pants!

Yeah, it's overwhelming
But what else can we do?
Get jobs at offices and wake up for the morning commute
-Time to Pretend, MGMT

It snowed here pretty heavily last night. I enjoyed the crunch beneath my feet as I made my way back and forth to the hospital at all hours of the night. I try to concentrate on small pleasures during those times or it's easy to start disliking the state of affairs.

We've started playing on an indoor soccer team with some colleagues and friends. It sure is nice to meet some people who aren't doctors, nurses or patients. When you're married to a doctor, your best friends are doctors and you find yourself working 80 hour work weeks, it can be a little overwhelming. I find people who are not doctors or patients very interesting as a rule. Patients are cool sometimes but the way they are always telling you about their problems and expecting to be cared for appropriately often gets in the way of enjoying getting to know them.

I just started watching the TV show, Mad Men. That's a good show. I haven't been sucked into a TV program like that since Sopranos. While watching the Sopranos, I learned Italian swear words and a variety of ways of making money illegally. From watching Mad Men, I've learned that rich Anglo-Saxon men used to have alot of fun smoking, drinking, sexually harassing women and not feeling guilty about it.

Time for bed. Haven't had a chance to put snow tires on our car yet. Luckily our commute is a 3-block walk.

Goodnight.

rico's rubbermaid roughnecks

Dr Julian Bashir: So what do you want me to do?
Dr. Zimmerman: Just stand there and look like a doctor- if you can
-Doctor Bashir, I Presume?, Deep Space Nine

I'm currently on my last 12 hours or so of a 72 hour stint of call for pediatrics. It has been busy at times, but overall quite reasonable. Our house is just 3 blocks from the hospital, and peds is home-call, so it's really not so bad.

I've been loving residency so far, and am very happy about our choice to train in Prince George. In short, it's great to be in a small town again, and it's great to be working in a smaller hospital for residency. It's amazing how much more fun work can be when you aren't constantly having to learn in a place where everyone is annoyed with you as a default condition.

Since I've started, other than thinking a lot about how rusty I am, and how much I have to learn, I've been considering how to make myself seem more like a doctor, and in general how people identify doctors in the hospital. The first patient I saw as a doctor just stared at me after I introduced myself and exclaimed "How OLD are you?"

Nowadays, almost everyone wears scrubs, and it's often impossible to figure out what roles people play in the hospital. Courtney saw one of the family doctors that works in the office a few days ago and called out- "Hey, you must be Bill!", as she thought he was one of the IT support people.

I'll save a discussion on the merits of using titles and dress to decide how much deference to use with someone for another time.

For now, I will just make a list of ways to make yourself seem more like a doctor.

1. Call yourself Doctor. I find I still introduce myself by my first name, but if the situation warrants it, I now say that I am "one of the resident doctors working tonight". I think this adequately explains that I am in fact a doctor, but still training.

2. Wear a white lab coat. Unfortunately, this is not done on pediatrics rotation so I am unable to use this obvious boost to my ward cred.

3. Wear a stethoscope. Many people in a hospital wear a stethoscope, however, if you asked the average person to list 3 words when you show them a picture of a stethoscope, I would guess "doctor" would come up before "respiratory technician".

4. Be an (old) man. Despite the fact that medical school enrollments have typically had more females than males for quite a while, there are still more men in medicine. This will change soon however. Someone recently told me that in a few years, there will be more female doctors in Canada than male.

5. Wear a collared shirt. If you've hit some of the other criteria, this is not always necessary, but tends to be one of the most reliable indicators of whether someone you are meeting is a doctor or not. Add a tie and you are gold.

6. Look disheveled. Especially while on call. This may not get you any respect from the people you are working with, but typically the more unshaven and haggard, the better.

7. Discuss physiology. Combine one organ and one hormone in a sentence and this tends to impress people.

8. Drink coffee. Making a joke about maintaining your serum levels of caffeine "in the therapeutic window" gets you extra points.

Last night, as I was leaving the hospital in scrubs and carrying a skateboard at 0400hrs, I overheard a woman in early labour who was pacing the halls remark....

"Hey, that doctor rides a skateboard"

So I must be doing something right.

uptight secretary working for large bureaucracy

The very first step to success in any occupation is to become interested in it
-William Osler

I realized today that I'm graduating soon. As much as I try to pay attention, I'm guilty of cruising around on autopilot most of the time. So tonight, while in the process of compiling the necessary paperwork to write my MCCQE Step 1 Qualifying Exam and cursing all the busy work of getting my application together to write the exam, I thought about how I'm pretty close to finishing my time as a student. I know the busy work and the applications won't end when I get my degree, and that being a resident still counts as being a learner (and thank goodness for that), but I'm ready to move on.

It's a relatively common for doctors to have a fair amount of self-pity. I remember when I was getting wheeled into the OR for my ACL repair while I was still a medical school hopeful, the anaesthesiologist quiped about my interest in medicine (which my father had let him know about), asking me if I was sure there wasn't still time to switch to dentistry, or something where I wouldn't have to work as hard and could make a decent living. I have to admit that I've been guilty of the same sort of comments. My old housemate Trevor, who is my age, is currently in the application process for medical school. I'm confident he would make a great doctor, but find myself sarcastically warning him off the medical path. As he told me how an experience ski patrolling made him really excited about the possibility of one day being an ER physician, I started asking him if he'd thought about being a paramedic.

Because I'm prone to this sort of behaviour anyhow, and the culture I'm a part of reinfroces it, I have to snap myself out of my aforementioned auto-pilot-like-state and think about where I am. So the exam application made me do that tonight, and now flipping from self-pity to self-aggrandizing, I'm still pretty stoked about medicine. I still like seeing patients, I still feel like I'm doing something worthwhile and I'm excited about the next stage of my training.

There's lots ahead of me still before I graduate, including a cross-country interview tour, a 2-day OSCE and the MCCQE, thrown in with 3 more clinical electives, but they'll be out of the way soon enough, and I'll be moving somewhere on July 1st to start the next part.