Winding Down

This post has been simmering for a long time, mostly because not much has been going on in the med school world. Except for today. Two code blues, at the same time. And by my count, this would be my first code - at least where I did something. I ended up at the one that was actually kinda cool (except for the patient). Postop patient refusing DVT prophylaxis is begging for a pulmonary embolism. My money is that's what threw the poor guy into vfib. As an aspiring EM doc, I actually knew a lot of what was going on and why. I got to do chest compressions, which was kinda cool since I've never done them. It's actually a decent amount of work and ended up getting reasonably sweaty and tired - 100 compresssions/minute with each one trying to slam 1.5 inches into the guy's chest adds up. Long story short, the guy's heart freaked out since it didn't get oxygen and was functionally stopped, after about 12 minutes it actually stopped. And no exaggeration, with literally the last round of pressors, antiarrhythmics, and shocks before they were gonna call it, the guy flips back into sinus rhythm. Sixty seconds later, the guys writhing around and trying to verbalize. Pretty cool.

Anyway, I'm at the halfway point of my last rotation (internal medicine) and six weeks away from the end of third year. I don't feel as if I've studied all that much. Compared to a year ago, my former self wouldn't recognize my current self. I actually know some stuff, both book-wise and clinically. I'm somewhat comfortable on the wards, and can handle a brand new patient and managing a basic workup on an uncomplicated patient. As for the details and logistics of patient care, I'm lacking for sure. Same story if the patient is remotely complicated or requires deep differential diagnostic skill. But IMHO, I've progressed nicely over the past year and for sure over the past three years. I can actually see myself as a resident and not as a bumbling, awkward med student.

All that said, it's scary how much I don't know. Knowing limits and what one doesn't know is by far the best thing to have learned over the past year. I like the idea of being able to handle anything that's thrown at me, and don't really wanna give up anything. Fields that are typically polarizing I've enjoyed, including OB/gyne and pediatrics. As someone considering EM, I should traditionally despise the slower pace and more in-depth management of patients. Shockingly, I actually enjoy both aspects.

And it's for those reasons that my ever-evolving list of specialties includes the following: EM, EM/IM, med/peds. Part of me likes the idea of being able to handle pretty much anything. For the combined residencies, part of me likes being able to put off a true specialty decision for a little bit longer.