Week 33: No, I'm not a junkie, I'm a medical student.

No, I'm not a junkie. Yes, I know my arms look like I might be. 

It was another fast week in the hospital. This was mostly due to me cramming my days full with things to do after work.

At work, I sacrificed my beautiful veins for the greater good of our elective student's education again. This time he successfully placed a line on my right arm, tried drawing blood from my right hand but the vein busted and then successfully drew blood from my left elbow. A few days later, a couple of nursing students were being told how to theoretically draw blood with their supervisor until I interrupted and motivated a few men to let them practice drawing blood on their veins and mine. Medicine is a team sport. It's way less nerve wrecking to draw blood from someone with good veins and who offers and can handle you drawing blood slowly than going to an elderly patient with terrible veins and being expected to make it work on the first try. The chief found out about my little event and was rather impressed/amazed by the whole thing. 

The elective student started drawing the blood instead of the nurses so that he could practice. Often, he would come get me to come help him out. In all cases but one, I was able to help him. There was one patient we spent quite some time with. The student came and got me and upon entering the patients room, introduced me as the expert. The male patient turned around, looked at me and exclaimed, "and a beautiful expert at that!" Lol. Elderly men are so uncensored. I kindly smiled and proceeded to try to draw blood. Apparently, looks are no measure for blood drawing skills. The student had already tried one of the patient's best veins so I didn't have that one to use. Multiple attempts with all my tricks in the bag weren't successful (I refrained from asking the patient to take off his shoes so I could try from his feet.....although it wouldn't have been the first time for me). The nurse that is usually responsible for drawing blood came and was successful. 

Other than drawing blood and having blood drawn, we did our usual rounds. I did the admission history taking and physical examinations for our new patients. The rest of the time was spent reading up on cardiology. 

I went to my friends bridal dress fitting with her on Wednesday. She looks amazing and I am so excited for the wedding next month! 

So many dresses!

I spent Thursday evening in the lab. We are getting a new camera installed next week. Supposedly it'll have 4x the resolution. Exciting! .....no seriously, that really excites me. I'm a nerd. I know. 

Friday, I left work and took the train to Hamburg. One of my colleagues from the urology department invited me to his alma mater's graduation ball. Saturday morning, I met up with a friend for brunch before exploring Hamburg a bit with the urologist and then attending the ball at night. It was so much fun! I knew no one except the guy I went with and two of his friends. I ended up meeting some really fun people and had great conversations. Sunday, I stopped by my grandma's for a few hours.

5k run along the Elbe in Hamburg

Ready for the ball!

Flowers & Bubbly

One more week of cardiology ahead of me and then it's a week of vacation! 

Stay healthy!

V

Week 32: "Don't go breaking my heart." "I couldn't if I tried....ok, I probably could but I'm trying really hard not too!"

Oh lordy its hot! Summer has finally arrived in Germany. Its about time but it also sort of came out of the blue and our circulatory systems had no time to prepare.  Speaking of circulatory system, I finished my first week in cardiology!

We received our rotation schedule on Monday. I'll be in cardiology then haematology/oncology then gastroenterology/general medicine and in the end pneumology. Each for 4 weeks. 

I was told to go to the ward and that a doctor would be there waiting for me. My doctor is actually a general surgeon but since he wants to start working in a practice, he needs to do 1.5 years of internal medicine. He has only been in the department for a few weeks. I think its actually pretty cool that I'm working with him because he also has to look up things and can explain the basics really well since he just recently reviewed them. He is also interested in me learning something while I'm there so he asks good questions during rounds that get me thinking. The other residents are also very nice and if they have an interesting ECG or patient case, they'll ask me to take a look. 

The big differences to being in internal medicine and not surgery anymore have so far been:

-I've used my stethoscope more times in the last 5 days than I have in the last 32 weeks. It is hangs out around my neck more than it does in my lab coat pocket.

-Rounds take FOREVER! Every morning is easily spent exclusively on rounds. Three to four hour rounds are the norm. My back and feet were not used to that the first few days. 

-Patients go on forever with their stories. We had the odd talker as a patient in surgery as well but most issues in surgery were rather clear on how they would be handled and usually surgery was the cure. There weren't a lot of followup questions there. In internal medicine, each person's story is long, their list of complaints many and the treatment is often with medications that take their time to start working and are taken for a life time. Many of the internal medicine patients, if not almost all of them, are multimorbid. This meaning they don't just have one chronic illness but a combination of many. This of course makes treating patients more difficult and requires a good sense of pharmacology since one drug used to treat illness A might not react well with a drug to treat illness B. 

-The average age of patients seems to lie in their 70/80's.

The department meeting starts at 12:15 and goes on for about 20 minutes. Afterwards, we all head to the cafeteria for lunch.

After lunch, the doctors are usually busy writing release letters and I take to my 3 medical text books and read up on cardiology. There is way more potential for learning in internal medicine than there is in surgery. I also really want to learn as much as possible while I'm in my internal rotation. So I'll read a section about heart murmurs for example and then go to the patient that I know has an aortic valve stenosis and listen to it. There are also various tests happening with patients after lunch like stress tests, so I go look at those in between.

Wednesday, an elective student started in the department. It's his first elective. He'll be starting his 7th semester soon. It is like having a living/walking/talking/breathing-reality check hanging out with you. He hasn't had cardiology in school yet so when he asks questions, we all have to remember that he hasn't heard the things we assume he already knows and we can add on to. Its really convenient for me because I get to explain things as if I was in my practical exam and had to explain something to the professor. I have to understand what I'm saying before I can teach it to someone else. It also gives me feed back on how much I've learned over the years.

I sat down with him and explained different heart murmurs, how they develop and where on the chest they are heard best. He told me he had never placed a line. I showed him how its done on one patient and then he got to try it out on me. (During med school, I was the genuine pig for my friends and had 7 puncture marks on my arms at once.) I supervised a few of his attempts on patients. He also came and got me to help him with patients where he was having trouble drawing blood. I loved being a TA in med school and teaching students so I enjoy being able to be one of the first people to explain things to him and then take him to patients so that he can hear things we discussed earlier. 

I really like the residents I work with. Three guys and all rather funny. The hobby-internist (my doctor) really is a surgeon at heart. Surgeons sense of humor is just more similar to mine. Three of the four attendings are women. I think that is great for women and shows an active movement towards more women in higher positions. For me personally, they all don't really seem like people I would become friends with. I think our personalities are too different. Obviously I am not in the hospital to become friends with the attendings but I feel it sets the atmosphere at work differently when you get along with attendings on a personality level.

I already had a good 1st week where I tried to learn as much as possible and hope to add on to that the next few weeks.

I left the hospital early twice this past week because either the lecture was done early or the doctors let me leave but not in time for me to catch the next train. I finally used the opportunity to look at some other parts of Hildesheim. If you leave the straight shot path from the train station to the hospital, you can see beautiful things. People have often told me that Hildesheim is beautiful but I couldn't really confirm that notion from my usually walking path. Now I am totally convinced as well. I'm sure there is a lot more to see and I will try to explore more if time allows!

The rose bush on the back building is the famous 1000-year old rose bush of Hildesheim

This weekend was so hot I could hardly function. I was in the lab Friday night until 9:30pm and was still sweating. I decided I would probably melt away if I went to the lab Saturday morning, so instead, I went to the library that has AC and sorted the pictures I have taken so far for my doctoral thesis. After the library session, I headed to the pool with two girl friends and attempted to lower our body temperature.

Happy 4th of July to all my American friends! 

Stay healthy!

V