My dad unknowingly stole my idea for my next post over on his blog. I was going to spend my time on this post reflecting on how a once loathed activity like gardening can turn into the highlight of one's day. However, he has much more eloquently described those sentiments.
The last three months have been wonderful. Spring time in Chattanooga is without parallel. I've been on research the last three months, which means reduced call responsibilities and a much less rigid schedule. However, my days of mid-afternoon naps, lots of extra-curricular reading, and just plain old free time are fast coming to an end.
Beginning in June, I'll be back as trauma chief again. My last stint was during the cold months of January and February. Summer months tend to be crazy busy with people out and about doing redneck/hillbilly sorts of things or just plumb driving too fast. Though the schedule for the coming academic year (starting in July) has not yet been released, I'm guessing that I'll be on trauma again in July.
July is always an interesting time of year. The surgery program here is 6 years long. About the middle of June every year, the 6'th year residents disappear. People who have become comfortable in their roles as interns, junior residents, or senior residents are suddenly bumped up one notch into positions of more responsibility. The feeling is one of mixed trepidation and exhiliration. Exhilirating because you've successfully traversed another year, but full of trepidation because you're trading a role that has become comfortable for one that stretches you to the edge of your skills once again.
Though I'm not really experiencing any change in my role here this coming year since the responsibilities of 4'th and 5'th year residents are virtually identical, there is an added element for me this year when the changeover occurs in July. It is then that a new batch of freshly minted doctors arrives fresh out of medical school. Medical school tends to be a very affirming, supportive sort of place. Though competition to get in is stiff, once there they do everything they can to retain you. A surgery residency is not that sort of environment.
July 1, they show up and are expected to morph into doctors after years of being a book-worm. Somehow most people make the transition, and actually make it quite well. However, along the way, some are so afraid of their own shadow that they are incapacitated by the fear of messing something up while others believe that they are the greatest gift ever bestowed upon surgery and fearlessly blaze trails better left unknown.
So far, I have been far away from the main campus every year when the newest batch of recruits arrived. During my second and third years I was stationed at outlying hospitals away from the mayhem of July at Erlanger. Last year I was on Cardio-thoracic surgery for three months and also escaped the transition time. This year there will be no escape. I'm on track to probably have trauma chief duties during July.
Trauma is a very difficult rotation for a green intern to start with in July. At that point you don't know how the system works, you're unsure of exactly what your job is, and even if you do eventually figure out what your job is, you're unsure how to execute the steps of doing it. Furthermore, you're on the busiest service at the busiest time of year for that service. Nothing can be handled over the phone. You haven't gained a sense of which details are important or superfluous. They therefore all become important, which is a rather stressful way to live. It all works out though. All of the patients get taken care of, and don't suffer any ill-effects from the transition going on. One of my former chiefs actually speculated that more mistakes occur at the end of the year when people are more confident and not quite as likely to regard every detail as being of the utmost importance.
As trauma chief, you have the pleasure of trying to provide some oversight to this whole process. You spend a lot more time awake at night, and more time overseeing minor details that interns eventually learn to handle without your help. You also get to listen to the attending surgeons, who usually are of the rather vocal persuasion that the newest intern class is exceptionally idiotic. According to them, every year's class is of unparalled stupidity and laziness, and as chief, you're admonished to whip things into shape.
I was recently talking with one of the nurses who has been here for decades. We were discussing the upcoming influx of greenhorns and the derogatory opinion the attendings usually have of the new arrivals. She remembered when many of the current attendings were new interns, and started telling stories. One of the smartest attendings we have, who is usually also of the persuasion that the field of surgery is going to the dogs, was an intern when she was a nurse there. One day she called him up for because a patient had a low grade fever, and she wanted to give him tylenol (a rather low-risk, standard intervention). He was rather flustered about what to do, and told her that he really wasn't sure that he could do that and needed to ask more experienced people what to do. How soon we forget how helpless we once were, and how much more we have to learn ourselves.
Even though I am sad to see this year's 6'th year residents leave, much the way staff and friends at NYP did when I was growing up, I am eager to help a new batch of interns take those first few baby-steps towards becoming a surgeon. Its a path I'm not at the end of yet myself, but one that I'm just far enough along to know how to help them navigate the start of.
