Medicine - Thank you, Doctor.

For this new round - err, new month - in the hospital, I've been assigned to the cardiology service and today met my new team. I began the day by hitting "off" instead of "snooze" and waking up at 7:05 this morning, and made it to the hospital late and disheveled. (M, are you sure you weren't talking about me??) ;) Trying not to obsess about this great first impression I'd be making on my new team (and cry about losing my last team), I paged my senior resident and found her on the fourth floor. My resident is an R2 instead of an R3, so this would be her first shift on floors as the senior resident on the team. We would be her first student and intern.

Spending the morning listening to the resident orientation, I realized that as my resident and intern both spent the last month on elective and night float shifts, I could actually help them find their way around hospital, figuratively and literally. I spent some time after the orientation (which was NOT meant for me) showing the intern how to find labs and vitals on the computers, and by now I'm actually feeling that I'm a seasoned part of the team. Except that its 9:30 and I have to pre-round on two pts and write their notes in the next half hour.

I scurried through the hospital, running into the new fourth year on my old team, who asked me some questions about a pt I had been following. I insisted that he and the new team not hesitate to page me for any other questions that come up. I found my pts' charts and copied the pertinent information, starting my notes and feeling efficient. A unit secretary made some copies for me without me asking her (I later found out that her nephew is in our class). Then I saw my first cardiology pts.

One of my pts spoke only portugese, and his granddaughter translated. Later that morning I would correct my resident about 3 times in the pronounciation of his name, and my attending would get it wrong when addressing him. Later that morning I would also insist that my attending go back to talk to the granddaughter who was still confused about the treatment plan, and end up bringing her out of the room to talk to him. But for now I just noted his lower extremity edema and that I could not hear his S4, try as I could.

My other pt was a filipino lady in her 70's who told me that she couldn't sit up or eat a full meal because her blood pressure would go up into the 200's, but that she wanted to go home. Later that afternoon as I was at my outpt clinic, she would be discharged. But while I examined her, I just noted her PERRLA and other normal physical findings. I told her I would talk to the doctors and that we would be back that afternoon.

As I walked out of the room, she said, "Thank you, Doctor." I don't know why, but I didn't correct her.