Yullock

Still an intern

2005-07-28T21:50:00.000-04:00

In any other job, I would have taken some sick days this week. Just a bad summer cold, but fatiguing when working 13+ hour days and working overnight 26+ hour shifts like last night. I'm sure my patients also haven't appreciated my drippy nose and hacking cough either. Universal infection precautions.

I'm starting to understand the rush-rush-rush mentality of medical care. You get so swamped with patient care duties, spread so thin, that you are reduced to spending the minimum of time necessary to take care of your patients in order to be able to see everybody else waiting. I used to feel surprised when I witnessed somewhat abrupt communications with patients, but now I have found myself being the one cutting to the chase and dispensing with any extra chit-chat. Taking care of ill patients recovering from surgery, seeing acutely bleeding patients in the ER, all in between trying to get through a whole waiting room full of people with office appointments...where do you find the time to talk about anything but the bare essentials?

Aaron made it!

2005-06-22T23:00:00.000-04:00

Well, I was not been here one minute and I already made it harder on my dear wife to do her job. My plane was delayed nearly four hours in Detroit so I didn't get in until about 1:00am local time this morning. Nevertheless, Emily was there to pick me up even though she had to be at work at 7:00am. I'll have t0 make it up to her somehow; I started by cleaning all three bathrooms in our new place, fixing a cabinet, a shelf, hanging a mirror, and scouting out some of the local coffee shops and restaurants. We live in the Inner Richmond which possesses a host of Korean, Chinese, Vietnamese, Japanese and Russian restaurants, with a few Irish pubs thrown in for good measure. There is a Safeway less than a block away, and a Cala Foods less than five blocks from us. We're well situated, so be sure to come visit!

I have interviews tomorrow at two different high schools in the city: the Waldorf High School and the Jewish Community High School of the Bay. I'm neither nervous nor terribly excited about them; perhaps it's because I just finished teaching for the year -- or because I've been teaching for 15 years -- but I will only teach next year if I'm inspired to do so. Part of me would like to take some time off and work at a coffee shop or bookstore, or see what sort of other jobs are out there (in the non-profit sector which is huge out here; teaching a UC extension or adult ed. course...). I also wouldn't mind having the time to work on a book idea I've been kicking around. So, the interviews tomorrow will be as much me finding out about them as they will be interviewing me. They are both small private schools, and since I've taught at a huge public school, I'll have a number of questions for them. We shall see...

In the meantime, it's 8:30pm and Emily just called to say she'll be home soon. Since we have no tables or chairs and only one place setting, we're going to go down to Clement Street and try one of the Korean BBQ places.

Keep in touch!

Aaron

Obsession!

2005-06-21T23:58:00.000-04:00

Oh, and I am completely obsessed with the idea of replacing my old Sony Clie PDA and new LG cell phone with a cool multifunction TREO.

Day 1

2005-06-21T23:46:00.000-04:00

7 am I arrived at SFGH after a night of unsatisfying rest interrupted mostly by obsessive worries of sleeping through my two-alarm alarm clock, which unfortunately only gives me two chances to wake up (there must be a snooze function I'm missing on my clock!). I made it into the hospital on time with ePocrates PDA software updated, fingernails clipped to stubs, and a blank slate ObGyn brain ready for learning.

Twelve hours and ten minutes later, I finished day one. I did learn a few things. 1. I am slow. 2. I am inefficient. 3. I performed a mere fraction of my assigned duties. and 4. My 4th year medical student is a godsend. So my role as the gynecology intern includes several responsibilities:

--inpatient gynecology service: seeing post-op patients first thing in the morning, examining them, writing progress notes, issuing care orders, coordinating care with other services, discharging home with post-op plan
--emergency department and hospital gynecology consultant: being first responder to requests for gynecology consultations to the ER and other medical units, assessing patients, recommending plan of care, admitting patients with more urgent needs
--gynecology outpatient clinic: between 8-5 every day seeing patients in the outpatient gynecology clinics, assessing patients, coming up with treatment plans, coordinating follow-up care
--tracking "floating" patients: organizing care for all patients still requiring care who are not currently in the hospital (e.g., tracking and communicating pending lab/pathology results, making appointments, tracking patients who are getting serial blood tests to manage care from home); this may be the most tedious responsibility
--teaching medical students

Today I accomplished part of number one. The medical student on our team carried my pager and took care of everything else I should have done that I couldn't or didn't get to. And I guess really she was teaching me much more than I was teaching her (about 100% to 0%). I'm supposed to be taking care of all of the above items simultaneously, becoming a goddess of multitasking I suppose. Tomorrow I guess I'll be happy if I can manage to do two tasks. Baby steps.

Residency Orientation

2005-06-16T10:16:00.000-04:00

So I'm here! In the city by the bay. It's gorgeous, energetic, and exciting!!!!! I've moved into our new apartment in the Inner Richmond, which is pretty much empty except for my AeroBed, alarm clock, and some food/bathroom items. But it's bright, modern, and HOME. 2 bed 2.5 bath with soon-to-be unemployed husband, so come visit!

I met my fellow interns at an informal gathering on Monday night. Everybody's sharp, friendly, and fun. A few went to school here, a couple are from Harvard, one from Wash U, and another from Albany. And everybody has done incredible things in their lives.

Orientation started Tuesday morning at San Francisco General Hospital, aka The General. This is the hospital serving as the health safety net for the city and county. The faculty are mostly young, energetic, and driven by a shared passion for social justice. You really feel like you're making a difference here. Inspiring!

Today we continued at UCSF, the main hospital, where we were thrown into a whirlwind of paperwork, policies, and regulations. Work hours, leave policies, board certifications, etc. More and more orienting to come until the first official day of patient care next Tuesday...eek!

Matched!!!!

2005-03-17T15:32:00.000-05:00

UCSF!!!

Match Week!

2005-03-15T14:29:00.000-05:00

This Thursday is Match Day, where the location of my next four years of training will be revealed. Match Day starts with brunch and a video before the Matches are revealed. Students are called to the stage by random drawing, pick up their white envelope, read their Match, then tag their location on a map. I can't wait to find out! Check back for results later this week!!!

February 2005

2005-02-11T00:21:00.000-05:00

Hi everybody! Not much going on here. I am back in the anatomy lab for 4 weeks, dissecting a woman's pelvis. What an amazing thing, to be able to learn the intricacies of the human body without endangering somebody's life while doing it! I am learning a ton.

I am also on my third version of my rank list. Between my first and second drafts, I changed the order of 8 programs out of 13. On my third attempt, I decided to give Aaron's preferences more weight, which resulted in another 8 position changes out of the 13. The only constants between all three rank lists are the programs ranked #1, 12, and 13. Well, I guess if I'm lucky enough to match at my #1 program, it's all just an exercise, right? I can only hope! Final lists due February 23rd, then Match Day is March 17th!

NEVER FLY US AIRWAYS...

2005-01-12T13:33:00.000-05:00

...especially out of small regional airports with no prospects for nourishment except whatever processed items are left in the half-empty vending machine when they leave you stranded for 7 hours with low morale and customer disservice before shipping you off to the next closest airport a 3 hour cab ride away with not even the decency to pay for your meal or airport hotel room much less compensate you with free first class tickets to Europe.

That was the final insult to a trip that started off with taxi dispatchers that hang up on you after you've been on hold for a while if you even pause for 2 seconds to answer one of their questions, then cab drivers who leave you waiting 30 minutes late at night on a dark street with all your luggage with hostile pan-handlers verbally abusing you for not handing over your change, then paying $40 for the privilege of fearing for your life when your cab driver drag races another cab on the way to your destination on icy roads.

What can I say about Yale, an amazing institution that has played a role in shaping and inspiring our current president? A quote heard multiple times from some of the residents here: "We are very happy here." I was very happy to get home.

On the road...Salinas, CA

2004-12-16T23:38:00.000-05:00

I've completed nine interviews now and they have mostly blended into each other in my memory. Nine hour days of incessant smiling and inane small talk. Some immediate thoughts about each program:

Northwestern: lots of patients, lots of residents, crazed Christmas shoppers nearby, but oh, the shopping...
U of Washington: 8 interviews in a row, not even a restroom break--this must be some kind of evil torture!
UC San Diego: hmm, no recollection whatsoever
UC Irvine: the nicest, most outgoing, most interested residents, SO friendly!
UCLA: sweltering in my interview uniform in 80 degree weather, but feeling like I returned home
Stanford: boy would I love to live here, I would get to be a real Auntie Em finally!
UCSF: getting motion sick careening up and down hills touring the three hospitals

But really, all the residency programs seem excellent, all the residents claim to be wonderfully cohesive as a group, resident-faculty camaraderie is great, etc. etc. etc. Who can tell one apart from the other?? The upside to all this is that I can't go wrong! I've met a lot of great applicants along the way, some of whom will be my fellow interns. There was a small group of us that trooped from UCSD to UCI to UCLA to Stanford to UCSF...by the end, it felt like seeing old friends when we would bump into each other at the socials.

Tomorrow I get to see Aaron again after two weeks on the road--hooray!!! I sure missed my partner in life while I've been single-handedly and guiltily orchestrating the next four years of our lives.

EY

On the road...San Diego, CA

2004-12-09T17:55:00.000-05:00

Hi! I'm wearing a tank top, sunglasses, and sipping iced coffee...I'm back in California, yahoo!! Not that I don't love Michigan, of course. But I'm on my way to Irvine today in my sporty convertible. I'll post specifics about my Northwestern, University of Washington, and UC San Diego interviews shortly, but here are some of my recent favorite questions: "If you were a tree, what kind of tree would you be? And if you were an animal, what kind of animal would you be?" and "Name five American Nobel laureates in literature." Ugh! Who knows?! Who cares?! More on the joys of interviewing later, stay tuned!

EY

Interview: University of Michigan

2004-11-30T17:25:00.000-05:00

What can I say...I loved my home institution!! They are a national powerhouse in Ob/Gyn with both breadth and depth in every major division, with fellowship training programs in every accredited subspecialty field, and more! For example, UM is a pioneer in the field of robotics surgery, and have their own million dollar DaVinci robot in our ORs. Who would have thought?? The residents were a hoot. We had our social event the night before, and it was a circus of mad fun with dogs, toddlers, and a mass of friendly laughing diverse people who all seemed to get along with each other. The department has an established core of health services research, which is unusual to find, and multiple faculty and residents have public health backgrounds, which is perfectly in line with my own research career aspirations. Other pros include supportive faculty, a strong commitment to resident education and satisfaction, and lastly, but most importantly, that intangible feeling of goodness. Cons? I can't think of one.

Interview: Brown University

2004-11-19T15:09:00.000-05:00

Brown has a fantastic program deserving of the unanimous kudos I had heard prior to visiting. Great espirit de corps among its residents, a longstanding supportive residency director strongly committed to resident education, large volume of cases for plentiful learning opportunities, and the most beautiful and modern hospital facility I've ever seen. And the best part of the Brown residency is their call schedule: a dedicated team covers nights five days of the week, which means the remaining residents have no call responsibilities five out of seven nights! This means that residents have two rotations a year where they work nights, which I think is still preferable to having to work a 30 hour shift every fourth day for the entire year.

And the cons. I had this vague feeling like I was sort of out of my element, but I couldn't quite put my finger on why until I looked at the picture sheet of the residents: 26 of 28 residents were white women, and the other 2 were white men. They were all very friendly, but I was half expecting them to break into their sorority cheer and serve me lemon-flavored water. Plus all the administrative staff, midwives, nurses, and faculty I met were all white. Sampling bias, self-selection, program selection, bad coincidence, or does it even matter? Another area of concern I have is in their formal teaching curriculum. They have a small core of teaching faculty, buttressed by a large group of private physicians who rotate through. Will the teaching be largely personal anecdotal experience versus evidence-based standards of care? My interviews also didn't help my cause: my first interviewer was an academic subspecialist who raved about my qualifications and said I was so competitive I would likely get my first or second choice program; two others were general community practitioners who gave me the distinct feeling they were unimpressed and wondered why I was there (one of them even ended the interview early because she had nothing left to say!), and the fourth was one of the residents who spent the entire time answering my questions.

Conclusion? Great program supportive of their residents, unsure of teaching, and a questionable personal fit.

On the road...Providence, RI

2004-11-16T17:29:00.000-05:00

This is it! Day 1 on the interview trail. I'm in my executive room at the Radisson Hotel Providence Harbor. The unctuous front desk manager gave me "the best room available," the only benefit of which I can tell is that I need to use my key in the special "executive floor" lock on the elevator, although it did impress the woman wearing the Rabbit Breeders Do It Best shirt who was on the elevator with me. Providence looks like a city. I was expecting some quaint quiet town with lots of picket fences, but wait there's graffiti and big buildings! And snow on the ground already. Tonight I'm heading to a pre-interview event where we're going to watch and discuss some video on abortion, then socialize with some of the Brown residents. More later. I miss my husband already.

EY

Grand Rounds, November 2004

2004-11-13T19:24:00.000-05:00

The UM Ob/Gyn department presented me with an award at their monthly departmental Grand Rounds. I was pleased to be chosen for the award, but also felt like a moron because the presenter first told an untrue story about me, and then read off some "accolades" including that my "clinic notes were legible." My finest attribute is my penmanship??

Tough interview choices

2004-11-13T19:03:00.000-05:00

I now have interview offers from 30 of my 31, and haven't heard from the last community program. Here's my latest more realistic plan for interviewing:

11/17 Brown University
11/30 University of Michigan
12/04 University of California, San Diego (hi Celeste and Eric!)
12/06 University of Washington
12/10 University of California, Irvine
12/11 University of California, Los Angeles
12/13 Stanford University
12/14 University of California, San Francisco
12/20 Oregon Health Sciences University
12/22 University of California, Davis
01/04 Tufts University
01/05 Beth Israel Deaconness
01/07 Brigham & Women's Hospital
01/08 Yale University
01/15 Northwestern University

Scheduling conflicts: University of North Carolina, University of Pennsylvania

Maybe, if I still have energy: Kaiser LA, St. Joseph, Santa Clara Valley, Cedars-Sinai

EY

Interview Insanity

2004-11-03T18:59:00.001-05:00

21 of 31 and counting...

11/17 Brown University in Providence, RI
11/18 St. Joseph Mercy Hospital in Ann Arbor, MI -- tentative
11/20 University of North Carolina in Chapel Hill, NC -- new!
11/29 Washington University in St Louis, MO
11/30 University of Michigan in Ann Arbor, MI
12/03 Johns Hopkins in Baltimore, MD
12/04 University of Illinois in Chicago, IL -- new!
12/06 University of Washington in Seattle, WA
12/11 Yale University in New Haven, CT -- new!
12/13 Stanford University in Palo Alto, CA
12/20 Santa Clara Valley Medical Center in San Jose, CA
12/22 University of California in Davis, CA
12/28 Kaiser Permanente in Santa Clara, CA -- new!
01/04 Tufts University in Boston, MA
01/05 Beth Israel Deaconness in Boston, MA
01/07 University of Penn in Philadelphia, PA -- rescheduled
01/07 Pennsylvania Hospital in Philadelphia, PA
01/12 William Beaumont in Royal Oak, MI -- new!
01/14 University of California in Irvine, CA
01/19 Cedars-Sinai in Los Angeles, CA
01/20 Kaiser Permanente in Los Angeles, CA

EY

A Call Day Puzzler

2004-10-30T13:21:00.000-04:00

Long call today. This is the first year I have not celebrated gaining an extra hour in switching back to standard time. But, this GI subI is nice because I'm on a q6 call schedule: long call (taking admissions only from noon to midnight), post call, short call (admissions 7 am to noon), regular day, short call, regular day.

So here is the puzzle my senior resident posed to us on rounds today: a man walks into a 7-11 and purchases four items. The total came out to $7.11, but the clerk had accidentally rang it up by multiplying the cost of all four items. However, when the clerk re-rang the total by adding all four items, the total still came out to be $7.11. What was the cost of each of the four items? Anyone, anyone?

EY

Interview Update

2004-10-30T11:48:00.000-04:00

The schedule is starting to get tight and I'm still waiting to hear from 15 more programs.

11/17 Brown University in Providence, RI
11/29 Washington University in St Louis, MO
11/30 University of Michigan in Ann Arbor, MI
12/03 Johns Hopkins in Baltimore, MD
12/06 University of Washington in Seattle, WA
12/13 Stanford University in Palo Alto, CA
12/16 St. Joseph Mercy Hospital in Ann Arbor, MI -- new!
12/20 Santa Clara Valley Medical Center in San Jose, CA -- new!
12/22 University of California in Davis, CA -- new!
01/04 Tufts University in Boston, MA -- new!
01/05 Beth Israel Deaconness in Boston, MA
01/07 Pennsylvania Hospital in Philadelphia, PA
01/08 University of Pennsylvania in Philadelphia, PA
01/14 University of California in Irvine, CA
01/19 Cedars-Sinai in Los Angeles, CA
01/20 Kaiser Permanente in Los Angeles, CA -- rescheduled

EY

New rotation

2004-10-27T17:03:00.000-04:00

It's been a rather quiet week on the application front. St. Joseph Mercy Hospital offered me an interview and they're willing to pay for my hotel stay. Great news, except this means the only program willing to defray some of my travel expenses is the local program, which helps me not at all!

In other news, I managed to finish my ICU rotation with all my patients alive and kicking, which is a success in my book. I am now on my second sub-internship rotation, this time the inpatient gastroenterology service (my brother-in-law JP jokes, you need three things to be a gastroenterologist: a good sense of humor, a bad sense of smell, and lots of brown shoes!).

Today my hand and arm are sore from trying to drive a colonoscope on a simulator. Unfortunately, my pretend patient kept moaning in pain when I kept driving the scope into his bowel walls and I ultimately ended up oversedating him. So in the aftermath of achy frustration, I came up with a brilliant idea...a video game for would-be docs! How many overachieving parents out there would get this for their prodigy children to play on their Xbox after Suzuki lessons? All of them! And the kiddies would have a grand time manipulating bronchoscopes, doing laparascopic appendectomies, performing remote robotic surgeries...and the "joystick" could be designed exactly like the scope handle so unlike me fumbling to go up/down, right/left, air/water, suction/camera all with one cramping hand as an amateur, they would be conditioned and ready to go by the time they're in their GI fellowship. It would be a huge success, I'm sure of it. Along with my sleep-cycle-alarm clock, but I'll save that for some other time...

EY

Yikes, what if I don't match?!

2004-10-21T19:24:00.000-04:00

The Dean of Career Counseling spoke to us today about the residency match. In his advice for compiling a match list, he advised that our final match list should include a couple of sure-bet programs. I panicked, because the programs I applied to are mostly places that I think are reaches. So I succumbed to the panic and added on 6 more programs, mostly community-based training sites in both California and Michigan.

For those of you unfamiliar with the finer points of the Match, here's how it works. I submit an application via an online centralized application system, the residency programs offer interviews as they see fit, and I visit the programs as I see fit. In February, I submit a list of programs I would be willing to go to, in rank order of preference. The residency programs also make a list of students they want for their program, also in rank order. Then, a computer runs my list against the residency program lists, and "matches" me at my highest ranked program that also indicated that it wanted me. So on March 14th, I will find out if I matched at all (and if I don't, I then start the "scramble" process, basically getting on the phone and groveling for any open position in the nation). On March 17th, aka "Match Day", I will receive an envelope which will contain the name of the residency program where I will train for the next 4 years. And voila, that is how the National Residency Matching Program works.

EY

Interview Update

2004-10-20T15:54:00.000-04:00

I've heard from just under 50% of the residency programs I've applied to. Here is my working interview schedule, which I'm still tweaking on a daily/weekly basis:

11/17 Brown University in Providence, RI
11/29 Washington University in St Louis, MO
11/30 University of Michigan in Ann Arbor, MI
12/03 Johns Hopkins in Baltimore, MD
12/06 University of Washington in Seattle, WA
12/13 Stanford University in Palo Alto, CA
12/30 Kaiser Permanente in Los Angeles, CA
01/05 Beth Israel Deaconness in Boston, MA
01/07 Pennsylvania Hospital in Philadelphia, PA
01/08 University of Pennsylvania in Philadelphia, PA
01/14 University of California in Irvine, CA -- new!
01/19 Cedars-Sinai in Los Angeles, CA -- new!

I've picked up the regulation black interview suit and some comfortable but not quite orthopedic walking shoes. Now I need some advice, strategies, tips for finding travel bargains! Welcome any comments...

EY

MISCA Conference, September 2004

2004-10-14T16:55:00.000-04:00

Aaron recently won the Bruce Harlan Award, which honors lifetime achievement in coaching high school diving in the state of Michigan. Denny Hill, who is the school's much celebrated swim coach, is also pictured. If you squint hard, you can make out the shape of the glass award over Aaron's right abdominal area. What a fantastic accomplishment!!

OMG, Stanford!

2004-10-11T20:56:00.000-04:00

Interview offer from Stanford!! Yahoooooooo!!!

EY

Blue Monday

2004-10-11T17:27:00.000-04:00

And I'm on long call AGAIN! These q4 call schedules are punishing to the lazy among us. Here's how q4 cycles: Day 1 is Long Call, which means showing up in the morning to see patients, then staying all day and all night admitting new patients. Day 2 is Post-Call, which really is the overnight continuation of Long Call, and hopefully ends sometime in the early afternoon. Day 3 is Short Call, which means showing up in the morning to see your patients and admitting new patients until 3 pm, when the Long Call person takes over. Day 4 is Pre-Call, where you spend the entire day dreading the next day, when the cycle all starts over again.

We have early word that somebody with pneumonia is on a general medicine floor, just waiting to blow out a lung. Which is when I would come in and take over their care in the intensive care unit. Let's hope, for the patient's sake, that this doesn't happen. So far, so good. One patient already coded this morning, but we got her heart beating and her lungs breathing again, for now. What a bloody mess.

Keep reading, for Aaron's inaugural post!! I never thought I'd see the day...

EY

is this on?

2004-10-11T16:12:00.000-04:00

hello? hello? how does this thing.... wait, am i supposed to click on the icon, or just start typinsdln234tp98sd98.a, before sending?

how come i can't see the rest of the blog, where all the entries are? why

does

the
thing keep

doing

this? i'm doing exactly what it says to do but it won't

do WHAT I

want it to....

ok. i think i figured it all out:

this is my first ever attempt at blogging. i'm sure if it was available when i was in college, i probably would have tried it. but now, everyone says that these newfangled computer things, (instant messenger, ebay, paypal, auto-pay, the internet...), are supposed to be 'totally convenient' or 'amazingly user-friendly,' so in the spirit of teaching an old dog new tricks here is my innaugural entry into the world of blogdom:

i spent the day teaching my high school junior classes about manifest destiny, the texas war for independence and the mexican war. seems like the u.s. had this idea that americans were chosen by god to spread libery and democracy clear across the continent, even if there were already people in possession of those territories we acquired. in 1846 u.s. president james polk sent the army into territory claimed by both the u.s. and mexico. feeling as if a foreign army was threatening its territorial integrity, the mexican army launched a probing attack to determine the u.s. army's intentions. when casualties resulted on both sides, polk claimed to congress that 'american blood has been spilled on american soil' and demanded from congress a declaration of war which, given the intelligence provided by the president and his cabinet, was promptly voted pon and passed. a young congressman from illinois, however, was troubled by the president's claims, so he put forth a resolution in congress asking that the administration identify the exact spot where american blood had been spilled. the 'spot resolution' as it was called, was deemed by much of congress and the american public to be rather unpatriotic, seeing as though the country was already at war. thus, the congressman from illinois was resoundingly defeated in 1848 when he ran for reelection. of course, the congressman was young abe lincoln. believing he was retiring from a life in politics, he wrote in 1848:

"Allow the President to invade a neighboring nation whenever he shall
deem it necessary to repel an invasion, and you allow him to do so
whenever he may choose to say he deems it necessary for such purpose --
and you allow him to make war at pleasure... The provision of the
Constitution giving the war-making power to Congress, was dictated, as I
understand it, by the following reasons: Kings had always been involving
and impoverishing their people in wars, pretending generally, if not
always, that the good of the people was the object. This, our Convention
understood to be the most oppressive of all Kingly oppressions; and they
resolved to frame the Constitution so that no one man should hold the
power of bringing this oppression upon us. But [polk's] view destroys the
whole matter, and places our President where kings have always stood."

hmmmm, sounds familiar, eh?

tonight i'm off to hear folk musician, dan bern, at the ark (a local folk/acoustic blues venue) with a bunch of friends. supposedly, his concert has been dubbed, 'music to beat bush by,' so we'll see...

[am i allowed to voice political opinions on a bolg? just don't give any of my students the blog address!!]

talk to you all soon,

aaron (with a formerly luddite disposition]

Bad television

2004-10-10T16:38:00.000-04:00

I'm embarrassed to admit that Aaron and I have finally been sucked into reality TV. We happened by The Apprentice while channel surfing a few weeks ago, and I became fascinated by the real-life challenges of business decision-making, but even more, by the vicious pettiness of the Apexiennes. Mrrreow!! I want them all fired.

2004-10-09T14:37:00.000-04:00

A&E in San Diego, October 2003

Medical errors...oops

2004-10-09T13:17:00.000-04:00

It alarms me that as a medical student, I am the primary caregiver for my intensive care unit patients. I have supervision of course, and my senior resident reviews and ultimately has final approval on all of my orders. But nine hours into a busy call night, with my senior covering both the medical ICU and the cardiac care unit, and thus responsible for the management of twenty or more critically ill patients with more coming in through the ER and being helicoptered in, she isn't necessarily able to take the time to carefully peruse the nitty-gritty aspects of my decision-making. So this is how I almost made my first significant preventable medical error.

My patient was in the unit for a diabetic crisis and had been improving, so I was going to transition him to his home regimen of insulin using the protocol spelled out by the ICU. I calculated it out, double- and triple-checked it, then entered an order for him to receive an insulin injection in the morning. My senior approved the order, then I went to sleep. I woke up in the morning, and my first thought was...OH NO, HE'S NOT EATING!! HE CAN'T GET A FULL DOSE OF INSULIN IF HE'S NOT EATING!! Too much insulin with no counteracting sugar could cause a person to get hypoglycemic, have seizures, fall into a coma, and possibly die. I managed to get up to the unit 15 minutes before the scheduled insulin dose and cancelled the order. Oh my...

I suppose if my patient had received the excessive insulin dose, it wouldn't have been catastrophic. Patients are so carefully monitored in the ICU that he wouldn't have gotten into much trouble without being noticed and appropriately treated (with orange juice or IV sugars). But still. Scary!

In other news, it's a beautiful football Saturday in Ann Arbor, with blazing autumn leaves on the trees. Aaron is being a true fan and rooting on the blue in person while I'm still in my ICU scrubs curled up under a blanket at home, trying to make up my growing sleep deficit.

And for an application update, two more interview offers, hooray!

Pennsylvania Hospital (Philadelphia, PA)
Brown University (Providence, RI)

EY

Residency Application Update

2004-10-05T16:22:00.000-04:00

My Ob/Gyn chair advised me to apply to 15-18 residency programs, so of course I applied to 25, just to be safe. And actively continuing to resist the urge to add just one more. So...just to bring people up to speed, here are the interviews I've scheduled so far:

University of Michigan (Ann Arbor, MI)
Johns Hopkins (Baltimore, MD)
University of Washington (Seattle, WA)
Washington University (St. Louis, MO)
Beth Israel Deaconess (Boston, MA)
University of Pennsylvania (Philadelphia, PA)
Kaiser (Los Angeles, CA)

As one might imagine, this is turning into a bit of a logistical puzzle, trying to figure out how to coordinate very few interview date possibilities with minimizing class absenteeism with strategic travel planning. Cost of course is always a consideration, but hey, I'll soon be making $10/hour next year! That's like a $70K raise from this year.

EY

Welcome!!!

2004-10-03T22:11:00.000-04:00

Hola, welcome to the Yu-Pollock blog! Those of you who know us can probably guess that Yu set this up and Pollock is still oblivious in that so charming Luddite manner of his. The Yu part of this adventure just ran up 4 flights of stairs to a Code Blue in the hospital, experiencing her own dyspnea on exertion before the No Code message came on. Whew. Way to get the adrenaline pumping on a slow call day in the medical ICU. Tick tock...the night is still young.

EY