Friday, August 28, 2015

Week 40: Rent-an-Intern

For the lack of a better intro for this post, lets just get down to it, shall we?

After a few great days in Munich visiting friends and family, it was back to the hospital for a quick two days. Again, I was rotating to a different department and I had my reservations about it. Much like I did rotating into hematology/oncology thinking it wouldn’t go nearly as great as the cardiology rotation had gone, I was afraid my experience in gastroenterology wouldn’t mount to the same level of fun as hem/onc had offered.

I was also worried about how the interaction with the chief would be. During his seminars, he had a way of letting you know just how knowledgeable he was and how, in comparison, uninformed you were. Not that his seminars weren’t extremely informative, they just left you feeling a bit unworthy. My fear was going on grand rounds with him and being asked where every little factor or enzyme was produced (like one instance in a seminar of his). Due to the usual train delay in the morning, I was running a few minutes late. In Hem/Onc, the morning meeting didn’t start until 8:15AM. I had no idea where I had to be or what time the morning meeting started in Gastro. Luckily, another intern crossed my path that had been in the department before. He informed me that the meeting had already started (8:00AM) and where I had to go. Great. I was prepared for some remark on my tardiness.    

My green essentials

I arrived at the room and snuck in. Although my arrival was noticed, the meeting went on and it wasn’t until the end that the chief kindly introduced me to the staff and welcomed me to the department and offered me the opportunity to see anything I wanted to see. Gee,……why thanks!

From there, it went directly into the grand round. Uh-oh. I braced myself for a storm of complicated questions that I would only be able to answer with limited knowledge. It’s not that I doubt the amount of knowledge I have. I know there is a lot of information in my head, its just that for years on end, we were trained to answer multiple choice questions. So, if I see a question and you give me 5 answers to choose from, I’ll most likely be fine. If you ask me to answer an open end question……there are bits and pieces of information that pop up in my head but managing to put them in an acceptable spoken answer is a whole other thing. I approach questions in grand rounds openly however since that is how my practical exam will be. Might as well start practicing!

A nice surprise for me was that the questions that were asked were rather fair. Nothing totally out there. The chief also really likes to explain things. He probably even expects me to ask question just so he can explain some more. Sure, if I don’t know an answer I feel somewhat unworthy. 

Oh look, sun out there!

Often, tid-bits of information or random words will immediately come to mind when I’m asked a question. The annoying thing is that I can’t immediately explain why that might be the right answer and don’t always say the first thing that comes to mind. Even more annoying is that often, the first thing that pops into my mind is the right answer! I’m just not compulsive and think ahead knowing that the person asking the question doesn’t just want an answer but also the explanation. „I don’t know why its the right answer, it just is.“ doesn’t seem like an acceptable explanation. If you give me time to think it through, I can usually tell you why it is the way it is. But the chief ain’t got time for that! ;) Luckily there are still enough things I can explain just beautifully to make up for the answers I can’t.

The residents in the department are all super nice. They might be the internal medicine department were the comfort level of communication was almost instantaneously were as in other internal medicine departments it took a few days for them to really warm up to me.

I spent the rest of Thursday helping a resident with her patients, drawing blood from the patients that the nurses weren’t successful in drawing blood from, placing lines, etc.

I stopped by the thoracic surgery chief’s office because I was told he had been looking for me the last few days. Of all the chiefs in the hospital, he and I are totally on buddy level. He is the one who tried to convince me to stay in Germany by offering me a husband and house and a job! He informed me that the department was still suffering from a lack of doctors due to injury and vacations and asked if I would be willing to come work a week for him in two weeks. I’d basically play the role of a resident. Take care of the patients, do rounds, write release letters, be first assistant in operations……basically do that which a full blown doctor does…..just without the full accountability. I told him he’d have to talk to my current chief. He called him up right away, offered him a cup of coffee and asked him he could borrow me for a week. My chief said he’d have to ask me if that would be okay with me. His reaction nicely surprised me once again (maybe I need to change my perception of the chief). It wasn’t unheard of that chiefs would absolutely NOT give up their intern to another department. Rather, it was an exception that the chief would allow it.

After the morning meeting on Friday, chief stopped to ask me if I’d be willing to go work in thoracic surgery in two weeks for a week. He said that he wasn’t going to place stones in my way if I wanted to do it but that it was my internship year and I should be able to decide. If I wanted to learn internal medicine, I should be able to. Haha, the backhanded guilt trip. I told him that I was rather interested in learning as much as possible in internal medicine but that I understand that the thoracic surgery department is in a situation of need and that I should be so kind and help them out.

After I had my work on the ward completed Thursday and before the afternoon seminar, I found myself back in the thoracic surgery chief’s office with their current intern (pseudo-resident) and the chief of Pneumology. We talked about how theoretically fun it would be if the other intern started to work for the pneumology department and I for the thoracic surgery department. The men proceeded to joke about my arranged marriage with the chief’s brother-in-law and how crazy fun the wedding would be with all sorts of celebrities in attendance. We really threw the wildest ideas out there and the secretaries in the room next door were able to follow every word. If they have a sense of humor, they thought it was funny. If they don't, they probably thought we were the cockiest, most stuck up and narcissistic people on earth. I love when people can get over the hierarchy of a work place and just have fun with one another.  

After a bit of stress, the natural nerve-calmer

Friday, I was once again a few minutes late to the morning meeting but that didn’t seem to bother anyone. I went on rounds with my resident. We did an ultrasound on a patient with the help of an attending. Its pretty nifty what a good ultrasound machine can show you. We finished up rounds and I finished up the blood draws before getting started on some release letters. Since all the computers were being used on our ward, I wondered to the surgery ward and hung out there to write some letters. I stayed comparatively late because the right moment didn’t present itself to ask if I could leave. I’m always bound to the train schedule so I have to think about the likelihood of me being able to leave ahead of time to have enough time to change and make it to the train station. If the right moment is missed, I have an hour to wait for the next train. I missed my opportunity to ask twice because my resident and I were so involved in the care of a patient with the attending that I didn’t feel it was appropriate to ask if I could leave. After missing both of the trains I had planned on taking, the resident finally said I could leave and could have left two hours earlier, she just hadn’t thought of telling me. Oh well, I’d rather stay longer and miss the train I planned on taking than looking like I’m trying to leave early and am not interested. Its just a constant battle of right timing.

This weekend, I am back in northern Germany to visit my grandma in the hospital and to babysit my godchild since her parents are celebrating their 2nd wedding anniversary. If all goes according to plan, she and I will go visit the Hagenbeck Tierpark, a huge Zoo in Hamburg.

And as a little treat, here are some of my pictures from the last weekend in Munich! 


A moment of relaxation

Where to?

Looking for a new Dirndl

Pretty Bavaria

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