Inpatient Medicine and other reasons why I am so sleepy

Dear readers thanks for sticking around even though I haven’t been around much. My husband is likely more upset than you are. I am 5 weeks into my 8 week inpatient medicine rotation–one of the big bad scary ones, with the long hours and exhausting schedule. You will never know what it feels like to be at the hospital 14 hours a day multiple days in a row until you actually do it. It is thrilling, but puts you through the grinder only to spit you out with bad hair, dark circles under your eyes and a crabby sleep-deprived outlook on life (I honestly don’t know how parents do it with an infant!). On top of it all, you are supposed to be studying. My MKSAP question bank is in a sad state–with the % complete abysmally low. Why do they have to show you the question progress…just to remind you that you aren’t doing enough questions each night. I can barely put together some dinner…let alone 20 questions.

But I digress, I don’t want to make it seem like I am not enjoying every second of this experience. Yes, waking up at 5:20 am I wish I could just roll over to the other side and keep sleeping. But by the time I am on the road with the sun rising and my first cup of coffee in my hand my brain starts to wake up to the reality of where I am going. There are real people who need us. The more chaotic the happier I am it seems. Emergency medicine is still definitely where I feel I belong. On one particularly sleep deprived morning I walked in to a rapid response on one of our patients. You obviously never wish ill of your patients, but I find myself drawn to those situations. Whereas some people hate the stress of managing acutely ill patients, those are the patients and type of medicine I enjoy most. Any feelings of tiredness melt away.

I’ve also really enjoyed our mystery patients, those with diagnosis pending. It is so exciting to look up new lab results and completely change your frame of view of what could be wrong with them. These patients have taught me the most as I’ve been able to become a mini expert in whatever condition we are considering them for. As a medical student perhaps the best thing you have is time. While residents are carrying a heavy patient load with responsibilities for putting in orders, med students have the time to really dissect each lab value and read up on the literature. It is my personal goal to contribute to each case I am assigned to. Some times that consists of small things I can do for my patient, like saving them a trip to the pharmacy on their discharge day or explaining their lab values or condition to them and answering any questions. Other times its helping the team learn the nuances or latest updates on a condition or just paying attention to everything that happens. It is the ultimate goal to find a physical exam finding someone skipped or a lab value that changes your perspective.

Perhaps the thing that has surprised me the most is how close you get to your fellow team. Each team consists of a couple residents, a senior resident, one or two medical students and an attending. After spending 12-14 hours a day together  6 days a week complete strangers start to feel like people who have been in your life for years. It is inevitable you will find out each other’s life stories, how they take their coffee, how much sleep they need, what makes them angry and their sense of humor. Each time the team switches you feel a little sadness to see them go. We’ve come to depend on one another.

Overall this rotation continues to challenge me every day. I think most difficult has been adjusting to the demanding schedule and finding time to study while maintaining my personal relationships. A wise friend told me you will have enough time for two things– being a good medical student and one other thing. Pick wisely. She was right.

With 3 weeks left I hope I can pick up my slack and do enough questions to get me ready for our shelf exam. This may mean my time must get skewed slightly more towards medical student, with awesome wife a close second.

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2 Comments

Filed under Medical School Experience

2 responses to “Inpatient Medicine and other reasons why I am so sleepy

  1. Yes! That’s why internal medicine is the best! I’m biased 🙂

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