Sunday, July 31, 2016

Three Quick Takes

ICU and STEP 3 and ACOG, oh my! Abstracts are due in August for ACOG, which means I am trying to accomplish too many things this month. Therefore, short posts on topics that I've been meaning to blog about forever. (There are only two of them, it's not even that exciting.)

1: Nursing is Cooler than You Think

Seriously, how cool is it to be a nurse? Doctors are kind of like prima ballerinas: they come onstage when everything else is ready and everyone is waiting for them. Then they do their thing and let everyone else wrap up and finish everything. (This is especially true of surgeons in the OR. They're paged when the patient is asleep and positioned and they gown/glove, do their thing, and leave afterwards and let the staff +/- resident take care of everything from closing to recovery.) Nurses, on the other hand, are with the patient, advocating for them. 

And the profession of nursing more closely resembles what we are meant to do in salvation history. God is the physician: He alone has the knowledge that heals us. But He lets us assist: he lets us nourish and spread His gifts, in our own souls and in others'. Nursing is an image of what saints and angels do for sinners.

I know I am in the right vocation. But now that I am working with nurses and that I know someone in nursing school, I'm thinking so much more about this. Nursing is so cool.

2: Awesome! The Linacre is On Pub Med! And a Dilemma

I seem to be able to make a dilemma out of anything. It's really good news that the Linacre Quarterly, the journal that has been published by the Catholic Medical Association since 1934, is now archived in PubMed. It's a mark of legitimacy, and research that gets archived there is shared with the general scientific community. I'm much more attracted to publishing there, since any articles that appear will have a PMID and a real DOI.

Linacre is also growing more professional, with a new format (as of like eleven months ago, I'm super late blogging this) and more scientific research to balance its many essays, book reviews, and philosophical and theological reflections.

But the dilemma is: do I publish new research in the Linacre or do I publish it in a professional journal? (I'm a little embarassed as a I write this, because it's all hypothetical...I haven't got a single abstract to speak of.) It'd be so awesome if some big important paper put Linacre on the map. But I don't want to hid all my findings in the Catholic corner--today, who would take a paper published in a Catholic journal seriously? Am I being career-centered or just practical? Gah.

3: Why I Don't Have Pets

Some consecrated virgins have pets, both to keep them company and to keep them from thinking about themselves all the time if they live at home. I currently have no pets. I'm not allergic to them and I think they're adorable. And my parents' house has seen all kinds of pets: birds, fish, gerbils, mice, chinchillas, cats, and a dog (not simultaneously).

But now is not the time for pets. Let me explain. I dog-sit for friends occasionally. Their adorable terriers are affectionate, well-behaved, and clean. But last night while dog sitting I burned the midnight oil researching the ethics of emergency contraception. The dogs snoozed while I stayed up with my laptop. But then, five and a half hours into my sleep, they woke up and needed a walk. Dogs don't understand fides quarens intellectum. They just need to lick your face and chase some squirrels.

So, for now, while I burn many midnights studying OB/GYN and medical ethics, no pets. (Also, I don't really want to become the old cat lady. I'm on my way to becoming the old church lady already.)

Friday, July 15, 2016

Easter Fire: In Which God has a Laugh

I notice things; maybe you do this, too. Maybe you always know where the fire exits are. Maybe you notice the elderly priest at Mass and think about what you would do if he fell or fainted. Maybe you notice the pregnant lady in the car next to you and think about what you would do if she got in an accident (maybe you even keep a scalpel in your car to do a stat C-section...).

Easter fire. (Stock photo, obviously not the situation I was in.)
I think it's neat that I can notice these things and be ready. But sometimes I think God makes fun of me for it, just to keep me humble.

I worked days this past Easter, but I had the nights off. So, after I got off on Holy Saturday I drove to an abbey not far from my city for their midnight Easter Vigil. It was going to be my rest: for just a few hours, I had no responsibilities. I didn't have to cantor, talk to people, or even stay awake! Thank God, I prayed.

This is the abbey where I made my week-long retreat before my consecration. It was an otherworldly week, partially because the abbey really lives the vow of poverty and the life of silence. Each member lives in a tiny (6x10ft) hermitage without heating or air conditioning. They also have foundations in Africa, and they live the same way on both continents. 

Given this spirit, I wasn't surprised to see a make-shift, but lovely credence table for the lighting of the paschal candle. In a broad stew pot were some coals, and this was placed on top of a cheap card table, covered with a white tablecloth.

I felt strange coming back after so many months in the world. I was then more than halfway through intern year: I was a competent, resident, I paid bills and bought stuff, and I was neck-deep in ethical questions, all far from ethereal prayer. That night, I re-entered the world of silence feeling like an outsider.

I slid in a few minutes early next to another woman. It was hot (remember: no air conditioning), and she had brought a water bottle. The plastic crackled in the monastic quiet before Mass. When the time came to light the candle, we all stood. Because I'd slid in the back, I was only a few feet away from the humble credence table. An acolyte poured some lighter fluid on the coals and clicked a lighter. My face and the faces of the whole back row were illuminated, and I felt even more exposed. Hide me, God. Please, just let me cower in the back and absorb the Mass.

All was well for a few minutes. Then the fire blew out of the pot and the tablecloth caught fire. The same sense of duty that makes me notice pregnant and elderly people was immediately awake: DO SOMETHING, it said.

What? I thought immediately. God, are you joking? 

The seraphic abbot and acolytes all stepped away in refined surprise. Inwardly, I groaned playfully at God, because it was as though He was nudging me lovingly. It had only been half a second since the fire started, and I grabbed my neighbor's water bottle, tore the cap off, and emptied it onto the table. There was just enough to put out the fire. I have residency to thank for the reflexes, and God to thank for His sense of humor.

Friday, July 1, 2016

Another July 1

Another July 1 is here, and this time I am a second year. It's bizarre to watch another cadre of interns come in, especially ones I knew as medical students.

It's a strange experience to think, after a long workday on July 30, "I'll be a second year tomorrow." I'll hold the ER pager. I'll do the crash repeats (the emergent C-sections on people who've had C-sections before) and the crash classicals. I'll run the list. I'll do the MIGS cases.

Last year, I heard people saying to the second-years, "see how much you've learned?" I know more than the new interns, but I don't know how much. I still haven't finished my Gabbe. I still haven't studied the things I missed on CREOGs (in-service exams during residency).

Before I start romanticizing a little too much, let me say: it's not as abrupt a change for me. I'm doing my ICU month first, so I'm still an acting intern this July. Even so, the difference between me and the medicine interns is dramatic. I know how to put in orders, I finished my note 15 minutes before rounds (and theirs still aren't done), I know how to present a patient. Even though I'm the off-service rotator, I was the one called to do the emergent new patient, because most of them still needed  help from the R3 for orders. (Not that big a deal though, the R3 came in to assess vitals with me...and it was even something I know how to deal with--acute anemia.)

But it's interesting.

I'm studying for STEP 3 this month. This is the last exam I will take before I have a medical license to practice independently. It's not the last exam I will take in my life, because I want to be board certified in OB/GYN, which means CREOGs and Boards (final exam at the end of residency to make sure I can start a job) and periodic recertification. STEP 3 is a two-day long multiple-choice test, with some (apparently) weird formatting in questions to simulate real-time case management of acute patients. I'm not super excited.

I think I'm a calmer person and I can now recognize when a person is really sick, and when a pregnant woman is really uncomfortable. I think I'm becoming a good doctor. I see a lot of potential in my career and the future seems bright. I still expect the day when I will make my first Big Mistake, the one that will make me look back on this time wistfully, wishing I could go back. I don't fear having adverse outcomes; I only fear causing them.

There's a very important blog post coming up, one about faithfulness to calls. And that's all for today, because the ICU attending (who is a complete genius) is expecting me to present on neuroleptic malignant syndrome in an hour.