January 2008 coming to a close

It's been a busy month. For the first couple of weeks, my "cold" continued to get worse - to the point that I think I had walking pneumonia. My preceptor (Dr. Wiss) wrote me a prescription for a Z-pack and in 24 hours I was feeling 100% better. I'm sure my immune system was weakened by the stress and exhaustion. The ironic thing is that I had two of my easiest rotations yet over January.

The first two weeks of the New Year were supposed to be Neuro. However, my preceptor, Dr. Winograd, took vacation over the first week so it ended up as a one week rotation. I saw a lot during that week though and gained a new appreciation for neurology. It was actually quite fun, but would be too narrow to interest me from a career standpoint.

Becky's relatives then arrived for an extended stay. Her mom and significant other (S.O.) started working on a long list of home projects that we needed done to get the house ready to sell. it was a great help since I was worthless between being sick, traveling, new rotations and playing with the kids. In fact, I've been a terrible host.

The second half of January was a rotation in gastrointestinal medicine. However, the preceptor, Dr. Wiss, didn't make me go to the hospital for colonoscopies and procedures. Normally I would have loved to get in some procedures. But in this case I could rest and try to recover. The second week I missed most of my clinic time with my last two interviews, to St. Vincent's and Case/Metrohealth/Cleveland Clinic. In the end I worked one full day and three half days!

The interviews went great. I really enjoyed seeing many of the residents I got to know at St. Vincent's and they made it clear they would love to have me. The only reason I'm not ranking the program high is that Toledo is in a depression, like Detroit and most of Michigan, so Becky would have a difficult time getting a job. In fact, the program is very similar to UConn: friendly, great training, good facilities, good patient volume and some good attendings.

Case Western was new to me and I ended liking it more than I expected. The program seemed very good with great didactics and friendly residents, attendings and staff. It felt like this familiar attitude is a Midwest culture thing. And for a county program (Metrohealth) it is pretty cushy and well supported. Moreover, you spend 1/3 of your time at Cleveland Clinic (they pay 1/3 of your salary) and, while not as glitzy as I imagined, the place is pretty impressive. Finally, while Cleveland certainly offers more job opportunities for Becky than Toledo, the city sure showed signs of economic hardship. At this point, I will probably rank it fourth or fifth.

I enjoyed a rare couple weeks of being a slacker by sleeping more, riding our new mountain bikes on family trips to local mountain trails and playing some World of Warcraft with the boys. They are now at the age that they enjoy social games, whether playing with me or friends from school. And while WOW isn't that impressive from a graphics or class/race aspect, it plays on even my dinky three-year-old ultralight notebook.

This week I started Trauma Surgery at Maricopa county. It's kind of like a long second look at the EM residency program and a warm-up for residency. However, I'm feeling like a glutton for punishment when senioritis is starting to take over. We start at five or six am everyday and end at five or six pm. Then it's at least a 40-minute commute into downtown. Worse, with PAs, PA students, interns, residents and fellows on the service with me it's very slow. I've had one patient each day this week and got to do a couple procedures for the first time today: a foley and a bronchial lavage of blood from an motorcyclist vs. semi victim (without helmet of course).

Maricopa isn't looking too impressive at this point. I like the residents, but the volume is slow, the facility adequate at best and, worst of all, the hospital is on probation with JHACO. When residents joke about the place closing down, you really have to consider the implications.

I'm just getting up to speed now and tomorrow, on day five, we have three new residents replacing the experienced ones that were doing most of the work this week. Tomorrow I will one of the "experienced" people on the service! I'm just thankful that I will miss most of nest week while I travel to Christiana and Johns Hopkins for second looks. I may ask for Monday off even though I don't fly until Tuesday just so I have a day to rest up.

I got a 92% on my neuro test, so now it's time to start studying for Critical Care test. That is once I get used to my new schedule. I'm exhausted because I can't fall asleep until 11 or 12 and then get up at 4 or 5. And I still need to find a way to fit workouts in during the week. I finally stopped by an LA Fitness to swim after work today only to find the pool was an unattended facility off by itself with a bunch of ducks swimming laps! Obviously that wasn't going to do, so I'm still looking for something outside of our weekend mountain bike rides to keep healthy.