It seems that summer turned to fall at some point—not quite sure when, but I think it was right around the time that hordes of people began to make their way to Ann Arbor for the start of football season. Personally, I have always been one to get more excited for the approaching field hockey season, and although they are off to a solid 6-4 start, the fans don’t flock to the Phyllis Ocker Field in quite the same numbers (>100,000!) that file into the Big House each Saturday!
It’s been a crazy couple of months, and now being the eve of my sub-internship in Boston in Orthopaedic Surgery, I don’t anticipate things getting any quieter for the next month! I spent the month of August rotating in Emergency Medicine at St. Joseph Mercy Hospital (affectionately known as “St. Joe’s”), a nearby hospital in Ypsilanti that is affiliated with the University of Michigan and is known for offering students a great glimpse into life as an Emergency Medicine physician.
I have to say that I enjoyed ER a lot more than I thought I would, to be honest. One of the things I loved most about it was the sheer variety—I would literally bounce between rooms where the chief complaints ranged from a motorcycle accident to OB/GYN issues to psychotic delusions to a heart attack, all in the course of one eight-hour shift! I also really enjoyed getting to do a variety of procedures–we had a whole session with nurses and technicians dedicated solely to putting IVs into patients’ arms, as well as learning to obtain Arterial Blood Gases, insert nasogastric tubes, put on splints and casts, and obtain EKGs. In addition, I got to be involved with procedures like suturing up lacerations, putting in central lines, reducing dislocated shoulders, performing lumbar punctures, and inserting chest tubes. Most of the shifts flew by, and I really liked the intensity of the ER and the excitement of not knowing what might come through the door at any time.
What I liked less, however, was the lack of continuity of care—except for some occasional “frequent fliers,” an official medical term for those who pay many a visit to the local ER, it was unlikely that we would see any of these patients again after they were discharged. I realized how much I missed getting to know how things turned out for these folks after they left the ER. In addition, I missed being part of a team in which everyone in the room—attendings, residents, and students—are focused on working together to take care of one person at a time. In the ER, residents fly back and forth between patients, discuss their findings and management plans with the attending and possibly confer with one another if they have questions, but for the most part work pretty independently. And then, most importantly, I realized how much I missed the operating room—as much as I enjoyed procedures like placing central lines and sewing up lacerations, it was nothing compared to the excitement of working through a big case in the OR.
After finishing up Emergency Medicine, I started on my month of “Vacation”—I use this term lightly, as I spent most of the month studying for my Step 2 Clinical Knowledge Exam, which I took this past week. The day after taking the exam, I hopped on a plane for Houston, Texas, where I spent the next day taking the 8-hour Clinical Skills Exam before flying back to Michigan and then headed to Boston for my sub-internship out here. As much fun (and by that I mean nerdy) as it sounds to spend one’s month studying for a big exam, I actually had a fantastic month. In a way, it is sort of fun to go through review books and questions and realize how much you’ve learned throughout the year as an M3 and M4. Whereas with Step 1 studying, you are memorizing biochemical pathways and drug mechanisms and in general trying to maintain your sanity, with Step 2 you have often actually taken care of patients who have the diseases described in questions, and you can think back on how your team managed that patient’s case. I found a great coffee shop in a nearby town with some very friendly people (and cheap coffee!) to study from morning to evening, and the process of studying itself became a relatively peaceful journey. The week of the 2 exams itself was not too much fun—although it seemed like a good idea at the time to schedule both exams for one week, it turned out to not exactly be as smooth as I had hoped given all the travel—but it is a relief to know that both of these tests are done as I move into my away rotation and interview season.
The reason this past month was so great was not the “excitement” of studying, however, but rather was mostly due to some exciting things happening outside of the books. First, my father was inducted as a Lieutenant Colonel into the U.S. Army, and I got to fly back to Boston for the event (pictures are forthcoming; not currently available due to some technical difficulties!). It was a really proud moment for him, and after all the events he has come to for me and my siblings, I was so glad to get to be a part of it. A few days later, I competed in an Ultra-Marathon—and actually finished! It was a 50-kilometer (or 31.1-mile) race, and it involved everything from wading through streams to sliding through mud to climbing up hills to consuming obscene amounts of Gu, an energy gel that I would not otherwise recommend as a snack for taste reasons alone. It took several days before my legs felt the desire to try to walk again, and a week after the 50k we undertook a much more modest 5k—although truth be told, even this distance felt somewhat punishing after the previous week’s event.
So this month I’ll be trading in my running shoes and test-taking pencils (not actually true, since all exams are now done on the computer, but you know what I mean) for scrubs and clogs, and headed back for another round of Orthopaedic Surgery. I am nervous—but excited—to see what it’s like to rotate through a hospital outside of Ann Arbor, and another perk is that I get to live at home, complete with free home-cooked meals! I will be missing Ann Arbor, as fall is probably the best time of year in my adopted home city, but I’m excited for what lies ahead.