#personal mjmd

Applied to PHM fellowship and got 3 interview offers on the first day!!!

My attending this week on service sent a kudos to the medical education office about my performance as a senior and said “she’s performing as a resident at the end of her third year about to graduate” YALL IM CRYING 🥲🥲🥲

5 year old T-cell ALL with disseminated fungemia.

17 year old with osteosarcoma of her pelvis with myonecrosis.

5 week old full arrest.

All the patients in the PICU in the past two weeks that have passed away.

The arrests didn’t hit me as much as the heme/onc kids. I think because the arrests came in basically brain dead and I didn’t know them at their neurological baseline.

I took care of the two heme/onc kids during my month of heme/onc in fall. I have memories of the 5 year old with his bowl cut, chubby cheeks, and rain boots walking the halls hand in hand with his parents. I remember when the 17 year old shaved her head because she was losing her hair when she started treatment, and how her mom decorated her room with fall colors and decor.

This morning I did chest compressions for the first time on a real patient. I have a 2 year old with blunt abdominal trauma most likely non-accidental. I have a 21 year old in heart failure for her failed Fontan.

Hi friends. It’s me, MJ.

Since we last chatted I leveled up to PGY-2! I’m almost 3 months into my second year of residency and boy, do I have some thoughts. 

Thought #1: senioring is hard

Being a senior has certainly come with its challenges. Sure, I knew that I would have to know the bigger picture of the patients and be expected to manage an entire team of 15-20 patients. I knew that I’d have to help my interns figure out their workflow, make sure the sub-interns are getting enough experience, and that the medical students feel like they’re part of the team. I knew that I’d have to stay late on some days to finish up work for the night team and give sign out to the night team. 

But I didn’t know that finding the balance of doing just enough to help out the interns without overstepping them or doing everything would be so hard.

I’m a go-getter. I like to get tasks done, and it’s been difficult for me to sit back and be hands-off and let the interns get the experience of calling consults, calling pharmacies, and doing discharges. I know it’s important for them to learn these tasks, but when I have rotators that are unfamiliar with the system that are learning how to do admissions, write notes, and put in orders sometimes it’s just easier to do myself. 

Thought #2: your team is your team

If your interns miss something, if labs aren’t ordered correctly or imaging isn’t scheduled right, it falls back on you. I felt this very hard today when a patient got an MRI of the abdomen & pelvis instead of a whole body MRI like the consulting physician recommended. (In my defense, this was not relayed to me personally and the consulting physician’s note was completed after I left work so these recommendations were not known to me until the next day.) But still, since I am the senior on the team I should have recognized this lack of foresight and planned accordingly. 

Thought #3: it’s exhausting

Since I have to stay late to give sign out, tidy up loose ends for the night team, and follow-up on every little detail, I often stay 1-2 hours after my shift has ended. I’ve worked 70 hours a week in the last two weeks and 23 in the last two days. I have little time for anything else when I get home and as a result have barely seen my fiance. Trying to make time for self-care, but it’s not the easiest.

Thought #4: it’s compiling

I’m on a current 3 month stretch of inpatient floor blocks. I finished NICU, now I’m on the busiest inpatient service in the hospital right now, and next month I move on to inpatient heme/onc where the hours are 6-6 and you get two weekends off. Oh, and I’m by myself. 

On top of my current schedule, trying to finish all the mandated busy work (ILPs, annual learning modules, IHI modules), trying to coordinate and run a new QI project I started last year, do a literature review for a research project, and participate in 2-3 other projects, I’m starting to feel stretched thin. 

Oh, and not to mention I’m also trying to plan my postponed COVID wedding and my elopement in November. 

And stressing about my chief interviews later this month.

And also trying to be a good senior.

Cue the mental breakdown.

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All in all, it’s been everything and not at all what I expected. We had a wellness lecture today about physician burnout that I think just put a lot of things into perspective for me about how I’m feeling. Writing this post is sort of my way of getting all my thoughts out and to cope with how I’m doing. To end this post, here are some good things that I’m doing in order to allow myself to be the best version of myself that I can be:

1. I reached out to my therapist today to schedule a long overdue session.

2. I bought two bags of Halloween candy for my team to bring in tomorrow.

3. I created a gift bag of goodies for one of my co-seniors who didn’t get the job that she applied for to make her feel better.

4. Tonight I sat down and emailed a bunch of people for the wedding aka the officiant, the restaurant I want to host the after meal celebration at, and the hotels for our new wedding room block.

5. I’m going to share this post with my fiance since I didn’t have the energy to organize all of these thoughts earlier when I came home.

6. I’m going to go to bed now.

I bought my wedding dress today!!!!

‘Sup. It’s been a while.

I’m more than halfway through intern year and can hardly believe it. Since my last update I completed two back to back floor months, a month of ED, and a month of adolescent medicine. Now I’m back on the inpatient floors. (Woohoo!)

At this point in the year, I can safely say that I feel so much more confident about my medical knowledge and skills than I did six months ago. In the ED I received glowing feedback from attendings stating that I was way ahead than the other peers in my class and that I should consider moonlighting in the ED next year since they liked me so much. (Plot twist: I don’t want to do ED.)

An MRT was called on one of my patients earlier this week and throughout it a lot of the nurses and my senior resident commented that I did a good job. My attending gave me feedback on Friday and stated that I’m doing wonderfully and that I did very well during the MRT and know how to command a room.

So while at the time it feels like I don’t know what I’m doing and I’m just flubbering through, it’s nice to receive good feedback and realize that I have learned and grown so much since July 1st.

Also- I’ve only cried like, five times total at work. My week of nights in December was particularly awful (I’m talking crying before sign out, crying in between patients, and then just crying at the end of the night). But I’m engaged in counseling and working on self care so these times are few and far between. 

As far as everything else goes, fiance and I are still planning our wedding for this November. We will be going back to MedSchool City next month to meet with tasters and our photographers. We’re also planning on moving in June to a newer town home and we’re looking forward to that.

Let’s go!

Worst thing about this week: I have two patients with suspected child abuse and neglect, and also I worked 7 days in a row and my next day off isn’t for another two weeks.