Sunday, October 25, 2015

Nights

It's currently 2 am and I'm writing this post from the hospital. While at work.
Best thing about nights: sunsets in the res room

A big reason I haven't been updating as frequently of late is that I've been on a nocturnal schedule for so long. Ever since I started residency, almost half of my time working has been at night. The shifts vary, from 5 pm - 7 am or 11 pm to 7 am, but that still means that out of the past 12 weeks, I have spent 7 weeks living on the complete opposite schedule as the rest of the world.

My rotations have ranged from admitting (where you just admit patients from 8 pm to 7 am) to ED shifts at night to covering the ICU at night. Don't get me wrong, the work is not particularly hard. The pace is lighter on nights. Patients don't tend to come in unless they're really sick. Or in need of a bed for the night.

But no matter what the work is, I've come to dread nights the most. I'm lucky that I have no trouble sleeping during the day (in fact, one of my talents is being able to sleep anytime, anywhere) but I still feel shitty sleeping away the whole day while normal people go about their lives. While it's nice to have random weekdays off, I still have the prospect of working a full night looming ahead of me. And then I have to go into work at night when everyone else is coming home for dinner, watching TV, and relaxing.

Right now, I'm on "cross-cover," which means that all the internal medicine teams "sign-out" their patients to me at 5 pm, and I cover their patients from 5 pm to 7 am. Yes, this means I'm the only doctor taking care of these patient overnight (Don't worry, there is backup). But depending on the census of the different teams, I am the first call for up to 100 patients. Most of the time, it is just answering pages about their diet or prescribing cough medicine, but I usually have to take care of at least one real medical problem a night. One night, I had a heart attack, stroke, seizure, and sepsis all under my watch. Needless to say, I didn't sleep that night.

I'm counting down the number of nights I have left and then only one more night block this year in December. One good thing about being front loaded with nights is that I'll be on days until June, when my second year starts. One more block until I join the land of the living!

Thursday, October 22, 2015

Golden Gate

One of the worst kept secrets of San Francisco is that the best view of the Golden Gate Bridge is on the other side of the Bay. Taking advantage of having a few random weekdays off, I recruited a few of my friends to chase the sunset with me in the Marin Headlands. I live a mere minutes from the Golden Gate bridge and jog by it frequently, but I don't have a car so never get to make the actual crossing. Today, a friend volunteered and we piled in his car like high schoolers eager to go for a drive.
I think it was all of our first times up in the Marin headlands, so we were all amazed at this iconic view, just 15 minutes from my house. 

CPMC residency photo

Our only ok one where we were all looking, eyes open, and the bridge was in view after asking 3 different people 

 
 Golden hour portraits




We then drove further up into the mountains and came out above the clouds to get this view of these cotton candy skies.

As my friend said, this view of Karl the Fog rolling in over the city was "hecka" cool. 

After sunset, we drove to Sausalito for a hearty Mexican dinner (as our measly resident salary couldn't afford a seafood dinner) for some much needed destressing and venting. What I've learned in the past few grueling months of residency is that you just have to go on living your life and go out, do something, whenever you can--you can't wait until just "after ICU" or "after medicine," or else you'll never find a reason. 

Last weekend, a group of us went out for a resident's birthday. There, we all remarked about how great of a time we were having, but how tired we were. I had just come off of working an overnight shift, napping for 3 hours, and then going straight to an all day conference and presenting my research, then a 3-course dinner, then out to a bar. I was tired. But I remarked how if it were all up to us, we would all be in bed by 10. But since we were having a good time, we have to constantly push ourselves to be social and enjoy each other's company. Some of my most memorable nights out have been when I've had to work the next day. It's worth it.