Month one, down

Lessons learned from my first month of hospital service--very stream of consciousness and also call-centric given that I am now post call.

1.  Hospital air (especially elevators) is super greasy and hell on my complexion.  I don't care how weird it feels, I am taking a shower on overnight call.  Ugh.

2.  Overnight call is hell on my dark eye circles and my ability to avoid the side effects of caffeine.  But when done right (I know I will disagree with this at some point, probably very soon), it is pretty freaking fun.

3.  Things to pack for overnight call:
toothbrush
toothpaste
shampoo
soap
(towel provided by hospital)
phone charger
sense of adventure
courage
curiosity
liquid caffeine
snacks
reading material

4.  I have reason to be confident!  I stumbled around this whole month never really knowing what to expect and generally feeling wholly inadequate.  Of course, every attending and every rotation is way way different, and I am pretty much wholly inadequate to practice medicine at this point, but there is hope. :)  My evaluations (the subjective part I was most most nervous about) came back very positive, as good as I really could have hoped for, and still (following the trend in my life) much better than I feel like I deserve.  I think this will give me the confidence I need to move forward and say, good gracious I have a lot to learn, but gosh darnit I do know part of this sometimes.  I'm sure that sounds like a very mediocre statement, but I feel like it is a giant leap ahead from the knot of anxiety that was my first month of orientation to life outside the classroom.

5.  After a while, giving rectal exams is still awkward, but it loses its awkward novelty.

6.  Thank God for approachable patients/interns/residents/attendings/nurses/custodial staff.  Every single person in that freaking hospital is a part of making me a better person.

7. Despite my upgraded aggressiveness from pre-debate days, I need to be more aggressive.  This is sort of tied up with taking personal responsibility for the patient and not depending on the resident or the EMR protocol or the consult team or even the nurses to do my job.  Obviously I can't and shouldn't do everything, but as the doctor the ultimate responsibility for whether or not something happens for a patient falls on me.  So I've got to step it up and follow through and do my least favorite thing to do and politely harass the appropriate people or do the work myself when something needs to be done (wow what a run-on!).

8. Medical ethics is so much more interesting and so much more difficult to get right in real patients than in classes.  That goes for medicine too.

9. Plan fun evenings for the day before your day off, not the day of, so you can sleep in.

That's it for now, but a lot better outlook than the last note I think!