every patient as your mother, you won't last long in this profession. Or, you'll become a bitter jerk." Empathy is key, but so is maintaining some level of emotional distance. I already know that's going to be tough for me. Today we went on a tour of the EW, and I felt so bad for pretty much every patient we saw. I want to see "interesting cases", but that's just another way of saying people in distress. A person in a great deal of pain, who just got hit by a bus, or somebody who collapsed while walking to their office, or a dude who stopped taking his meds and is now screaming curses at all the nurses in the psych emergency ward. When a case gets especially interesting, someone usually dies. This isn't House, MD. At Bellevue, people die. Several times a week. If we're in the EW and we hear "Trauma in the slot", we're allowed, even encouraged to go watch the nurses and doctors rush to resuscitate the patient as soon as we finish our task at hand. I want to see trauma. I want to see the nurses and doctors stabilize an airway, defibrillate, stop blood loss, and generally patch the patient up well enough to be sent to the OR or whatever the next stop will be. But I know that in order for me to see trauma, someone has to have a serious accident. So many staff members have said to us already that "Folks never plan to spend their day here at Bellevue with us." But I also have to consider that I'm not wishing for bad things to happen to anyone. I know that accidents happen, taxis run red lights, folks have heart attacks, and there's all sorts of interesting mishaps that can happen when one uses a chainsaw while intoxicated. Trauma happens, whether or not I'm in the EW to see it. So I just want to see it!

More training and orientating tomorrow. I hope I get my schedule!!