The last several months have been amazing.  Unfortunately, my own ineptitude at this blog has prevented me from logging in to actually share it with the world.  We have much catching up to do!

My rotations have been as follows:

• July – Internal Medicine, Hospitalist
• August – Peds
• September – OB/GYN
• October – General Surgery
• November – Rural Medicine
• December – Psychiatry
• January – Internal Medicine, Hospitalist – take 2
• February – Anesthesiology/Radiology

So let’s start from where we are and work backwards, shall we?

I just finished my month of anesthesia.  I kind of came into it thinking that it wouldn’t be for me, but I’ve actually really enjoyed the month.  Yesterday I successfully intubated 3 patients and performed a couple of LMAs, as well.  I can’t decide if I love the rotation because a couple of my attendings were just phenomenal teachers, or if I loved it because I actually love it.  Only time will tell.

There is something to be said for learning one-on-one in this environment where you either learn it or you look like an idiot.  Plus, everything is repeated so many times that one day you expect it to just stick.  For example, I think after alllll of my rotations talking about it, plus all of our morning reports – I’ve finally started putting together all the renal failure stuff – electrolyte imbalances as a result, fluid overload, etc etc.  It’s awesome.  Today’s renal failure pop quiz when something like this: You have a patient with renal failure – would you give them succinylcholine for rapid induction ?

There is something awesome about being able to think through an answer.  It’s one thing to know an answer and be able to parrot it back, but to not know the answer and be able to figure it out?  That is a whole new level of excitement.  The answer is because succinylcholine is a depolarizing muscle relaxer – and without renal failure it can increase your  potassium 0.5 -1.0…which means in renal failure you can find yourself in trouble from hyperkalemia very quickly (read: spiked T waves, PVCs and ultimately asystole).

It turns out I am that girl.  I have loved every one of my rotations without apology.  I am ruling more options in than out.  I am excited to go to work.  This is the part that I signed up for.

Anyway, ahead for the weekend: Valentine’s Day.  Looks like I’ll be spending it hanging out with friends and doing a little traveling for opportunities to play!  Come Monday I’ll start my radiology rotation!  More to come soon now that I’ve got the system down!

Let’s talk about how much I love rotations!

There’s something to be said for finally being out of the classroom.  I am now officially into my 18th year of education, and in honor of my 18th education birthday, I get out of the classroom.  Fantastic!

I love the hospital.  I love the rush, I love the people, I love the drama…I just love it all.  If I ever had any doubts whatsoever about medicine, I find them fleeting more and more as I spend my time soaking in as much as my little brain can hold.  I can now hear some piece of information and retain it for longer than up to the next test.  I’m just retaining it for the sake of retaining it.  Love it.

Today I started my surgery rotation.  I don’t know what it’s going to be like.  I’m coming off of an OB/GYN rotation.  I really enjoyed hanging out with the laboring moms and assisting with a c-section or several   It was a good intro into surgery since I learned how to gown and glove myself, as well as how to not look like a complete and utter fool walking onto the real surgery floor this month.  What advice could I give you for rotations?  Befriend anyone and everyone because everyone here has been doing this job longer than I have and they all have something to teach you.  I learned the instruments on the Mayo stand for C-sections, I worked on suturing and stapling…I learned how to prep and tear down from a surgery…I even got to sew up a C-section…with sad shaky little arms.

Overall, this is what it’s about.  This is what I have always loved about medicine.  I’ve ruled some things in and ruled some things out…but I’ve definitely been reassured that this is the place I need to be.  Rotations rock!

Before I tell you all about rotations, you probably deserve to know a teensy bit about me.

I just started my third year of medical school.  I’m not sure if I ever thought I’d make it to this point, but here I am out of the classroom and into the hospital and clinic.  After college, I spent a summer at Bradford Woods, a camp near Indianapolis, IN for kids with various disabilities and illnesses.  I think that was the most valuable pre-medicine experience I could ever hope to have.  It’s one thing to sit in an office and shadow doctors, it’s another thing to be responsible for the kids with CP who need Gtube feedings overnight, the ones with Sickle Cell who are at risk for a pain crisis at any moment, or the ones with seizure disorders…especially the “mini-mal” seizures that require your attention to even catch.  I was changing depends, chasing wandering campers, and doing everything in my power as a counselor to give those campers the best experience they could possibly have in an effort to help them forget their disability for a few days out of the year.  Honestly, in same ways I think that experience gave me the best understanding of what it means to be not only a caregiver to these campers, but how to communicate with them on a friendship level.  Learning to be comfortable in a situation where my campers were not able to communicate verbally, but finding a way to converse was an extremely valuable lesson that has already served me well in my rotations.  In short – I think that experience helped teach me the true meaning of compassion, and the importance of avoiding judgment of the families who have done everything for these, their loved ones.

During that summer, I fell in love with my campers during the Sickle Cell Anemia week.  I worked with boys who grew up in a very urban environment, most of them had a parent in jail and their families seemed to be struggling to make ends meet.  Several told me about how their teachers wouldn’t pay attention to them because of their family history.  These were kids who were being judged on their families and not on who they truly were.  Many of them had suffered strokes, had seizure disorders, GH deficiencies, several had ports for blood tranfusions…and most of them were less than 14.  In their whole lives, all they knew was the tragedy of their broken homes and the pain of their crises.  My heart went out to these kids because of the difference I saw in them when we gave them our trust, when we gave them our attention, when we showed them how much we loved them…they went from rough exteriors to softies who were sacrificing fun to help set up for a party at the end of the week so the younger boys would help…they became positive influences for the kids who looked up to them.  Oh, a touching story indeed…and the reason I’m incredibly interested in Pediatric hematology and oncology.  To be quite honest, I struggle with the intricacies of the blood stuff and all the crazy cancer markers, but I hope to one day work with this population.

Since this has already turned rather long, I will simply say that I am loving rotations.  I just finished my month of pediatrics and I absolutely loved it.  In July, I was on Internal medicine and I thought that was also super fun.  I’ll share more about the actually experience of rotations as time progresses, but I figured you all deserved a chance to find out a little bit about me and what I want to do after this crazy med school experience!

Much love – Casey