#audition 2

1110: Super informal interview lasting 10 mins. Answered questions about whether I was going to do the AOA match at all, if I was open to moving to the region, how I liked the city, some background questions about myself. None of the hard-hitting questions I was expecting. Granted, they don't have my MSPE/Dean's letter yet.

1120: Recounting interview and general feelings about rotation with the miss. Moved between texts and accidentally write "I think I'm gonna ask the current attending for a rec, think it will go a long way here haha" to the ID group chat. Immediately explain that it was meant for my gf, who I awkwardly referred to as “my spouse.” Attending plays it off but I'm unsure if that was a yes to the letter. Immediately become flustered, get in the elevator to start a consult. Run into him and the intern, who see me trying to go to the wrong floor. Get more flustered, try to take a step back and almost step on someone. Get off on the right floor and sit in a chair, exasperated.

Continued to get blasted with consults, I think we topped out at 12 full work-ups. Meanwhile, my ride to NY left at 4pm with four patients left. I could have asked to leave early but it would have been kind of a dick move since it was the one day that week we were slammed AND I had just asked for a letter of rec.

1800: Arrive at the house and immediately start cleaning.

1845: Shower. Hope to catch 1930 train.

1945: Realized I had more cleaning to do. Miss 1930 train.

2010: Landlord comes to do key handoff.

2037: Grab uber to catch 2045 bus.

2045: Run headlong out of the uber and manage to grab the bus by 30 seconds.

2315: Arrive at airbnb. Eat six tacos. Go to last part of music festival.

Before those tacos I had consumed a small caramel macchiato, a small protein bar, and a small bag of chocolate covered salted caramel bites. There was no glory in this--I felt like shit before and after.

All in all, still not the worst day I’ve ever had.

Which is funny because I am 99% sure I explained that I was going to be gone for 3 months and wanted to recoup some of my costs because I also had to pay rent for the places where I’ll be located. Why would you hear that and expect me to only rent out one month?

I’m going to lay it all out again as crystal clear as possible when I call tomorrow, and if I’m still getting the attitude that was apparently given to my subleaser I’ll honestly just go under the table. If you don’t understand why it’s important for me to recoup some of the costs of audition season (in a way that benefits multiple people), it shows you don’t care about me despite an otherwise great tenant-renter relationship and I won’t feel inclined to go by the book as I’ve been trying to. I’m not even making profit, I charge people rent at cost plus a very low flat rate for utilities. On top of everything else, I’m only offering to other 4th year auditioners. I feel if they pass the company’s background check and can prove they’re a medical student, any objections should be discarded. AND I’ve been referring other incoming 3rd years as potential residents.

Consults flying in all day, and we were one down this afternoon. Attending rounded with one of the interns early to get her to a flight.

But it turned out fine.

Patient 1 had multiple left leg revascularizations/grafts over the past few months because of some bad PVD, they all failed. She continued to smoke, so I’m unfortunately not shocked that it came down to an emergency amputation. My guy going on about the chessboard of life yesterday told me he kept smoking through his various revascs/grafts and kept having problems with them until he quit smoking.

Patient 2 had a series of sickle cell crises over the past year so they put ports in his chest for apheresis exchange. Got a call about possible staph infection with “unknown source.” Patient is running on/off high fevers, has malaise, neck pain, and some crusting/erythema/tenderness at one of the port sites with a chest rash, feels shitty. Blood cultures grew one, two, then three bottles with staph aureus. IR was convinced it was an allergic reaction to the adhesive/prep, my doc stops me half a paragraph in and goes "those ports are infected and they need to come out today... it’s 2pm on a Friday, let’s go see him real quick so we can call them.”

The funny thing about being on a consult service is that the questions are usually really simple but because we have to work the patient up individually, a full H&P is done. Seems redundant but having a fresh set of eyes on the patient can elicit a better diagnosis.

A couple of stumbles on presentations, and I took a little longer than I’d like (especially with my last patient) but overall pretty seamless. Lot of interesting cases lately... I have a guy with profuse green-brown non-bloody diarrhea that was so bad his lytes tanked and he started getting peripheral cramps. No C. diff, no growth in the blood, stool culture pending. No travel. Went to a picnic on Saturday but no one else got sick. Same with his dinner on Sunday. That being said, I heard second-hand that he was the only one eating the potato salad at the picnic... guess we’ll see what the stool shows.