Live from the Library

One of the amazing things about IM residency is the sheer breadth of practice. I’m on an inpatient cardiology service right now, and yesterday I managed a patient w/ severe decompensated heart failure on dobutamine and lasix drips, went to pulm clinic and managed pulmonary hypertension, messaged a primary care clinic patient about their hepatitis B titers and recommendations for HCC screening, then called another clinic patient to ask how their gender affirming care is going and if they want to increase their estrogen. Obviously as the resident, I have specialists supervising me who I can ask for help at any time. But often at this stage I get to manage things on my own first, and it’s wild to be doing all of this in one day. And I’ll never have this much breadth again—residency is the only time you are a PCP, an inpatient doctor, and a specialist consult all at once. Pretty fucking cool.

They are actually playing ‘How to Save a Life’ in this hospital cafe lmao

There is one resident in my program who is far and away the favorite. They are the program darling: universally adored, wins every award, every faculty member knows and loves them, etc. If they want something—a leadership position, a grant, etc—they’re going to get it, no question. And they are absolutely a kind and hardworking resident. But I don’t think they’re like leagues and leagues above the rest of us. And I know this is, ultimately, a silly and largely inconsequential thing to be bothered by, but it does just sting sometimes to be constantly hearing about how beloved and amazing this other resident is, constantly having it reinforced that the rest of us could never measure up or compete, even if it’s not how people intend it. The other day, I was sitting with the favorite resident (“A”) and one of our friends (“B”), and B said “A, I think you’re the number one person in our residency, all the attendings love you and talk about you. No offense nerdgirl.” And like…how is that not gonna be a little hurtful on some level. It’s especially hurtful because favorite resident has actually fucked me on a couple projects, so I got screwed out of working on things that I now have to hear them constantly praised for. And I know this largely just speaks to my own insecurities. I do also think that knowing I am a little limited professionally in a way that the favorite isn’t and that no amount of work I do could make up for it is a bit of a tough pill to swallow.

One of our pulm/crit fellows said that if a resident isn’t up to snuff, they just freeze them out and take over their work. They said they usually do this to medicine interns on nights. And like…what the fuck man. First of all, they’re an intern, of course they don’t know that much about the MICU. You have to teach them, which you apparently aren’t interested in doing. Second, I’ve long felt that our MICU has zero team cohesion, and hearing a fellow say they have no interest in teaching us either is a blow. Our job in the MICU is just to write notes and place orders. Eternal scut monkey. It’s so demoralizing.