Ready Or Not

Y’all, I have about a month until my residency application is due. A month. That’s like no time at all, especially if you live in my world where time insists on zipping by like a shooting star. I remember first learning about the ERAS (Electronic Residency Application Service)  and the whole timeline of fourth-year like it was yesterday. I also remember feeling like I had so much time left during that fourth-year information session back in the late fall of last year. Back then, I was more concerned about powering on through my Psychiatry and Neurology rotations so that I could get to winter break. Fourth year seemed like a mile away…..but here I am now, about to start the last week of my third rotation of my final year of medical school, only about a month out until the application is due.

hm wow GIF

Luckily for me, my school ensures that we are prepared to submit our application well in advance by not only making us go to information sessions throughout the year, but also allowing us to pair with residency advisors during the summer in order to review the various elements of our application. Because I had to have drafts of my personal statement, CV and MSPE characteristics completed before my advisor meeting, I’ve already done all the hard work. I’ve even gotten a few people to review my personal statement already. All I need to do now to complete my application is to finish revising my personal statement, ensure that the people I’ve asked to write a letter of recommendation for me do so before the deadline, and complete the other fill-in-the-blank sections of my application. Then I’ll be pretty much set to submit! Oh wait, I also have to come to a final decision on which programs I’m actually going to apply to. 😅 Whittling my list down to about twenty-or-so programs is still a work in progress and is actually harder than I had anticipated, especially when there are so many fantastic pediatric programs across the East Coast. But I assure you, it’s getting done!

This past week was another one that went by in a blur. I woke up on Monday morning ready to start my week and before I knew it, I was leaving the hospital on Thursday afternoon wondering how the heck I was already approaching Friday. Carrying up to four patients at a time most of the week kept me pretty busy, which at the same time also helped make time fly by. By being responsible for this many patients, I felt like I was getting a taste of what being an intern was going to be like. I was writing notes for my patients, presenting them on rounds, assisting in coming up with plans of care for them, assisting in procedures (I helped perform a couple more of those 15-minute head taps that I wrote about last week lol) and even helping write orders for them. I really was feeling like the doctor that I’m going to become in less than a year!

Barack Obama Swag GIF

Overall, this past week in the NICU was another solid one. I even had a baby smile at me multiple times as I played with him! 😄 That about made my week, especially because of the straight-up sad nature of the NICU. These babies are literally the sickest infants that I’ve ever seen. Some of them fortunately end up getting better and going home, but many of them have been there for an extended period of time, with some of them having spent their entire lives in the hospital. It’s pretty depressing man. As a healthcare provider for these infants though, it’s extremely important that you don’t let your feelings cloud your judgment, no matter how sad and unfortunate the patients’ circumstances are. Of course you need to be able to emphasize with these patients and their families, but you also have to ensure that you’re not letting their circumstances affect your life in a negative and destructive way. It’s a much harder rule of thumb to follow than you may expect. Or maybe you actually do expect it to be a hard thing to do because, well you know, sick babies are naturally a sad sight to see.

While I feel like I’ve been able to emphasize with the patients and their families in an appropriate manner, I’ve found my mind frequently drifting off to what this experience in the NICU must be like for the families that come to visit their loved ones. Whereas each day in the NICU is just another day of school to me, it’s surely an emotional and unforgettable experience for each of the parents whose children are recieving care there. During these times of reflection, I tend to be brought back to the times I volunteered in the Ronald McDonald House’s Brenner’s Family Room in the hospital (located on the same floor as the PICU and the NICU), which is a place where families of the hospital’s pediatric patients can get together in a comfortable place close to their loved ones and rest while having access to free food and coffee. I remember witnessing how distressed and hopeful these families were about their loved ones, and being reminded that there was another world outside of the hospital that was full of the worried relatives and friends of each patient. It’s pretty terrifying how easy it is to go about your daily routine in the NICU without even taking a moment to seriously consider the perspective of the families who are scared to death about their loved ones. I hope to continue this habit of making time to consider the perspectives of others so that I can be that much more of an empathetic, caring and effective physician.

Well that’s it for today! Go on and live your best life this week!

“The question isn’t who’s going to let me; it’s who’s going to stop me.” – Ayn Rand

– Black Man, M.D.

Lessons In The NICU

This week flew by so fast man.

And I’m already at the halfway point of my NICU rotation.

Like, how??

kevin hart jokes GIF by Kevin Hart: What Now?

Between the long hours at the hospital each day and the great learning experiences that I’ve been fortunate enough to enjoy, I guess it’s easy to see why time has seemed to pass by so quickly. My mornings are primarily spent pre-rounding, pre-charting, rounding with Radiology, rounding on patients with my regular team, and finishing my notes. I’ve learned so much about routine care in the NICU just by paying attention to other providers during rounds and keeping up-to-date with my assigned patients. Although I had an idea of what day-to-day patient care looked like, it amazed me just how many calculations need to be done on a daily basis in order to adequately maintain the status of these infants.

After eating whatever I manage to come across for lunch, I typically spend my afternoons checking on my patients, finishing up whatever notes I have left, attending various learning sessions, and/or observing/participating in various procedures. As a matter of fact, my colleague and I actually performed a ventricular tap on an infant who was suffering from brain swelling and increased cranial pressure due to her overproduction of cerebrospinal fluid. The Nurse Practitioner supervising us walked us through the procedure, but we were literally the ones doing it. Can you believe that I actually stuck a needle into the baby’s fontanelle (“soft spot”) so that my partner could draw fluid from her brain? Wild man, just wild. Can’t lie though, it was pretty cool…..until I realized that I had to be immobile with the needle for about 15 minutes as my partner SLOWLY drew the fluid out of the baby’s head at a rate of about 1 mL a minute. We had to draw out 15 mL.

Sad Music Video GIF

The little kid took it like a champ though! What a soldier.

I spent part of another afternoon with a Neurologist and a group of third-year med students who were learning how to perform an effective neurological exam on a newborn at the bedside. That ended up being a really good review, and I also learned about the 5 S’s for the first time. Best believe I took notes on that. And speaking of third-years, I got the chance to orient another group of them to their Pediatrics rotation earlier on in the week. Like, I was one of the people giving them tours and tips during their rotation orientation! Talk about having things come full circle!

There were other various afternoon learning sessions that I attended during the week such as lectures on antibiotics and ventilators, interdisciplinary meetings about the next steps for our patients’ care, and my partner’s talk about abdominal wall defects. I even gave my own presentation about the development and usage of the HeRO score in a clinical setting! (The link lets you download my powerpoint, in case you were interested in the topic for whatever reason. It’s pretty interesting, but then again I’m biased. 🤷🏿‍♂️) However, the two sessions that I’ll probably take the most away from were the Medical Improv session and the Brenner Schwartz rounds. The Medical Improv session was actually a fun group activity that took the idea of improvisation and applied it to clinical settings. All the various healthcare providers in the room practiced using affirmative phrases such as “I appreciate you said that” & “yes, and” on each other in order to get an idea of how much more effective conversations can be. We also used negative statements such as “yes, but” and “no” to capture the feelings that patients can get when providers use them without thinking twice about it. We all had a good amount of laughs from the activity, and it made us more aware of the different ways that we can build rapport with patients as well as with our colleagues and other people in general.

The Brenner Schwartz rounds was a multidisciplinary forum that focused on discussing the experiences that various healthcare providers have gone through. There was a panel made up of two nurses and a Neonatologist, all of whom talked about various “best days of their lives” in their careers. It was neat to hear each of their stories and how much of an impact some of their patients have had on their lives and careers. Listening to their stories also motivated me to begin documenting my best experiences with patients so that I can look back on them whenever I’m having a tough day in the future. But then I quickly reminded myself that I have a whole blog to look back on whenever I’m having a tough day lol. But still, having a place where I have my patient encounters documented wouldn’t hurt. There are a good number of experiences that I just haven’t written about, simply because I don’t have the time to write them all out in the manner that I would like to write them out in. But even with that said, I’ve been able to touch on many of my experiences at one point or another in prior posts. Who knows, maybe I’ll end up creating a separate section on the blog dedicated to patient encounters at some point in the future…

That’s all I got for this post! Even though I don’t have to spend my time studying for a Shelf exam, I still managed to find a way to keep myself busier than I would’ve liked to be…so with that said, I’m gonna go and get some work done.

You all be sure to have a spectacular week!

“Opportunity is missed by most people because it is dressed in overalls and looks like work.” – Thomas Edison

– Black Man, M.D.