Wednesday, May 12, 2010

the subconscious knows

"a MTX level of 171!??"
i woke up all in a froth, dreaming that one of my patients was toxic on her methotrexate because i had failed to adjust the dose in response to a previous level. never mind that none of my team's patients are actually on methotrexate -- it was still quite a realistic and disturbing dream.

luckily i never even write for this stuff!

stunned awake, it got me thinking about the escalating levels of responsibility as one moves up the ladder of medical education. it's hard to kill someone as a medical student, but it gets easier every time you move up a level on the chain of command. perhaps i am more nervous than i thought about starting my endocrine fellowship in just 7 weeks (!!!).

book learning
despite my determination NOT to kill anyone, my motivation to study has been really lacking lately. i can't imagine why:

in all seriousness, i still feel a little guilty about this. there IS a lot of high-yield learning time on the wards (conferences galore and rounds with the good attendings that teach) even without extracurricular studying. but even though my chunk of daily 'free time' has been whittled down to a veritable nubbin (a nubbin which i am wearing away at as i type), there is still the expectation that i go home and read/study about the patients.

except i just can't force myself to do this with a schedule THIS packed full of call and the like. and today, i have decided to just be okay with that. i will have the rest of my life* to study outside of work -- a life that doesn't include 29.25 hour shifts and 7 AM start times.

in some odd way, i am actually looking forward to having to study for the pediatrics boards (they're in october) -- being forced to systematically go through every topic i was supposed to have learned about during residency will be a great way to provide some closure to this academic chapter of my life. but i am completely okay with waiting until the end of this rotation (1.5 weeks left now!) to get on top of this.

off to run! yes, i put my (short) workouts higher on the priority list than a study sesh. sanity > smarts . . . i feel this is the right choice!



workout: 5 miles on the TM, purposely slow (0.5% incline, 9:13/mi - 8:57/mi). i think my lungs are still making their final recovery from the virus!

pizza index: there is a direct correlation between the number of hours i am working and the number of nights per week pizza is consumed:

served with an arugula salad and a beer shared between two tired residents

currently we are in a high-pizza zone, approaching the upper limits of acceptable cheese consumption. luckily, 1.5 weeks are left. let's type that one more time: 1.5! hooray!


  1. Love the pizza index. As you say, you are so so so close to being done. You also have the rest of your life to continue making healthy meals. And pizza (or at least the pizza you guys get) isn't really that bad all things considered.

  2. Anonymous8:02 AM

    that sounds like a scary dream! and youre so close to being done....that must be scary too but in a much nicer way :)

  3. Ahh the dreams of killing someone...I've had those before. :) While I understand that doctors have a bit more responsibility that nurses do, I was always told that there are lots of people double checking what is going on to make sure harm doesn't reach the patient. For us, we have doctors and pharmacy around, and for you guys, you have us REALLY SMART NURSES (haha) double checking what's going on.

    That being said, after calling a doctor three times, I was once still really concerned about how much IV Haldol I was giving this one guy...I attached the blood pressure cuff and everything just in case something went wrong after I gave it! It didn't even touch him and ten minutes later I was literally laying on him trying to keep him in bed! Fun...

    I will never understand how anyone works for 30 hours...boggles my mind!