The junior resident this month has a laudable and conscientious enthusiasm for educating the medical student. Which makes my life very difficult. For the last three weeks, no one wanted me to talk about any patients, so I got out of the habit of reporting correctly. Thus, every time today that he asked me, “How is she doing?” I acted as though it was a normal “civilian” inquiry, and gave a brief and somewhat jumbled answer. Very incorrect, and I know better. So he corrected me. Entirely my fault, and I should be more thorough, and it doesn’t do any good to know all the information, if I can’t manage to state it before he says it as something I missed. I ended up getting one of my grading cards badly marked by him. Entirely my fault. . . But I have had enough interpersonal interaction for the day. So I sat down in the stairwell and shook myself, and have retreated into a corner of the library to type assignments, and thus avoid further possibilities of error.

It is so much easier to get along with doctors who have only a semi-enthusiasm for teaching. Actually learning is so stressful. . .

Last night was fun. The resident on call spoke with a strong southern accent, forced me to walk through every door first, addressed every lady in sight as “ma’am,” and joked pleasantly with the patients. So when we sat down to eat, I asked him if he was a Confederate sympathizer. He was dumbfounded by my guess; it seemed obvious to me. We spent a while discussing the origin of the Civil War (or, the War Between the States, or, the War for Southern Independence, or, the War of Northern Aggression, as you please), and the heroic and devout Southern generals. He insisted that Lincoln was truly principled in his desire for unity, although he altered his views on slavery to suit the times, and that the Reconstruction would have been better done if Lincoln had survived. I think he was rather pleased to discover a “northern” medical student who knew so much about the war (even though I know relatively little – but with his slant). (And we both disapprove of slavery, and are not racists, for my Northern-indoctrinated friends out there; but the war was fought because the South’s cotton export trade was the principle source of tax income for the country, and the Northern industrialists couldn’t afford to let it go. See Charles Adams’ When in the Course of Human Events, and DiLorenzo’s The Real Lincoln, for original sources on the subject.)

So, I got all my cards signed in clinic today; not to my satisfaction, but at least I have almost all the paper requirements for this rotation done with. This evening the school is having an informational session about applying for residencies. I shall go, and try not to become more nervous than necessary.

In clinic today we saw the pathology report on one of the patients from last week, who had a needle-localized excisional biopsy of some calcification seen on a follow-up mammogram of the other breast, after she had the first one removed because of cancer, and had just finished several weeks of chemo. The attending had assured her there was a very low risk of anything concerning coming back, and we had all expected to see just benign calcifications. I don’t know why we were so optimistic, since a personal history of breast cancer is such a risk factor, and since this is how her first cancer presented. So yes, she had both lobular and ductal carcinoma, out to the margins of our (very large) specimen. I feel like kicking something. I guess I should add this kind of sad event to my list of reasons to stay out of surgery; or is it a reason to stick around? Bother; and she is such a nice lady.

On another note, one of the surgery attendings looked for me yesterday evening, to tell me about the American College of Surgeons’ meeting this fall, and to urge me to go to the student sessions. I thought I had firmly decided to stop considering surgery as a career, but I keep reopening the question. I need to make up my mind; I spend almost as much time considering that, as studying.

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