Currently 3 a.m. on nights in the ICU. The commotion has settled, leaving the beeping of monitors echoing the halls. It is almost peaceful. An opportunity to take a nap. Nights like this are ones to take advantage of, knowing that things can become chaotic in an instant.
This rotation has been one of my more enjoyable ones. While the patients are unfortunately more critical, each provides a learning opportunity. I am constantly reminded of how little I know. While I am sure the 3rd year version of myself has come a long way, there is still so much to study. However, I will say that through the first few years of medical school I was studying mainly because I had to, in that there was an exam that I had to prepare for. Now I find myself looking up concepts or reading guidelines in fear of not knowing and being unprepared as a resident. As a medical student, our jobs are to absorb as much as we can and try to be helpful in the process. However, 9 months from now all that will change. For I will be required to make decisions that will influence the care of a patient and, while it will be exciting to be finished with medical school, it is simultaneously terrifying. To give some perspective, let me provide an example. I was reading about how a patient who was involved in a trauma who came into a hospital. He was triaged and had multiple CT scans performed. A critical result of a superior femoral artery occlusion in the right leg was found. While the radiologist noted this finding in the report, the intern resident was also notified of the finding with a phone call. For whatever reason, this was not properly communicated to the rest of the team. Hours went by before the vascular team was consulted and, after taking the patient to the OR, there was concern that the leg may not be salvageable. Such instances like this where a single miscommunication can lead to such drastic effects is frightening. I can only hope not to make such mistakes, but also realize that mistakes are inevitable. I asked an attending of mine, “Were you terrified as an intern?” She replied, “Everyday, and even my first year as an attending I was scared almost every day.” It provided some reassurance and perhaps the “fear” is necessary. It will ensure to me I'm grounded as a physician and always remember that this field is truly one of lifelong learning.
While I have learned a ton, this ICU rotation has also been depressing at times. Most of our patients are post trauma and, while it is sad to see anyone in critical condition, for some their stories are particularly more emotional. Nobody expects to be involved in a trauma and trauma patients usually have no idea what happened to them, sometimes being a day or two before they wake up and realize they are in a hospital. I want to share a story that particularly resonated with me. A mid-20's male came in with a traumatic brain injury after being involved in an unhelmeted motorcycle crash. His injuries were confined to his head. Brain bleeds and serious skull fractures. Seeing him initially, I knew his prognosis was likely going to be poor. Then came having to tell his loved ones the state of his condition. He lived here away from his parents whom were in another state. It is difficult delivering such news to families but not nearly as heartbreaking as being on the receiving end of such phone-calls. Unfortunately, this patient’s condition did not improve. A man just around my age with kids and a family who two days ago was going about his day was now brain dead. Leaving his family the heart-wrenching decision to withdraw care and let him go peacefully, all of which could have been prevented with a helmet. His story, family and parents all repeating in my head. Absolutely saddening. It serves as a reminder how lucky we are and that every day is truly a gift. I drive more slowly now, always put my seatbelt on first and continue to be thankful for every day. Sorry for the sad story :(
I have been writing away for an hour now. Time to wrap this up. These past few months flew by (I feel like I say that in every one of my posts). I took Step 2, did an away rotation back home in Virginia and, most importantly, submitted my application for residency. Probably the single most important application I have ever submitted. In competition with every other student applying for general surgery, I can only hope that the eyes that read over my application find something of interest and give me an interview. I am looking forward to the interview trail. It will be exciting to visit other schools and try to find the best fit for me. Who knows what my Match envelope will hold in March. To be honest, the application process is a game. We spend hours writing about our accomplishments, volunteering, research, places we have worked, and of course our personal statement. The overarching goal being how well can you describe yourself, appeal to the reader, and do they find something among all those words to want to meet you personally. I feel someone reading my application will probably get under a 30% feel of who I am as a person. I suppose that’s where scores come in. A numerical filter to give you an edge or disadvantage depending on how well you do. Nonetheless, these next few months are going to be exciting. Only a few months away from achieving the goal I set for myself as a kid. A dream which is now on the horizon of coming true.