I keep on fallin'

Alas, another Jonah day for yours truly today. It was more than that. It was mortifying, embarrassing, humiliating, *insert adjective of choice* because you get the picture sort of day.

I'm on Pediatrics right now. This is my second week of Peds Critical Care (aka ICU for kiddies). And thus far, I've really adored it. It totally appeals to the ICU-loving Med Student in me - what with all the cool acronyms like ARDS, RDS, TTN, PPHN, HFOV, etc, etc. Plus all the Attendings here? Love! Yay for 2 hours of one-on-one Chest X-Ray teaching today! So you will understand why it would be doubly horrible that this happened to me during this rotation, in front of these attendings.

The story from the beginning? Well I was a bit sleepy going in to work today. But no big deal I thought. I'm pretty much tired every day in clerkship. As we were doing hand-over this morning (essentially where the resident on call over night talks about all patient issues they encountered), I felt sort of hot. Strange considering as how the unit (and hospital) are normally freezing, ice-cold. Anyhow, we start doing our bed-side rounds and I continue feeling a bit sleepy. Not any more different from any other day though. As we get to the third patient, the Senior resident randomly assigns the patient to me and starts asking me how I would manage them. Again, not really an issue. I felt a bit put on the spot, but it's not like it was the first time I was pimped. I had been in much, much worse.

But then all of a sudden it started getting really, really hot. And then I started having cold sweats. Then things started to turn black and the resident's voice became all muffled and distant. And I thought to myself 'Oh crap, fight it, fight it, deep breath, deep breath!' Then the next thing I knew everything turned blurry and voices around me were saying

'Are you okay, are you okay? Help her down. Lie down. Get a wet towel!'

Yup. I had passed out. I had fainted on rounds and was now lying supine on the floor of MY PATIENT'S ROOM!

I heard people around me saying:

'Should we do a blood sugar? (no poking me please)'
'Did you eat breakfast today? (I did) '
'Get her some orange juice (they did).'

I came around pretty quickly after that (I was never actually fully out, more of an out-of-body experience).

So yes. I reverse face-planted (trendelenburg!) in front of the whole unit. It was like my first year nightmare come true. How mortifying. They probably thought it was because I couldn't take the pimpage. Sigh.


I always thought that if or when I passed out it would be under more romantic circumstances. For example, I would be standing and operating oh so heroically for a long marathon 14 hour surgery. And then I would finally collapse out of exhaustion as a hot resident (hot senior would fit the bill nicely) or attending (Dr. Vascular would do) would rescue me and carry me out as others around cheered & clapped at my bravery (and birds would sing, and little animals would join in 'tra-la-la-la-la'... hmm, probably have been watching too many Disney movies). Alas, reality is so much more mundane. I would never have guessed it would be during rounds. Much less in the ICU. Even much less on Peds.

Oh, the humiliation

Don't make me angry. You won't like me when I'm angry

12 weeks of surgery can really change a person. Like I said, spending all that time with the surgery residents had me slowing morphing into them. I began developing that surgeon attitude. You know the one. The swagger, the confidence, the cockiness. It's all about getting to the problem and fixing it (usually with a scalpel). Take no prisoners! So when I started to talk and act like them it became a bit weird. Because let's face it, all the people you're hanging out with are 1) guy and 2) guys who were surgeons. So there was a bit too much slapping me on the back (hard may I add), and making inappropriate comments. But there were times, when my new-found surgeon-esque confidence really came in handy.

I just came off of my General Surgery rotation 2 weeks ago. General Surgery is THE rotation during our surgery block. It's 4 weeks long, and you do a ton of stuff, and actually have a lot of responsibilities. One of the roles is to go down to the Emergency Department to consult and admit patients. It's fun. It's unpredictable. You never know who or what is waiting for you down there.

One night on call, I was paged to go see a patient with possible acute appendicitis. Easy-peasy I thought. By that point I had seen a ton of 'appys' so I was pretty comfortable with 'working one up.' Just had to ask the patient some questions, examine his belly and we would be good to go. Ah, if only every patient was so simple. You see, this patient - who we shall refer to as Mr. Stubborn, decided to make it a bit 'interesting' for me.

Stuff
Hi Sir, I'm Stuff the medical student on the Gen Surg team. They've ask us to come see you because they tell me you've been having some stomach pain?
Mr. Stubborn
Yes, the emerg docs tell me I have appendicitis and that I need an operation. They said SURGERY [stressing the word surgery] was coming down
Stuff
They told you that huh? Well I'm from the surgery team. But I do need to talk to you for a bit and do an exam before we know what exactly we're dealing with
Mr. Stubborn
[rolling his eyes]
Why? They told me I have appendicitis.
Stuff
[getting slightly irritated - it's way too late in the day for this]
I don't know what they told you exactly. But I really need to ask you some questions before we can do anything else.
Mr. Stubborn
[Like he's doing me a big favour]
Okay FINE. Just do it fast.
Stuff
[Trying to be nice]
Thank you

So I ask my questions. It's pretty clear at this point the guy has appendicitis, but I needed to do the physical exam in order to confirm.

Stuff
Okay Sir, now I need to have a feel of your stomach
Mr. Stubborn
[raising his voice]
What?! Why??! I already TOLD you that I have appendicitis. And that I need SURGERY.
Stuff
[getting very annoyed now]
Sir, I need to feel your ABDOMEN before we decide on anything. I have to confirm that this is appendicitis before we operate.
Mr. Stubborn
[starting to whine]
No! The other DOCTORS have already poked me enough. Plus it hurts too much. I want to see the SURGEONS already.
Stuff
Like I said I'm from the GENERAL SURGERY team, Sir.
Mr. Stubborn
You're not even a REAL doctor.
Stuff
[Oh no he didn't]
Look man, I'm the closest thing you've got right now to a surgeon. You want to get this treated? Well, turn around, stop whining and let me feel your stomach. The faster we do this, the faster you and I go to the OR. Got it?!
Mr. Stubborn
[meekly]
Yes ma'am

And that my friends is what 12 weeks of surgery does to nice girls.

Monkey See, Monkey Do

In clerkship, you rotate through lots of different services and specialties. You spend an insane amount of time with the residents on that service. It can be a stressful situation, and you really do need to work as a team in order for things to work well and efficiently. So I guess, it’s not a surprise and sort of expected that residents on the same service will share certain idiosyncrasies.

For example, during my 12 weeks on surgery, I noticed that many of the residents loved to use the word ‘perfect.’ No matter what the situation, they always used ‘perfect’:

Gen Surg Senior
Mr. X, have you pooped yet today?
Patient X
Oh yes, doctor
Gen Surg senior
Perfect

Hot Senior
[during morning rounds]
I’m going to take off the dressing now. It’s gonna hurt
[rips off bandages]
Patient
[Screams in pain]
Hot senior
Perfect

Hot senior
[in OR]
Stuff you’re going to suture up that wound okay?
Stuff
[After 20 extremely long minutes of suturing up a 5 cm wound, says triumphantly]
Finished!
Hot senior
Perfect!

Another observation? Surgeons walk fast. Really fast. And they always seem to be walking like they need to get somewhere very important. And when and if they actually go somewhere important, they seem to storm into a place like they own it. On one of my first days on Vascular, when I was basically being my other senior’s second shadow, we were going down somewhere – I don’t even remember it being that important, perhaps for a coffee run? Anyway, we were trying to get out of the elevator but it was super packed with people. I had to push my way out while he had already forged ahead. Partly owing to the fact that the guy had an unfair advantage in the leg length department (6 ft tall versus 5ft 4) it was not a surprise that he was quite a bit ahead of me. So I started to run after him, not wanting to be left behind. I guess he noticed me not glued to his side, so he turns to wait and sees my clumsy running. When I finally catch up, he gives me my first piece of surgery advice:

"Stuff, we always walk fast and we walk with purpose. We NEVER run, but we always walk fast. No matter what, got it?"

So what has happened to me after 12 weeks of surgery? I find myself now saying perfect in every possible situation no matter how irrelevant. And I walk fast. Really fast. Surgeon fast. And I do sort of storm into places (with purpose of course). And people always ask, 'Surgery?’ To which I answer confidently, 'Yup!' (except that doesn't quite work anymore seeing as I am on pediatrics).

I hope my pediatrics rotation cures me of these, because at his rate I'll be drinking my coffee black, and making inappropriate comments about everything and everyone, having somehow morphed into a male surgeon.