Peds down, halfway thru Toledo confinement

I finished the Pediatric ER rotation on Wednesday. Tuesday was my last shift in the ER. It was busy and the time passed quickly. Nothing too unusual, but good learning cases. At the end, my Attending gave me a glowing evaluation. I'm not sure how the Doc that actually pens my evaluation for the entire rotation will use it, but it sure felt good. I had had this Attending for most of my shifts, but he had always just checked off "performing as expected" on my daily log sheets. The paragraph or so he wrote was my first real feedback on my performance.

Wednesday I was coming down with a cold so I didn't do a procedural shift in the ER like I had intended. My only required duty was some mock codes with three other students on a $40k doll. A second year ER Resident instructed us while a tech handled the computer operation for the doll. This doll could be male or female. It breathed, cried, opened its eyes, bled, had heart and lung sounds, fractures and much more. We did scenarios like head injuries where the doll had one blown pupil and chest injuries with a tension pneumothorax and cardiac tamponade. Of course, we also had the AMI with ECG readout where we had to intubate (RSI) and run an ACLS code.

Pig lab a week or so prior was similar, but a first year Resident and I performed several procedures on a live (anesthetized) pig before it was put to sleep. It was a little weird (and smelly) but a great experience. I put in an IO line, did an LDP, pleuracentesis, cardiocentesis, chest tube and cricothyroidotomy. One procedure shift wouldn't have come close to that experience.

Interesting cases in the last two weeks included sickle cell crisis, respiratory distress, croup, an ovarian cyst that turned out to be GC, Candida and UTI, sunflower shell impaction, lots of fractures and lacerations. I sutured a bunch, did a digital block, stapled a scalp lac and helped set a couple fractures. And I had all the AOM, RSV, rotovirus, etc. that I would have been inundated with at a Pediatric office.

So was it worth leaving Phoenix, my family and all the comforts of home for this learning opportunity? Wow, that is still a tough question. I like to think so. It certainly gave me more exposure to Emergency Medicine than most MSIII students get. For a single student interested in ER, you could do a lot worse that St. Vincent's. The Attendings, Residents and fellow students were great: nice, interested in teaching and without any arrogance.

Now that I'm home though, I'm not looking forward to flying back to Toledo tomorrow for surgery. It's been a great couple of days with the boys and Becky - and the dogs. I didn't think I would appreciate the sunshine this much. Seventy degrees and sunny in the middle of January is pretty darn nice! I drank too much red wine last night ending my month of celibacy and sobriety. Tonight is Gray's Anatomy catch-up. Tomorrow I have just enough time for a lazy morning, packing some khakis, dress shirts and ties so I can look like a proper surgeon, and then it's off to the airport.

I hope I can get through the remainder of my Pediatrics book on the flights back. I have to take my rotation test in the next week or so. And at this point, I feel more prepared for an ER test. Time to hit the books.