Breaks between surgical pathology

Hmm, what can I say to you lovely people that won't be boring and predictable?  More about life in a pathology residency?  Or more about life in a pathology residency if you're me?

My schedule since December has pretty much been to be on call every three weeks.  This overlaid February, which was one of the worst surg path months I've had to date, which also led to getting piled on by people nitpicking my after-hours work.

Don't be that guy, people.  If you know your colleague has been at the hospital for over 70 hours, don't be the jerk in the morning that goes "You didn't get my protaste marginnnns!!!' and certainly don't be the one that whines to the chief about it.

This kind of covers a spectrum too.  If you see anything that's clearly a result of a fatigued oversight (so long as it doesn't hurt the patient), like a lid not closed, or a sticker placed on the wrong thing, or an uncleaned scalpel where all the other instruments are clean, put on your big girl panties and just move on with your life.  If you find something particularly offensive, talk to the person who did it directly.  If they throw you tude and refuse to stop, THEN run and find someone to tattle to, but otherwise, just be a grown up.

Anyway, so the month of February generally sucked.  I also still find myself reading out late into the night where I feel like I should be getting better at all this, but on the plus side, my reports have been improving markedly, so I do have that.  The last week of read out, I was actually doing better, and I'm feeling at home with the ART specimens, since I've dealt with them three months so far this year.  Breast, bowels, lungs, got it.

Breasts are nebulous pathological creatures.  You can rarely call a "benign breast" because there's always something going on in them even if it isn't a scary something.  So you get good at recognizing all the little halmarks of proliferative fibrocystic change diseases, biopsy site reactions.  Your apocrine metaplasia, columnar cell change, florid ductal hyperplasia, usual ductal hyperplasia, etc ad infinitum.

Lungs are more simple.  The complication comes with how much the surgeon mangles it, and how many extra structures (heart, ribs, bowel wall) you unexpectedly get.

While dealing with this, we've also been dealing with our new system.  This was put in place in October in time for Halloween, because the best "trick" in "Trick or treat" is the one that never goes away.  Communications with the new system finally reached a new low when I was on a Friday call with things going on simultaneously at two hospitals, requiring me to pack up my remaining work and bring it over to the main hospital.  It was about this time that the new system quit and refused to print anything I needed.  I had started this week on Monday going "I'm not going to let call get to me this time.  I'm going to really try a positive attitude and remember that I love my job" and ended with my sobbing in front of this uncaring machine, begging for it to let me go home.

In other news, I'm off all that now, and get to spend three months pulling my self esteem back together before breaking it all over my June surgical pathology month at the main.  Right now is immunopathology, which means playing with electron micrograph images, actually learning to read flow cytometry, and playing with the immunostains that light everything up.  Kidneys are weird business, and a lot of immuno-relevant stuff happens to them.  The process of their transplant and removal is somewhat fascinating as well.  Jam them into the abdomen, leave the old ones in place, the whole nine yards.

What else... I traded call so I could go to Brewvival on a wet and miserable Saturday following the Friday where I broke down, so got to try a number of exquisitely well made (if overly barrel aged) beers while watching shirtless men mud wrestle.

This weekend, I get to go back (and freeze) in NYC to show a new friend how to correctly negotiate the hedonistic trends of the city.  I'm excited about it, though it'd be difficult to compete with my last trip there.  May will be Vegas and Mexico Beach, the first with new Boyfriend, the second as a re-crash course into sailing once the season begins.  Roommate and I are trying to learn to turn faster, though the weather is currently not cooperating with our attempts to do *anything*.

I'm learning the surgeons I like, the surgeons I don't like, and the surgeons I wouldn't let operate on a cat.  One who did not belong in the latter category came down one lovely call night as I was attempting to leave the hospital and said "If you get the right answer, we all get to go home", and damn did I like those odds.

I saw Skyfall in the way back (hooray James Bond!) and Django Unchained in the more recent.  I'd recommend the first to anyone.  I'd recommend the second to any Tarantino fans because it's a Tarantino movie.  It's like he signed every scene.

Now that the crushing holiday season and its fall out are over, I can get back to exercising.  Surgical pathology plus crappy weather plus call plus stress equals horrendous weight gain and fatigue.

I'm getting my doctor's appointments in (never do anything that relates to your own hospital; I am dealing with absolutely jaw dropping lack of concerns for HIPAA from hospital administration which has required me to run around my own department asking for favors), trust me.  Hoping for dentistry next month, since it has been an embarrassingly long time.

So everything's kind of in a holding pattern.  I'm leaning toward cytopathology now more for fellowship but time will tell, my second year is starting to wind down in a way that's terrifying since I don't feel smart enough to be an upper level in July, and I wonder if there's ever going to be a time where I don't feel afraid of my own finances or of my own knowledge.

To those of you entering the final countdown of the Match, I wish you good luck.  It will seem awful at times, and then hopefully, you'll have those moments when you regret nothing.