In Pursuit of an MD

Is my life a fucking joke??

Not to get into too many details, but the surgeon cancelled the surgery in the OR today because...why?

In short, I had a concern regarding our airway mid-case. I alerted the surgeon and explained my concerns. I asked him to check the airway from his side. It seemed fine, so I asked to pause the procedure and check the airway from above. He agreed and left the room. I checked the airway from above and saw no issues. The surgical fellow called the attending to let him know that I was done and there were no problems. The attending replied that he was cancelling the case. The patient was stable this entire time.

Everyone was flabbergasted. I think every single person could feel my complete confusion and knew that I was wondering if I had done something wrong. The surgical intern looked me dead in the eyes and said "you did nothing wrong."

I called my attending, but his phone wasn't working. I ended up extubating with my substaffing CA3 (lucky I had one today). I told my attending what had happened, and he assured me that it sounded like I did everything right for the patient's safety. We brought the patient to PACU.

My attending texted me later that the circulating nurse sought him out to say that I did wonderful and the surgeon threw a tantrum for no reason. He reiterated multiple times, in person and via text, that what I did was the right thing. I know I did, but I can't help wondering if I could have said something in a different way that would have led to a different outcome.

First first job interview tomorrow! First date, kinda nervous...

Tried on my job dinner outfit on last night. Felt cute and pretty and more adult than I feel. Classy ankle-length black dress with a twist front, bought on sale from Old Navy for I think like $30 (definitely less than $100, almost certainly less than $50). It's super comfortable and I love that dress so much, I'm excited I have an opportunity to wear it and be so adult. Bought new shoes for this, basic black flats with a cute scalloped edge. I always struggle with shoes and never had flats that fit right before, but these ones have a cushy sole, good coverage, and I added foam fillers to make them fit. Not as comfy as sneakers but pretty darn good.

Prepped a few classic interview questions today. I'm not sure I'll get asked any (I hope not), but it's better to have thought about them a little bit. It's a virtual interview so I'll just have the sheet printed out and available next to me if I need anything.

Ahhh, I can't believe I'm approaching big girl life. I'm scared and nervous but also excited! When did I grow up? I can't decide between "mom I'm scared come pick me up" and "attendinghood can't come soon enough."

Positive vibes today!

My first patient was so very nervous. Her mother had passed away only a few years ago. I don't know the details, but she had multiple surgeries over a hospital stay. She passed in the operating room--the last time her family members saw her was as she was heading off to the OR. She was kind and polite, but it was clear that she was very scared. Her PCP had prescribed her Ativan to take over the past week, because she was having panic attacks.

I spent my time with her in pre-op. We talked about the plan. I reassured her that she would never be left alone, that we would be sitting right next to her, that we'd do our best to keep her safe and comfortable.

I had the fortune of passing her in the hallway later, when I was doing ICU pre-ops and had plenty of time to spare. She was awake, and alert, and remembered me. She reached for my hand and thanked me for being there for her and doing my job. We talked until her elevator arrived.

tw: self harm, suicide attempt

Woke up in the darkness to the hum of the blood pressure machine going off. I wait...

And feel nothing. The cuff isn't squeezing around my leg. Hmm. Oh, shit. I forgot to connect the cable. I scramble for it--if I reach it fast enough, I can hook it up before it stops and I'll still get a pressure.

I'm about to reach for the cable when I realize that I'm not in the PACU. That was my heater kicking on. I'm in my bed at home, and there is no need to take my vital signs.

New year, new "interesting complication" (as stated by CCM fellow).

Step 1. put in an arterial line

Step 2. suture it in

Step 3. accidentally stab through the distal artery and make a giant hematoma

Step 4. hold pressure

Step 5. realize you didn't screw the cap on tightly enough and you are continually leaking blood all over the field

I didn't know it at the time, but I basically saw someone die yesterday.

It was dark and I was driving to work. I'm waiting at my stoplight, which is just underneath a highway. I hear a screech and a crash. I look up to see a 10ft column of flames erupt into existence on the side of the highway. I say out loud, "oh, SHIT."

My light turns green. I pass through the intersection. Half a block away, at the red light, I scrabble for my phone and call 911.

I look it up online later. A woman experienced a vehicle failure and was hit by a truck. Passerby tried to pull her out but were unable to. Her car (and presumably, her) burned to a crisp. She was declared dead by paramedics.

She must have been terrified. It sounds like one of the worst ways to die. She was ON THE PHONE WITH 911 when the crash happened. I can't imagine what it was like to be the dispatcher on the line. I will stop complaining about physicians not getting first responder discounts--my job is nothing in comparison.

I was in a car accident two years ago on the highway. My vehicle was totaled, but the other party drove off safely and all I had was a headache the next day (and a car loan now). It didn't feel like a close call at the time, but it sure as hell does now.

I'm on my neuroanesthesia rotation. It's been nice because we have a few CA3s substaffing and floating around, helping me start cases. Coming back after 4 months out of the OR, it was overwhelming. Induce, intubate, arterial line, extra IVs, turn 90 or 180. Wires everywhere, trying to stay organized, always losing or forgetting stuff. I wondered how anyone could do this by themselves.

Today I found out. Brought the patient back, called my attending for induction. Induced, intubated, started prepping for the arterial line. My attending goes to start his next room and the last thing he did for me was put the a-line transducer in the patient's hand (my bad, I forgot). And then he was gone. Gone! Ahhhh! Oh god, I'm alone, have I ever done this before?

I get my arterial line. I treat pressures. I run around the table and get an IV. I look at the feet, decide I'm out of luck, put an IV in the other hand. Okay, cool, we're good on lines. I treat pressures. I hook up another IV bag. I organize my monitor cables. We spin. We did it! Drapes go up and it's show time, baby.

Phone: *rings*

Me: UGHHHHHHH

Me: *unreclines, drops book and blanket, gets up*

Phone: *stops ringing*

Trigger warning: miscarriage, fetal death

Uh hi I have been gone for too long!

I am currently on the start of my second month of OB anesthesia. We are staggered here at my program, so we have two residents that just started their OB rotation. I am senioring for the first time!

It's crazy to sit in the workroom, eat a snack, pop my head through the door, give the junior a thumbs up, get one in return, and leave. CRAZY!!!!

It's also another nice way to see what I've learned. Today my coresident struggled with an epidural, I tried to stay very patient and offer advice, but eventually I gloved up and I ended up getting it. Far cry from the night I was calling for help endlessly, or when I felt completely lost in the back. Grateful for the people who have given me pointers along the way and I know I still have a lot to learn.

After nerve blocks were finished today, I gave a lunch break to a CRNA. It was the end of the case, so I brought the patient to PACU. Closed out the chart, wasted narcs, changed and got ready to go home. My attending offers me a cookie, which I gratefully accept. I walk out to the waiting room, and I see the family members of the patient I just finished taking care of. I figure they would appreciate an update, so I let them know that he did well and is in the recovery room waking up. They thank me...and then I realize how absurdly unprofessional I must look. I'm wearing short shorts and a tank top (it's hot, okay?), dirty scrubs balled up under one hand, speaking around a mouthful of cookie as my other hand holds the rest of the cookie.