This morning I came in fairly early to make sure and round on all my patient before grand rounds. Yesterday, I underestimated how early the attending would be in. If it’s bad to be beaten to your patients by the intern, it is far worse to be beaten to it by the attending. Grrr. I will have to read my schedule more carefully; I thought he would be busy with the staff service, but it was his day off. So this morning I was bound and determined I would get everything done before Dr. A could possibly be in sight.

I did it too well. 7:15, with grand rounds at 8, I paged her. She replied from home. I guess she wasn’t really planning on rounding this morning. But we had two patients going home, and a circ that needed to be done for one of them. So she came in. Between the circ, and extensive discussions with the two patients (does she want an IUD? how shall that be arranged? is the other patient really going home? and general postpartum advice), we didn’t finish till 9am. Which was fine with me, because then there was no way I could fall asleep in grand rounds. The circumcision went more smoothly; I’m getting a little more adept with the awkward device that Dr. A uses. Although I’m getting to hate her style of mentoring, which consists of letting me do a thing (pelvic exam, anesthetic injection, whatever) without comment a couple of times, and then saying gently, “You know, I’m sure you’re doing just fine, but I myself generally do thus and so. . .” proceeding to demonstrate that I’m doing it very wrong, and harming the patient. I wish she would tell me sooner, or show me first!

I was supposed to do ultrasounds in the clinic this morning, and study this afternoon. There were only two ultrasounds scheduled, during lunch time. So I spent the morning curled up in the hallway of the psych department (one floor above ob/gyn offices, the only quiet and comfortable place I could find) reading Gabbe, and watching people walk in and out of elevators. Remarkable how many people made the same mistake about directions, walked out with the same look on their faces, etc.

Ultrasounds: good thing the tech was doing them, because I had no more clue than the patients what we were looking at. The first was a five-week ultrasound, rule out miscarriage. She was too early to see much more than a gestational sac, and verify that she hasn’t aborted yet, whatever may be going to happen in the next few weeks. The second was a young woman with her third pregnancy; husband and two cute little kids came along to “see the baby.” After going through the detailed fetal survery, and announcing that it was a boy – to the older brother’s intense delight – the tech let me play with the probe some. I was completely lost on orientation, couldn’t even tell which way was up, or how to get from a longitudinal view of the spine to a cross-section of the brain. I need to do this some more.

This afternoon, having made an appointment tomorrow to talk to the surgery residency director, I spent all my time on FRIEDA, looking up some programs that the residents here mentioned to me. They looked much better than the ones I found by randomly surfing FRIEDA on my own. They look so good, I can see I’m going to have to put some actual thought into this, rather than easily settling for the program at my current school. One thing I love: all the surgery residency descriptions start off by saying, This program completely covers all the ACS categories, and will produce a surgeon capable of handling all eventualities, and passing the boards on the first time. I love the confidence there; they seem so sure they can make anyone they accept, including me, into a good surgeon. How I hope it works.

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