Friday, September 5, 2014

Caitlin's in...residency??


As a friend recently pointed out (hi Amanda!) the title of my blog is now wildly inaccurate. I am no longer in medical school. I have closed the door on that part of my life and am pretty securely settled into the three years that will be known as my residency years.

The last few months of medical school were kind of a blur. We were looking for a new apartment and packing for that move, planning a rapid-fire Europe trip, making graduation plans, and actually finishing my last few rotations.

Cardiology: The heart! So cool. Amazing organ. I got to see an ablation for atrial fibrillation which was super cool in the first 45 minutes and then interesting in concept, but super boring in execution for the next 4 hours. Over all in the rotation, what did I learn? Lots of medications and treatment plans, of course, but then also a general piece of advice from the cardiologist to a future family doctor: don't send someone to a cardiologist unless you want them to get a full cardiologist work-up.This sounds silly, but you'd be surprised with how many primary care physicians aren't really sure what will happen when they send their patients to a specialist. They're not just going to double check all the meds you have them on and send them out the door. They're going to get an EKG, an echocardiogram, a stress test if necessary and then completely change up the medication regimen you started the patient on. That's okay! They're the specialists, they know what they're doing - you should just be ready for that and warn your patients about it.

Neurology: A short rotation. Two weeks with a couple of neurologists, mostly seeing patients with MS (multiple sclerosis). Now there's an unfair disease. Unknown underlying cause, but a relatively simple disease process (the insulating covers over nerves in the brain and spinal cord are slowly destroyed causing nerve communication problems) that leads to an insanely wide range of symptoms. One patient has some balance issues and feels more steady using a cane when walking outside. The next patient is severely disabled and in a wheelchair. No cure, but some exciting new drugs being worked on. One notable patient rolled in one day on a segway! It's his normal, everyday mode of transportation. He uses the term "Stand-up Wheelchair" to be allowed into more places that usually wouldn't let a segway.

Trauma ICU: Crazy last rotation to have. Long hours, lots of insane traumas. Mostly broken heads and broken bones. No one in my family please ever ride motorcycles, okay? One guy with at least one bone broken in literally all 4 of his limbs. I got to set a severely displaced tibia fracture (lower leg bone) one day and got pretty good at doing a quick, emergency room level assessment for major and minor trauma when a person first comes in unconscious. I'm really fast at cutting people's pants off - probably my most valuable contribution as a med student. One of my favorite patients was a gentleman with healing head trauma who was always a day or two ahead of where we thought he was. By this I mean that he kept pulling things out of himself before we could decide to do it for him. He "extubated" himself (pulled his own breathing tube out), pulled out his IVs multiple times, pulled his own urinary catheter out, and (my personal favorite) pulled out the wires that were going through his skull to his brain, monitoring his intracranial pressure. Luckily, the neurosugeon was cool with that one - "Well, I guess we don't need to be monitoring his pressures anymore, do we?"

I had a week and half off after my last block and then it was down to Arizona for graduation!


We took pictures under this sign with every possible permutation of supporters

(in order) Dr., Dr., Mr. and Mrs. Karplus

My mom made this! Amazingly accurate portrayal.

This guy, though. Couldn't have done it without him.

So, the empty diploma holder looked and felt exactly like a relay baton
An impromptu support-whiteboard created at my impromptu graduation party. How could I have NOT succeeded with these awesome folks behind  me?

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