Thursday, February 20, 2014

Residency flashbacks and a new experience

I recently did some locums work in a very small emergency department (four beds) in a very small hospital (26 beds).  It's so small, in fact, that I acted as hospitalist as well. While this is the stuff of a much longer post, I can say that I had flashbacks to residency.  I had to round.  I had to write orders and dictate discharge summaries.  While it has indeed been a while, I must say that it does come back...not exactly like riding a bike, but not terribly difficult on the surface.

Two things, however, were particularly odd.  The first, that I stayed in the hospital for 72 hours (except for quick drives to get carry-out).  I haven't been 'on call' for a very long time.  And the longest I was ever truly on call was about 24 hours (with 12 hours of subsequent rounding on the trauma service in residency).  It was surreal to stay in one place that long; to be 'on' that long. Fortunately, it was low volume and not stressful.  But when one is sleeping in the hospital, covering the emergency department, the threat of a phone-call always looms and seems to banish deep sleep.

The other, however, may be more bizarre.  In that 72 hour period, other than hand off from the previous physician, I did not see a single other doctor.  Nurse?  Sure.  Social worker?  Absolutely.  Case manager? All day long.  But no other physicians.  I can't recall a time in my medical life when I experienced that sensation.  And it wasn't all bad.  It was just different.  And oddly validating!

I hope that whatever and wherever you are practicing, you find new ways to stay fresh, sharp, engaged and interested.  To me, this work is what puzzles are to others. A way to challenge and stretch my mind. 

Because in medicine, ruts are easy to find.  But there are plenty of ways to climb out.  And one sure-fire path is to work off the beaten-path, and to do it all alone.

Edwin

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