This week I got the excellent news that I passed my oral boards for anesthesiology! Yes, now I will finally quit whining about studying and being nervous… And eventually I will stop telling everyone that I passed, as well. Not only that, but I will never really talk about exams ever again because I am finally done. Really done. I’m done with all medical training and exams and now I am entering the nebulous era that will be my career in medicine. I can’t believe this period of my life has finally arrived. It has made me rather nostalgic, and I’ve been reflecting on my 9 years in medical school and residency training. So today I have some memories to share. This is just a smattering of memories, there is so much more… More that probably isn’t appropriate to tell. It’s going to be quasi stream of consciousness, so bear with me…
1. Medical school hyperchondria.
There is a well known phase wherein medical students, blasted with new knowledge of the human body and the infinite number of pathological processes, begin to fear and diagnose any and every process in their selves (and innocent people on the street). I remember coming home to find my roommate sobbing, convinced she had lymphoma.
2. Anatomy class.
AKA “Are you cool with cutting people?” class. This was a trip, and the one class that is done some justice by movies and television. We were in groups, 4 or 5 people per body, and we would come in every day and do dissections according to our course book. There were also tanks of isolated parts (i.e. a tank of heads). People ran out crying on the day we did face dissection. I had a headlamp and real surgical tools that my Dad had given me from his office, just a slight hint that he was excited for me to become a surgeon. Yes, my tank mates made me do everything. Yes, I have sawed a body in half. Please still like me. One thing that isn’t always shown on TV and movies: Everyone was extremely respectful and reverent. No, we did not name anyone. There was a service for the families of the donors. Doing cadaver dissection actually felt like one of the biggest honors I have ever had and one of the hugest gifts I have ever received.
3. The Autopsy
In medical school, we had to “take call” to see an autopsy. When the morgue got a body, your group would be called when it was your turn. Your group then had to go down to the hospital morgue and watch a full autopsy. My group got called on Halloween and I’m not even kidding when I tell you that the assistant in the morgue who showed us the body and gave us an orientation WAS IN COSTUME. AS A SLUTTY COWGIRL.
4. My First Incision
I had tunnel vision for becoming a surgeon from day one. My first day on my surgical rotation, I was with this awesome endocrine surgeon who let me make the incision. I have never wanted to be better at anything in my life. It was so cool. As I put the knife to skin, The White Stripes ‘Seven Nation Army’ was playing. I felt awesome.
5. Living with My Bestie Awesome Roommate
My fondest memories of living with her during medical school were our nights drinking cheap champagne, ordering Thai food, watching movies, and knitting. The best of these nights? Watching The Notebook and sobbing our faces off, trying to convince each other that the old woman just had temporary memory loss from dehydration or a urinary tract infection.
6. Driving to San Francisco with My Dad
Crossing the Bay Bridge after the drive from Wisconsin into my new city? Amazing. I had never lived further than 3 miles from my parents.
7. My First Weeks as an Intern
I can hardly remember, I was so traumatized. It was so hard. I had nightmares all the time about patients. I remember getting calls about patients spiking temperatures and just freaking out about what to do. I was called to the ICU on my third day as an intern to draw blood from a patient… as if I could get it when the extremely experienced nurses couldn’t! I would round at 4 am to make sure I got all of the information I needed for rounds. It was so overwhelming. I couldn’t believe how many times a pager could go off – on Vascular surgery, about 98 times in one day! I don’t know how we did it. This isn’t even scratching the surface of the experience… But like I said, it’s hard for me even to remember.
8. My Rotation in Oral Surgery
The County Hospital. Patients everywhere screaming in pain with tooth infections. Three interns set loose to just inject numbing medicine and pull teeth with barely any instruction. I don’t know how I made it through that month. I was so terrified of getting bit, hit or inoculated with hepatitis. Don’t even get me started on going up to the mental ward to examine a tooth… No one should ever hear that story.
9. My Saddest Birthday
When I turned 28, I was scrubbing for a case with the Chief Resident. It felt weird just keeping my birthday to myself, no one knew. So to make conversation I awkwardly said “Um, so it’s my birthday,” while we scrubbed. He basically just said “Huh, oh.” Later on he brought a plastic surgery journal to my call room, and said, “Hey, I got two this month. So happy birthday”.
10. The County ER
This could be an entire book. I have so much love for San Francisco General Hospital, I might have to learn how to sing and write music so I can make a love ballad about it. The ER there was pretty wild. One time I put a staple in someone’s stabbed heart as we rushed them up to the OR. My heroes work at that hospital.
11. People Actually Play That Hand/Knife Game From Aliens
I spent Christmas Eve sewing up 5 drunk guys hands in the ER my second year of residency. They had been drinking and playing this game where you stab a knife really quickly between the spaces of your fingers with your hand flat on the table. I remembered it from Aliens. One guy was throwing up in a bucket the whole time I washed out his hand and closed it up. I guess that was a sad Christmas… But I thought it was pretty fun!
12. Getting Yelled At
I remember holding the phone away from my ear as the Vascular Surgery fellow screamed at me with multiple expletives NSFHG because I hadn’t gotten consent from a Russian-speaking patient for surgery. I was waiting for a Russian interpreter, because that is the right thing to do, but he was pissed I didn’t just make the patient sign the consent. Or maybe he was mad that I didn’t speak Russian. Anyway.
13. That One Patient
We all love caring for our patients, but every once in a while there is one that really gets to you. I had a lovely patient as a surgical resident. Her smile lit up the room and she had the most positive outlook. She died suddenly on the ward after a successful surgery. We tried to resuscitate her for what felt like hours, I was left crying in her room alone. The autopsy was not conclusive. I still think about her all the time, I still miss her.
14. Carrying a Finger
We were going to do a replant of a patients amputated finger and as an eager surgical intern, I was given the honored duty of getting the finger to the OR while the more senior resident took care of the patient. It’s sort of like being a ring bearer.
15. Switching to Anesthesia!!!
I made lots of friends who were anesthesia residents and I talked to a lot of anesthesia attendings. They were so cool and their job so amazing. Never had I thought of it… I was gung ho surgery, but then I started thinking. After much investigation and soul searching, I decided to make the switch. I loved the OR and the ICU and with anesthesia, those were the only places I ever had to be. I love it and I have never looked back. Well, laparoscopic surgery and doing nice wound closures is really fun, but no. I love anesthesia.
16. Cutting the Cord
As an anesthesia resident in labor and delivery, there was a woman having an emergency C Section who was entirely alone. No one was there with her, no husband/boyfriend/family member. We all found ourselves at a loss when it was time to cut the newborns umbilical cord, so I stepped up.
17. The Last Day
I had a neurosurgery lineup for my last day as an anesthesia resident. I was excited, emotional, all that. I did one craniotomy case, took the patient up to the ICU, and went back down to set up my OR. Lo and behold, my last case was cancelled. I. Was. Done. With. Residency.
There are so many more memories – this has really opened a floodgate for me! I am just so thankful for all of the amazing training, teaching and mentorship that I have had over the years. I am thankful for all the support of my incredible family and friends through the blood (literally), sweat and tears. I am thankful for the amazing and brilliant people I have worked with, and the friendships that remain strong. I am also thankful and indebted to the patients who helped me learn to be a good doctor.
Thank you for listening! It’s been quite a ride! No matter where you are in working toward a goal, remember that you will eventually get there. As painful as it is at times, the years of hard work are some of the best and most interesting years of your life. When it’s all done, it really does seem like it flew by…