The First Six Months of Residency

Guest post by Dr. Dre. Find more of his work at http://dr-dre-anatomy.tumblr.com

Wow, what a six months it has been. Never could I have imagined what residency would be like without actually having lived through it. The ups, downs, flips and turns. I am in my intern year in Emergency Medicine. I wanted to break down some of my favorite and not so favorite memories from my first six months of residency.

The Good

The amount I’ve grown in just a few months is astronomical. I started out a small baby and now I’ve become a slightly larger baby who can now run around and put random things in my mouth. The fruits of medicine have kept me full. First off, I realized I LOVE NURSEMAID’S ELBOWS! What a rewarding experience it is to take a young child who thinks they have broken their arm, do a quick supination and flexion and voila you cured them! Some children will still not move their arm because in their mind it is still “broken.” If you have the mom hold the uninjured arm, offer the patient a popsicle and watch how quickly the post-reduction arm launches towards the sweet treat. Next, I really do love my co-residents, almost as if they are my extended family. I urge those now interviewing for residency to really pick a program that feels like a good fit for you. Residency can be tough and having good friends to lean on and a leadership that listens to you can make things that much easier. Another positive from obtaining my medical degree and starting residency is having a sense of purpose each day I go to work. In medical school, it seemed like everything I did was to do well on a test. Each patient was a possible future exam question. Now that I have no meaningful upcoming tests, I treat each patient as an individual. After the case has finished the learning from that patient will transfer to the next patient with a similar complaint. Grades are no longer important and helping the patient is paramount.

The Bad

Unfortunately, incredibly sick patients are always coming into the emergency department which makes death a common theme in the emergency room. I experienced death in medical school, not often, but a few times. In some other specialties, patients are sick and their death was not unexpected. Almost every patient in the emergency room was healthy enough not to be in a hospital until “something” happened. That “something” is my problem. Often it can be a problem we cannot fix and I am trying to come to terms with that fact. I can’t heal everyone in the entire world. I must cure the patients that I am able to cure, stabilize those who can’t go home and must stay in the hospital while the doctors upstairs find a cure, and offer comfort to the patients and families when there is no cure. The last patients are the ones I’ll spend my entire life fighting for and in six months of residency I have just entered the first round of that fight.

The Ugly

Lastly, if you have a list of ranked “Worst Smells” you know you are in the medical field. Being in the Emergency Room means anything can walk through the door and you are obligated to see it. Those who seek medical care in the emergency department may not have regular access to healthcare. This can lead to diseases progressing far beyond their normal course. Personally, the grossest thing I have seen is when we find maggots in patients’ wounds. Now objectively, this isn’t that gross. The maggots are actually helping to an extent and eat a lot of the dead tissue. Subjectively, seeing the maggots crawling around inside a patient causes my brain to think they are crawling on my own body and I just can’t handle that feeling. The worst smell I have experienced would have to be a fungating breast cancer mass. You can Google it if you would like to lose your lunch. I do not have a worst sound or worst touch. Worst taste would have to go to olives, they are nasty. It is not these patients’ faults their disease or illness has progressed so far, they just want your help. Not every patient will have a Nursemaid’s Elbow but it doesn’t make them any less deserving of your passion to help the individual sitting on the bed in front of you.

Good luck to all those currently in or soon to be in your first year of residency. It is crazy insane bananas but you will love it.