INTERN

INTERN

Its hard to believe my first year of residency is already in the books. I ended with two night shifts at the county hospital that featured the usual chaos and urgency of a night at the county.

Now, although I have moved several times over the years, the move to California has been the biggest challenge by far as it was my first move as an 'adult'.  The bay area  is spoiled with gorgeous weather and jaw-dropping scenery. Picturesque forest backdrops drape the sides of the highway and stretch as far as the eye can see. Both the beach and mountains are  within driving distance from most locations.

Dolores Park, SF

However, the costs of enjoying such prime location are high. My rent quadrupled from what I was paying while living in Texas. The first time I filled by tank at the gas station I shed a tear as the meter crossed $70. I knew I was 'adulting' when I created a budget to ensure I would have enough money to cover my expenses (rent, gas, food, loan repayments), while still having a little to put away each month as savings.

The first few weeks of residency were akin to being hit with a sledge hammer. Learning to deal with the expectations that come with the initials MD was a shock to the system. Simple tasks such as repleting potassium, writing discharge summaries and orders, taking out chest tubes and pulling pacing wires proved challenging at first. The learning curve was steep but the acclimation period was short and before long the simple tasks became more mundane and I was able to focus more on getting time in the OR. Luckily I started off on the cardiac surgery service. There are plenty of nurse practitioners and physician assistants on the service and I was able to learn the basics under their guidance.

A date of significance for me was November 15, 2018. The day I did my first open gallbladder removal. At the time it was the most significant procedure I had done and it happened because I was essentially in the right place at the right time. Afterwards I was riding a wave of joy the rest of the day.

First gallbladder 

Open Gallbladder removal 

As the year went on I became more comfortable in the operating room. I made positive strides in core skills of knot-tying, electrocautery, fine dissection, suturing, laparoscopic maneuvers, bronchoscopy, endoscopy, wire skills and anatomy. Ive been blessed to be apart of amazing procedures and miraculous saves but I've also been involved in cases that ended with grief and sadness.

One of my favorite aspects of this profession is the interaction you have the patients and the stories you encounter and become apart of. Ill never forget a busy Saturday day shift at the county hospital. We had traumas coming into the emergency department left and right. One patient who was transported in by ambulance was a young female who had to go to the operating room urgently after suffering a temporal artery bleed. The injury happened after her even younger sibling through a knife at her head during an argument. She was rolled into the ED with a pressure dressing wrapped around her forehead. After checking her for other injuries we unwrapped the dressing to assess the wound and blood started jetting from the side of her head across the room. Needless to say we QUICKLY put pressure on the bleeder and took her to the operating room. Just as we got there another overhead pager went out that a MAJOR trauma was coming in.

When I got to the trauma bay in the ED I could hardly believe what was in front of my eyes. It felt like it was something out of a graphic horror film rather than real actual life. The man in front of me had been attacked with a machete and was literally hacked to pieces! He had deep gashes down to muscles from his chest, to his abdomen, down to his mid thighs. He also had very deep cuts into his neck with one extending all the way into the back of his mouth. Surprisingly he was still conscious and had an intact sense of humor to boot. Miraculously the guy did okay and eventually left the hospital. He had to be taken to the OR to explore the neck wound and while he was there the other deep lacerations were washed out and closed with multiple layers.

As I prepared to sign-out to the new interns for the first time I couldn't help but to think about the emotions they must have been having as they prepared for their first day at work. Excitement, Pride, Nervousness, eager to experience what it means to have the letters MD associated with you name. In retrospect intern year was everything I needed it to be. I have been challenged time and time again and know the weakness that I must turn into strengths. Time never stops and the grind continues on into year 2. Complacency is the enemy of growth and improvement. Pressure is part of the process that makes diamonds and success is sweeter after a struggle.

There is no doubt residency has been and will be one of the most challenging things I will do in my lifetime. Nevertheless, even the toughest experiences become survivable when surrounded by great people. Ill always remember the tough training sessions on the oval grass track in Ashburton and the winding shingle roads in the domain. Drowning in lactic acid I was still having a blast because I was going the process with my training partners who had become my closest friends. The group of young surgeons that I have shared the intern experience with are second to none. Through the highs and the lows we've had each others backs.  Endless laughs and the infamous quote board that immortalized the most ridiculous and sometimes delirium driven comments made throughout the year.

Another thing that makes residency surviveable... Vacation!
This year I went to Colombia with 3 other co-interns and we had a blast. We split our time between Medellin and Cartagena and took in the sites, the food and enjoyed the hospitality of the local people. Medellin is one of the most beautiful cities I have yet to visit however the lasting image from the trip came from Cartagena while on a catamaran cruise

Cartagena sunset

YEAR 2 starts here...