Jul 1, 2012

I no longer have my "intern" excuse

For I now rank among the second year residents.

This is a bit of a mixed bag.  I don't feel completely "NO MORE INTERN YEAR!!!" because we're relatively unabused pathology residents and I've been on clinical pathology rotations for the past few months so I've been particularly unabused.

We had a couple parties today: one a path party at one of our seniors' houses to celebrate the new residents/fellows and say bye to the remaining ones, and the other was the same awesome mixer at the marina, which we showed up at the end.  We made friends with two fellow SGU grads (one med; one vet) and upon leaving they were like "You're path people!  Why are you bailing at 9 PM?" and we had to very honestly say "We have to get up early tomorrow.  We're going sailing."

Yeah.  Hard times.

Because of the ACGME (residency police) regulations set in place last year, first year pathology residents don't tend to take any call.  Essentially, they made it so that newbies would no longer work 24 hour shifts, which is critical when you're a surgery resident trying to not develop a meth habit, but less critical when your call consists of going home and maybe answering your phone a few times.  What does this mean?  It means welcome to taking call, mofo.  I drew the straw of being the first resident on Anatomic Pathology call this year, so Monday to Monday, I'm the late night frozen section and weekend/4th of July autopsy girl.  It's mildly intimidating, but we have a decent support network.  I will at this point reiterate the advice of "try to avoid going to teaching hospitals as a patient the first week of July".

I will be back on autopsy next month, which critically means getting to wear nice breezy scrubs instead of people clothes during the 100 degree month, which, hooray.

Last few weeks... hmm... due to Step 3 and my Journal Club and my CP talk melting my brain, I had forgotten that as part of my last month's rotation in molecular pathology, I had to give a talk at what they call the Big Meeting.

So about ten days before that, our attending mentions it offhand, and I'm like "Uh oh", and casually ask him to *remind* me how long this thing is supposed to be.  Apparently like 20 minutes.  The two talks a year that we spend weeks preparing for is 30 minutes.  I spend 8 hours at the hospital over 5 minutes.  So I'm like "No problem!  (AHHH)"

A short time after that, at our afternoon meeting about Extremely Difficult Things, he's like "Oh, apparently I have to go to a meeting at 5 to discuss a new machine with the heme onc docs.  Wanna come?" and I'm like "N... sure!" because I am spineless enough to barely qualify as a vertebrate.

This impromptu meeting turned out to be incredibly cool.  It was all new technology-esque with abilities to sequence hundreds of genes for the same cost as five, and then they were getting into interpretation and marketing and it was all very Future of Medicine like and I got super excited about it.  Unfortunately for me.

I expressed my enthusiasm to my attending and he thought it was great and suggested I present it as my topic at the Big Meeting since the techs would love getting a look at a machine that might be implemented over the next year or so.  I wholeheartedly agreed.  Heck, half the work had been done for me and it all seemed really cool anyway.

Holy crap.  This stuff is HARD.  The difference between briefly explaining the implications of a new technology to doctors that don't work with it and explaining how the machine that uses it works when you don't even know is just wow...

Even the company website was taunting me.  "It's simple!  It works just like any other microchip!"

OH DOES IT REALLY?  Dude, I still think my iPhone runs on elf blood.

Wikipedia took an absolute beating.  "The technology uses next generation PCR".  (sigh)  Wiki.  "next generation PCR."  (sigh)  Wiki "DNA beads".  Wiki "Emulsion PCR"  Wiki. "PCR".  Wiki "DNA Sequencing".  Wiki "DNA".

"The DNA beads are then loaded onto the chip, which is made out of a silicon boule."

(sigh)  Wiki.  "Boule".

The whole thing gradually built into this mental house of cards on which my entire understanding of this technology rested.  I was thinking so hard that I felt like I was working out.  When roommate's boyfriend came home, I was squint-glaring at my computer screen and wouldn't greet him because I was afraid the fragile base of my knowledge would crumble into dust if I deviated my glance for a second.

So the presentation comes, and I was told the meeting was very casual and no big deal, which is what is colloquially referred to as a complete lie.  Fellow resident and I actually showed up at the wrong conference room because we thought it would be our three attendings and a couple lab people and some sandwiches, and everyone would probably be eating and doze.

Wrong.  We end up at our morning conference room, and it is *packed*.  We don't have that many people for the real morning conference.  I've met about half the people.  It ranges from the general techs, that do sciencey stuff all day long and work with the type of machines I'm about to try to explain to different types of techs to doctors to god knows who.  There's also some PhDs thrown in for fun.  Ya know, those people that were learning this subject specifically and writing papers on it while I was screwing up IVs and taking blood pressure.  I mentioned very recently that I don't tend to get stage fright for this stuff, and this proved a notable exception.  This was more like that dream where you have to take a calculus exam in your underpants.

I was in such a hurry to unload the giant ball of painful information in my head that I even forgot to introduce myself.  Possibly as an unconscious defense mechanism in case I screwed up.

It actually went really well.  In jamming the data into my limited capacity to understand it, I had inadvertently created a presentation that was apparently easy to follow while getting deep into the subject since it was the only way I could create a presentation on it in the first place.

I would say this taught me an important lesson about how to do this in the future and how to pick topics that I find extremely challenging, but hell no.  Brain drain.

So happy July to all of you, and congratulations to all my fellow travelers at your various stages of progress.  May your powerpoints never crash.


Anonymous said...

Hi Ishie- good to see the old Ishie back. You have come a long way from the days of wanting to resign from the program. Congratulations! Can you help me?I am 4th year SGU student preparing for step 2 ck. I have read on how you prepared -I have one more week left to prepare and of course I am panicking. Did you read master the boards or did you mainly do the questions?


Ishie said...

Ah yes, dark days. Nothing like feeling really good and stupid at the beginning of a residency.

I mostly just did questions for CK but I was in a weird mental place so felt "studied" enough and moved up the test. If you're super panicking, you can take one of the NBME exams just to confirm a decent passing score to give you some confidence (or a reality check) before the big day. I had finished the UWorld QBank by the last week, so I focused on starting to redo the incorrect labeled questions. That helped cement some problem areas. Good luck and thanks for reading!