It's been a great two and a half weeks in Show Low. I like the place and it's been a valuable learning experience. Moreover, it's been pretty relaxing. I haven't spent much time in clinic or rounding on patients here at the hospital. On slow days, like yesterday, I've been able to spend some time in the ER learning more about Emergency Medicine.
EM in this rural environment is interesting. You get to know the locals well (too well in some cases) and do a lot of procedures. I think compensation is pretty good as well. The specialty "feels" pretty good. But I'm not totally convinced. I still have questions about burnout, why none of the EM docs like to do procedures and how the EM "business" is set up. I had a conversation regarding the latter yesterday and was surprised to hear the Docs here have their own businesses and charge the hospital for their services. There's almost no overhead, so the compensation is higher than, say, Family Medicine. But I'm not sure who sets wages, how vacation time, overtime (extra shifts) and retirement benefits are set.
Yesterday was fine educationally, but a real downer career wise. I thought I had an EM rotation set up at UCSD for the last rotation of the year. I even talked with the EM coordinator and she said the Program Director was fine with my rotation, so it was a "done deal". Then I got a voice mail a few hours later that the UC bureaucrats nixed the rotation because I am only a third year student. I grabbed the FP rotation here in Show Low I had previously scheduled. But I'm disappointed that I'm going to spend my one elective this year in Family Medicine. I'll have three Family rotations under my belt already and no exposure to EM, anesthesia or radiology!
My fourth year rotation schedule came through yesterday as well. I only recognized two names from the list I submitted for the lottery last month. In talking with a classmate, I'm not the only one feeling screwed. Moreover, I received a reminder that my LORs for Maricopa County rotations are now late and may jeopardize those fourth year rotations. Ugh! Time to hound my Docs about the LORs they promised. And possibly time to start calling EM (or gas/rads) Docs about simply shadowing them for my last rotation this year.
As for surgery, the week and a half since my last post has been great. I've burned three gallbladders off patients' livers. I've intubated a few times and run into a couple very challenging anatomies. I've assisted in three thyroidectomies now, three more than last month. I was given the opportunity to remove an appendix so I got some firsthand experience with a GIA - a VERY fancy stapler that laparascopically places four rows of staples and then cuts down the middle of the rows. If surgery didn't have such an awful lifestyle, torturous residency and mediocre pay it would be very enticing. If I was ten years younger, you still couldn't keep me away.
Oh, in the ER I even stitched up a young lesbian's forearm after a self-inflicted serrated knife wound through part of her brachioradialis muscle. Fun stuff!
Finally, the wife and kids spent the weekend here with me. We had a good time hanging out Saturday and skiing Sunday. The skiing here was a bit icy in the morning and slushy in the late afternoon, but quite respectable. Connor took a little longer to remember how to balance, but by lunch both boys were bombing down the mountain. Dr. Greco, my preceptor, even managed to find me on one of my solo runs from the top. I think he's the best boarder I've seen so far. Even with his iTunes going and Bluetooth earpiece ready to pick-up any emergencies (he was on call!) he flew down the mountain with amazing grace. Typical surgeon, he doesn't do anything halfway!
This weekend we take the kids to BodyWorlds and I get a year older. If I can keep swimming 3-4 times per week and lose a few pounds, maybe the birthdays won't be such a downer. I love not having traffic here in rural Show Low. I get up at 6am, am in the water by 6:20, out by 7:10 and back at the hospital in scrubs ready for surgery by 7:30am! At 6500 ft above sea level, I can only do 1800 yards, but hope to get up to 2k in the same time by next week without sucking air too badly.
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