I love being a senior!!

Originally uploaded by horseballerina.

This absolutely makes up for all the long hours spent in a classroom or nose-planted into books. I got to cut this pony, explore its abdomen, play resident by quizzing my group-mates (they agreed that I’ll be a good resident , perform a small intestinal resection and anastomosis, and close him up. I even learned Dr. Freeman’s nifty sliding-knot trick and then got to teach it to Dr. Broome. Sherry closed the skin (beautifully!) and Linda happily ran anesthesia (no complications and never needed the respirator!). Melissa didn’t do anything, really. Especially set-up or clean-up! Oh well. I’m still on cloud 9. Makes up for the fact that we’re back in class now rather than on clinics which is where I’d always rather be!

Amy,Megan,Sara

Originally uploaded by horseballerina.
Bryan helped me to do this! I’m still trying to learn how to do it. Right now I’m able to post one picture at a time. Still trying to figure out how to get several in one post. In the meantime I’m going to put some more on Flickr .

One big question I have had about the whole Rood and Riddle thing is: can I in fact, as Troy put it, go four days without sleeping and still function? I hope he was exaggerating, but I know they work very hard for very long and don’t get much in the way of sleep at the busy times. And that, Mama, is one of the things that has kept me thinking maybe R&R is too much for me. Not because I don’t want it. But because it’s physically draining and emotionally exhausting. Nothing is all good, even a phenomenal hospital like that. So beyond how badly I want it, there is the Can I Cope factor.

This week I managed to accumulate nine inpatients, between being very lucky on my on-call nights and picking interesting cases that ended up staying in the hospital. Saturday I sent four home (yay!) then Saturday night/Sunday morning I acquired two new ones. I could have turfed them to someone else but I am notoriously stubborn about giving up cases. Plus, I thought, this is a good opportunity to see just how much I can handle.

Quite a lot, as it turns out. From Tuesday on I got minimal sleep and my patients seemed to multiply overnight. I learned that the clipboard is invaluable at a time like this. I learned that Diet Coke doesn’t contain nearly enough caffeine and sometimes I actually wish that I could stomach the thought of coffee. I learned that I can function on far less sleep than I ever would have thought possible. And I learned that you should really try to keep up with the paperwork. I spent the day today (I’m not on clinics this week) catching up on all the paperwork I’d gotten behind on this week. Mostly because every time I’d think “I’ll just do this and then sit down and do paperwork” Sarah would call me and ask me to help with something. Which made me feel good because she gave me a lot more responsibility than the typical student. However, it did bump the paperwork back. This reaffirms my aversion to paperwork and the need for my becoming rich and famous so I can have a secretary. Or at least an intern!

Anyway, the point is I found my limit and pushed past it. Then found my new limit. Which I think is pretty damn impressive. Even for R&R standards. All this plus excellent patient care and no mistakes. I CAN do this, even sleep-deprived. And I still love it.

Okay, fine. I’m not that bad, despite the fact that I’m often accused of causing trouble. But I do tend to leave a trail of confusion in my wake. For example, last spring I was on clinics for 2 months with the class of 2006. I have since been on my neverending road trip. I am now on clinics with the class of 2008 and am rebelling against the godawful standard issue polo shirts (I look like a bag lady AND they’re a shade of gray that looks perpetually dirty). Instead, I am wearing the cute polos that (gasp!) actually FIT me that Mama and I raided from Aeropostale (I look and feel sharp in these). Given the circumstances, it is perhaps not surprising that no less than four (and possibly five or six) technicians have asked me if I’m the new large animal intern. Never mind that that’s a nonexistent position at the vet school. I am feeling like Hot Stuff again because people think I am a doctor already. Except my friend Cathy, who, noting my butterfly logo for the 4th day in a row, asked me if I was the new Aeropostale model.

Also I have been trying to keep myself organized via the Rood and Riddle clipboard approach. Troy first suggested it, saying it helped him immensely during his internship. I kept thinking yes, if in fact I can keep up with it. Knowing me I’ll lose it in 2 seconds flat. Then I went to Kentucky. One of the interns lost his clipboard approximately 142 times a day. Yet it still helped him. This particular intern was also late to rounds routinely (not good since rounds consist of the clinician, the intern, and the technician) and had to wear suspenders over his scrubs to keep from flashing everyone when he bent over. You would think with the advent of drawstring pants this type of thing would not be necessary, yet there he was in his bright red suspenders. He was also told, routinely, that he was a colossal mess. He took it all in stride, partly because that’s his disposition and partly because it’s true. And I thought geez, if he can do it, I can certainly do it! So far I have and it is going very well.

Then there’s Dr. Sarah. She’s my resident this rotation, and she’s catching up to Aric for favorite resident status. I’ve often remarked, wistfully, that there will never be another Aric Adams. I still stand by that, but Sarah is phenomenal in her own right and gets better every day. She gets more done in less time than anyone I’ve ever seen, Aric included. In direct contrast to the last resident I was on with. With him, doing nothing still somehow took until at least 8pm. Every single night, for two weeks. She has given me hope that you don’t actually have to spend 24/7/3 years at the hospital during a surgical residency. You just have to organize and get things done. She has also given me a lot of insight into the Rood and Riddle internship, which she loved. And best of all, yesterday she glanced at my clipboard with its to-do list and little boxes to check off. She laughed as she told me You are SO on your way to becoming an intern!

So I look at her. And I look at Troy. Both of whom I admire immensely, although they are quite a few years apart along their career paths. I wonder just what it takes to make it at Rood and Riddle, and whether I have it. I try to, as Troy suggested, take a good long look in the mirror and ask myself what I really want. I’m not 100% sure, and I may never be. I do know that I am getting it together, little by little, one day at a time. So maybe in 10 months I will be ready for R&R.

But here’s the real question. Are THEY ready for ME?

Since my return to “real life”, my head has been spinning. Prepared to dislike Rood and Riddle, or at most have a good week seeing interesting cases, I was thoroughly unprepared for what happened on my drive home. I realized, driving and chatting with friends and family, that somewhere I had crossed the line from having a good extern experience to truly wanting to learn more from this incredible place. I’m still not sure when exactly it dawned on me.

When I left the girls on the lawn outside the house, we all hugged good-bye and they tried one last time to convince me to stay another week. I needed little convincing. But I was quite sure that Bethany, the angel who cares for my farm while I am gone, would cease her cherubic ways and possibly even sprout horns if I asked her to feed even one more day. I knew I would miss them terribly.

But when Cameron hugged me goodbye and instructed me to “go get my degree and come back up here”, I laughed and told him I didn’t think I could handle the internship. Somewhere on that 10-hour drive, imperceptibly, something shifted. Maybe I realized that I was selling both myself and the practice short. That we both have something invaluable to offer each other, something neither of us is likely to find elsewhere.

My preconceived notion was that in a practice that big I would never find the mentorship and willingness to teach that I had found in smaller practices. In a way I was right. I found instead a surgeon whose sarcasm and penchant for bursting into song made me look like a wallflower. Another who somehow works up a million lamenesses a day, but still takes the time to explain everything he’s doing and answer questions. Yet another who appreciates hard work and sharp intellect and who has no patience for the self-serving suckups who come out of the woodwork wherever he goes. An anesthesiologist who I first thought was an intern due to her youthful enthusiasm – until her permanent smile eventually tipped me off. She never looked stressed. I met an internist happy to share both his knowledge and his amazement at a pleuropneumonia so congested that her lung sounds sounded more like gut. And several phenomenal technicians doing their best to keep both their world-class doctors and their frightened new interns in line.

Mostly though, I keep coming back to the patients. Regal Chime, whose claim to fame was that she had sustained “the same injury as Barbaro”. She won my heart for entirely different reasons. She looks an awful lot like Maverick. And when she decided that she had no desire to walk with her cast, she threw every maneuver in her arsenal at the frustrated technicians, whose job was to get her to use all 4 legs. They would lead her up and down the barn aisle, and she would hop, skip, pivot, anything to avoid planting and stepping. Eventually they resorted to leading her around the outside of the barn, stopping occasionally for bites of fresh green grass. They were aggravated. I couldn’t help but admire her artfulness as she forcibly reminded me of another crafty bay thoroughbred.  

Sympatica, “Tica” to those who loved her, was a stately gray mare who had somehow managed to smash most of the bones in her knee. A valiant effort was made to save her – in vain, as it turned out. We all loved her for her sweet nature, soft eyes, and neverending enthusiasm for carrots and peppermints. Real peppermints. She turned up her delicate nose at the peppermint-flavored treats, regardless of the love with which they were offered. She actually looked offended that anyone would suggest her eating such a thing. Her death was a poignant reminder that even the most skilled surgeon cannot save every patient.

I knew and loved both of these girls. But the memories that surface most often are of Zebra ‘06 and Piper ‘06. Fractures of the femur are a fatal lesion in horses. The two that I saw had youth on their side – less weight to bear, and less muscle mass to dissect down through to reach the broken ends of bone. They also had access to a surgeon willing to try. I don’t know exactly how many would attempt to repair these fractures but it’s somewhere between not many and very few. In less than a week I saw two. They have a long way to go still, and complications can occur far down the road. But they were afforded a chance – a gift that very few surgeons could give them.

So, here I am. Spending an awful lot of time thinking about just how much I would like to see all the cases that walk through those doors in the span of a year. Wondering if I can forego sleep for days on end to do so. Talking to anyone who will listen about what I saw there, how they did things, how much I liked it. Shifting ever more from maybe-I’d-like-it to damn-I-really-WANT-it.

Trying to talk myself out of even visiting, I told Wendy that I didn’t want to have to fight to distinguish myself among 10 other interns. She said it’s because I don’t want to be famous - I want to be good. She was almost right. I want to be more than good. And I think that maybe Lexington would give me the best chance to be exceptional. Which is what I REALLY want.