Third Year

Today I finished the fifth week of my third year. I can't believe how fast the time is going! Third year is so different from and so much better than the first two years. The first two years are kind of starting to feel like a distant memory to me (I think the therapy is helping).

Anyway, here are a few observations/thoughts/ramblings about my first 5 weeks:

Nursing home - Everyone....EVERYONE is on antidepressants. Living in a nursing home + hypertension + diabetes + stroke + parkinsons + memory loss + incontinence = sad people. Why not hand out a few happy pills? Oh, and the nurses seem to be less than thrilled to help med students with.....anything.

VA wound clinic - Lots of wounds. Venous stasis wounds, diabetic foot ulcers, gun shot wounds (I'm so street). There are a lot of people here who just don't take great care of themselves. If your sugars are out of control, you're not taking your lasix, you're not trying to lose weight, well, your wound just might hang around for a while. Interesting fact: nicely healing venous stasis ulcers look a lot like ahi tuna. Yum!

Hospice House - It's amazing how the body can tell you when death is knocking.

Pulmonary clinic - "Pickwickian Syndrome" essentially a fancy way to say, "Hey buddy, you're too fat to breathe!" If your BMI is, oh say, 106, then you might fall into this category.
Favorite moment from pulm: GI/hepatology attending walks up to fellow med student, asks if he's a med student, then preceedes to steal his stethoscope. I wish he had asked me for mine....it's pink :)

Rheumatology - They are trying to KILL me. Most clinics have regular hours, even get done early some days. Not so in rheumatology. The last patient is usually scheduled at 3:30 or 4:00. We're lucky if we get to them by 6:00. That's right! We're horrible people who love to make you sit in a little room and WAIT! Haaaaaaa! Suckers!!!!! Totally kidding. If we don't see you untill 6:00, we don't get to go home until 6:45.

Also slightly frustrating because the attending expects me to know everything he knows about his patients who he's been following for 15 years. Seriously???? I've got 20 minutes to see a patient and read through the novel (sometimes 2 volumes) that is the patient's chart. Difficult. Maddening. I don't like novels, or books in general for that matter. I don't like to read. Here's a fun fact - the smarties that assess USMLE practice tests thought that I might have an undiagnosed reading issue. Does anyone have the phone number for one of those Sylvan learning centers?

General Med - You see a lot of everything here. I saw some nasty feet today. For a split second I kind of thought I might throw up. The toenails were a lovely shade of yellow and appeared to be growing in thickness instead of in length. There was some funky stuff all up under the nails too. Then there was a nice, thick layer of dead, calloused skin covering both heels which the patient claimed underwent shaving on occasion. Oh, and they smelled rather badly. I went to put the patients socks back on, and the afore mentioned toenails snagged on the socks like fingernails on a chalk board . Man....I sure am concerned about those diabetic foot ulcers. Look how much I CARE!!!!

Okay, I'm going to go wash my hands now, again, for the 500th time since the foot incident.

I'm back.

One more observation: There are sneaky little 4th years, posing as third years whose only purpose in life is to make me look dumb. These 4th years, for whatever reason, have a third year clinical rotation that they have yet to complete. This may be because they've taken time off, decided to push their boards back, or they may have failed a rotation....or boards. Unfortunately the attendings assume that we're all at the same point in our education, but in reality these 4th years have a whole year of clinical experience on us. So they know the tricks....they know how to give a good presentation. They flaunt their skillz but keep mum about their fourth year status. I may have to blow their cover.