Point

And again, I point you to this week’s Pediatric Grand Rounds. There’s a great series on vaccines mentioned there, if you’re into that sort of thing (and I know you are).

Squeak

Now up: this week’s Grand Rounds, into which I’ve again managed to squeak. This week: bloggers’ best-of.

True meaning of Christmas

I’m an M.O.T., so for me, Christmas, meh. It’s just kind of another day. I’m neither especially cranky about having to work nights through the holiday, nor is my heart filled with the dazzling light of yuletide joy.

But last night, a colleague reminded me of something that brought home the true meaning of Christmas: today, I am exactly halfway through my intern year.

Hallelujah!

We even had our own Christmas miracle: we got a kid with a huge neuroblastoma in his liver down to the CT scanner at 2 a.m….and he wasn’t bleeding into the tumor. (The real miracle is the first part.)

Huzzah! I shall celebrate by sleeping through the better part of daytime without showering first.

Home on paper

Yesterday, I discharged 5 patients from the hospital. Today, I feel dead inside.

For patients, hospital discharge is a happy moment. Leaving the hospital means leaving behind the unflattering gown, the interrupted sleep, the food that does not resemble itself, and the constant parade of people poking and sticking and looking at your business. Most inpatients eagerly anticipate discharge from the moment they are admitted.

For residents, hospital discharges are a little different. Patients leaving the hospital require instructions, follow-up appointments, outpatient testing, prescriptions, and sometimes, home care services. Their health care providers–all of them–require detailed information about their hospital course and about the plans for their medical follow-up. In my hospital, the responsibility for choreographing this administrative hoo-ha falls directly on the residents, and mostly on the interns.

Deep inside, in the part of me that is not an intern, I am happy for patients when they get to leave the hospital. But the rest of me–especially the part that operates computers and makes phone calls–seethes. Yesterday, after spending hours navigating a web of bitchy clinic receptionists and printing, then reprinting, this time on the right paper and on the right printer, I came to an unpleasant realization: I had spent more time discharging these patients than I had cumulatively spent face-to-face with all of them during their hospitalizations.

In theory, it is my job to treat people’s illnesses in order to get them medically ready for discharge. But yesterday, I spent so much time doing paperwork that I wasn’t able to think about or really, take care of, any of my patients who were still in the hospital. Getting patients home on paper left me no time to get patients well enough to go home in body. 

There is a light. Someday, when I am an upper level resident, I will ask my interns how their discharges are coming along. Oh, they will say, we are beginning to feel dead inside. And from my perch at a patient’s bedside, where we are together reviewing the nature of their disease process and the elements of their management, I will say, Let me help you with that. Which printer are you using?

But enough about me

Most of you know I’m not the only one writing about the medical profession out here in the blogosphere. This week, I’m honored to be in the company of many excellent medical bloggers at two weekly, appropriately named anthologies: Grand Rounds and Pediatric Grand Rounds. Please have a visit and view the greatness that surrounds me!

I also made it into WordPress.com’s A-Blog-A-Day column the other day. They called me “interesting,” which, as I recall, is fairly synonymous with “not interesting.” Whatever. It’s exposure.

But enough about me: anyone with an interest in verse should get their hands on this newly published poetry anthology called Body Language. The poems are written by and about the medical profession, and the few entries I have read so far are complicated and beautiful in the best of ways.

Now back to our irregularly scheduled programming.