Saturday, July 21, 2012

So This Is What People Meant When They Said Third Year Was Rough

   Let me start out by saying I am fully aware that many of my posts lately have been negative.  I hate to be so negative, so I'm going to end this post with positive thoughts, because really, you can always find something positive in everything - even though finding that positive thing doesn't necessarily improve one's piss-poor mood.
   Anyway, I mentioned in my last post that I was hating my surgery rotation so far.  I had previously said that I didn't want to post about it until after I recieved my grade, in case anyone happened to read it and it somehow affect my grade for the clerkship.  I've decided that I'll just talk about it now, but maybe in a more vague manner.  And like I said, I don't mean to be whiney or complainey, but I'm doing this more as a way of having something to look back to later on.  I want something I can refer to, when I forget the particulars of why I was so unhappy on this rotation, so that I know what things to watch out for when I'm deciding what specialty to go into or what sites to apply for residency. 

   First off, and this is not unique to surgery by any means, who you have to work with is SO crucial to everything.  Your co-worker's attitudes and styles set the tone for everything, so when you work with people who are passive aggressive, hate patients, don't want to be bothered by anyone, and are in a bad mood (because they are tired and overworked), it rubs off on the entire team.
   One thing that especially bothers me is some of the unprofessionalism I've witnessed from the more senior residents, who should be acting as role models for the interns and med students.  The way one of the senior residents talks about the patients behind their backs is appalling.  He casts judgement on all of them, doesn't care about their well-being whatsoever, and has even gone as far as calling them profanities.  Every time he opens his mouth, I find myself thinking, "Do you even LIKE patients?!"  I'm sure everyone has their periods of being frustrated by patients, but ultimately, isn't the reason most of us go into medicine is because we want to take care of people?  Or maybe that's just me.  Anyway, this guy just seems to despise patients and has absolutely no respect for most of them, so I don't really know what his deal is.
   Another thing I have a huge issue with, is how little respect many of the team members have for eachother.  They talk bad about one another behind eachother's backs, all the while in front of everyone else, making everyone in earshot feel extremely awkward.  Most of the time they are complaining about something that the other person has no idea they are even doing wrong.  It would be so much easier if they would just say to that person, directly, what they are doing wrong, and then they can just fix it!  And then everyone will be happy!  Some of the team members can't even show respect for the attending!  There is one girl, whose facial expressions allow you to read her thoughts like a book.  I've learned to watch her face during rounds (for pure entertainment on my part), because when other people are talking, including the attendings, she makes several expressions of disgust and contempt.  Maybe she doesn't realize how expressive she is, and has no idea that she is displaying her feelings for the whole team to see?

  That said, there ARE some things I like about this rotation.  In fact, all the things I don't like about this rotation are mostly dependent on who I'm working with.  And I'm not really sure if that's unique to this particular department?  Obviously I can't generalize these personalities to ALL surgeons, so we'll see how my experience on GI surgery is.  I particularly like the short get-right-to-the-point rounds.  From what little time I've spent in the OR so far, I like it!  I really like seeing patients, whether it's waking them up at an ungodly hour to preround on them, or popping in to say hi during rounds, I really enjoy all the little interactions I have.  I especially love the crazy patients.  I find them to be an entertaining challenge.  Luckily, I think I will come across crazy patients in any field of medicine. 

   Finally, I'll leave you with one of my favorite patient encounters.  There is one patient who suffered a severe traumatic brain injury, and is now severely disabled: physically and mentally.  He has a lot of trouble speaking, and most of the time, his words come out all mumbled and slurred.  Because he isn't really able to comunicate, a lot of the times on rounds the doctors would just ignore him and talk about him like he couldn't hear them.  Every morning I would go in to preround on him, and he began to be able to talk more and more.  One day, when I went to see him, he said, "yyyygghhh zzzhhhccckkin mmmeeaaaaan."  I had to have him repeat it several times, saying, "I really want to understand what you're saying, sir, but I can't!"  Finally, I was able to make out that he was saying, "You've been checking on me."  And I said "Ooohhhh... Yes! I have been checking on you every morning!"  He replied, "I appreciate it."     

    It's the little things that make me happy.


  1. your surgery experience is pretty much identical to my OB/Gyn experience in terms of the way the residents behave- that's the main reason I hated that rotation so much.

    I think this kind of behavior is more specific to the higher stress fields- I didn't meet a single person on medicine, peds, or psych that wasn't amazing.
    Good luck!

  2. That story of you checking on the patient that the other doctors just ignored literally just made me tear up. You are going to be such a good doctor Ashleigh!

  3. Wow- I totally just got teary reading that patient story- thank-you for sharing such a powerful moment. Every time I read your blog, I respect you so much about your kind comments on patients and desire for a positive attitude/outlook within your field. We need more future docs like you!!!

    Also- don’t worry about your posts being negative recently- it’s like you said, you want to be able to look back. It’s amazing what a little time capsule your blog can become when you really pour your heart into honest posts here and there.