Thursday, September 21, 2006


Somewhat amusing and yet at the same time very disturbing.

"Then if any man shall say unto you, Lo, here is Christ, or there; believe it not. For there shall arise false Christs, and false prophets, and shall shew great signs and wonders; insomuch that, if it were possible, they shall decieve the very elect."
Matthew 24:23-24

Sunday, September 17, 2006

More Thoughts on Internship

I am still baffled when I think about the internship program I am currently involved with. The General Surgery service truly is insane.

At the end of last week, I was the sole intern for a team that was taking care of TWENTY-SIX patients. What a disservice to the patients I was responsible for, let alone a crazy time for me.

Because of the new “eighty-hour work week” rule that is imposed upon all residents, the General Surgery department at my hospital has decided to crack down on anyone who defies the rule. They are essentially in danger of being closed down, or at least put on probation, because a disgruntled resident recently submitted an anonymous letter to the AOA (American Osteopathic Association) stating in so many words that the surgery residents were being overworked. Now the AOA is keeping a close eye my institution, which is why my chief resident sat all the new interns down at the beginning of our rotation and told us that we MUST work less than 80 hours per week. There were some new rules instituted to help us comply with that concept, one of those being that we are not allowed to come into work before 5 am.

Nonetheless, that poses a problem when I have to see 26 patients before rounds. At 5 am when I walk in the door, I go immediately to the fifth floor. I hide my bag in a certain cupboard of a certain conference room. Then I log on to a computer to check my patient list. I always gasp in horror when I see all the new patients that were added overnight. Then I proceed to rearrange their room numbers. I then spend some time assigning patients to my six students (I have 3 medical students and 3 PA students), making sure that no student has more than a maximum of 4 patients. Finally I go through and check the vitals signs on all 26 of my patients, making sure that none of them were hypotensive or tachycardic or febrile through the night. I check any new labs that I had not checked from the day before (but the AM labs are never ready by then, so I do not even bother to check for those). I make notes of who needs to be replaced with magnesium or who needs another set of AM labs. During that time, the night float person will usually call me to sign out. He spends about 5 minutes telling me about the issues overnight and any new patients that were admitted to our service. I also juggle answering questions from my students and the nurses about their specific patients.

By the time I finish with all of this it is already 6 or 6:15 am! If we are supposed to round at 7 am, I essentially have 45 minutes to see each of my 26 patients. They are usually all spread out over seven or eight units (5100, 5200, 5300, 4100, 4200, 4300, 3100, and 3300), not including the recovery room or the ER. Let’s do the math. If I spend about 30 seconds walking from one room to another and looking for that patient’s chart (which is impossible to do, especially closer to 7 am when the nurse’s change of shift occurs), I spend about 13 minutes simply in transit. Subtracting 13 from 45, I get 32 minutes to take care of 26 patients. Thirty-two minutes divided by 26 patients gives me an average of 1 minute and 13 seconds to look at each patient’s chart, talk to the nurse for that patient, talk to and examine the patient.

Needless to say, that is simply impossible. But that’s how crazy my life is this month.

Two days ago, I started night float. My hours are now 6 pm to 7 am. Friday night was quite busy. My pager never stopped going off. I received about 10 General Surgery consults and one major trauma activation. Fortunately I had two great students, Lisa and Nathan, helping me the entire time. Saturday night was slow until midnight. Then suddenly we had an onslaught of trauma alerts. From midnight until 6 am, there were about 7 or 8 traumas that came in back-to-back. All of the patients were intoxicated with alcohol. Most of them suffered bone fractures. One lady ended up passing away after a severe motor vehicle accident. What a night!

When I got home, I was exhausted. At 9 am I went straight to bed, and I woke up at 4 pm. It feels weird to be sleeping in the middle of the day, but I’m sure I’ll get used to it. By the time my body is adjusted, I’ll be back on the day shift again (This Friday I switch again). Although night float is busy, it is certainly a welcome relief from the insanity of working days. Oh, the joys of general surgery. . . =)

Monday, September 11, 2006

Erina and Ron

It has been a few weeks since my "cousin" and dear friend, Erina Lee, got married to Ron Im. I just wanted to post some pictures in their honor. The wedding was in Pasadena, California, on Sunday, August 27, 2006. I was so happy to have the day off work so I could attend the beautiful wedding.

Me, Erina, Ron, my brother James, and my fiance Paul

Ron and Erina with my parents

Congratulations to you both, and here's to a happy marriage!

Tuesday, September 05, 2006

Strep Throat

Absolute madness. That is what I would call this past weekend. Most of you who live in reality outside of the hospital bubble had a long weekend. For me, it was one of longest weekends of my life. Here is why.

Thursday, August 31, 2006. I started to feel sick. Malaise, headaches, body aches, fevers and chills, sore throat. I worked from 5 am until 6:30 pm that day, and by the time I was ready to go home I felt horrible. I did not eat dinner and went straight to bed, hoping that I could sleep off whatever illness I had begun to contract.

Friday, September 1, 2006. I awakened to my usual cell phone alarm ring at 4 am. I still felt terrible. My headache and sore throat were worse, and after taking a quick peak in the mirror I knew my tonsils were inflamed, erythematous, bulging. I popped some Tylenols into my system before I headed off to work. I continued to get fevers and chills throughout the day. Since I was switching services and starting General Surgery Team #1, I had the additional stressor of trying to figure out who each patient was and what we were supposed to do for him/her. In addition, I had five new students, three of whom bailed out on me (went to the operating room or clinic or lecture) so I was left to fend for myself with my limited knowledge of the patients during rounds. On our “short days” or “non-call days” the rule is that I am supposed to go home at 12 pm. Needless to say, that never happens. There was so much work to do that I went home at 4:30 pm, and I felt absolutely miserable.

When I took a look into the mirror again, I diagnosed myself with strep throat. I decided to start myself on oral antibiotics. I was too tired to go to the urgent care center for a rapid strep test or a prescription, so I just took some amoxicillin that we had lying around the house. This time I decided to choose nutrition over sleep, so I ate some pureed food for dinner before going to bed. My tonsils were so inflamed that every bite was sooo painful to swallow.

Believe it or not, this is what my throat looked like. Look at that white exudate. Yuck!!!

Saturday, September 2, 2006. Crazy weekend days. Our two General Surgery #1 and #2 Teams are combined into one huge team on weekends or holidays, and so the senior resident rounds with me on all the surgery patients. We had about 30 patients total on our lists, but only two students to help me write notes. I ended up writing about 13 progress notes by myself that morning. Consults started coming in one by one – and pretty soon we had about 8 consults by the end of our shift. We didn’t start rounding until about 11:30 am, and we didn’t finish rounds until nearly 4 pm! Imagine 11 straight hours of running around like mad, not stopping to drink or eat anything! After rounds, my students and I grabbed a quick “lunch.” And then we had a little less than 2 hours to finish all the floor work. It was insane. Although I was supposed to leave at 6 pm, I left at 8 pm. Fortunately, I had more energy on Saturday than I had had on days prior. Perhaps the antibiotics were kicking in. But, more likely, God was helping me (I know my fiancé was fervently praying for me). All I know is that I’m thankful He got me through that crazy day.

Sunday, September 3, 2006. I had the day off. Just got my hair trimmed and went out to eat with my dear friend, Kar-Yee. Physically had time to recuperate from my illness. Feeling sooo much better.

Monday, September 4, 2006. Another crazy “weekend” day (since it was a holiday). This time, I had to write notes single-handedly on 15 patients, as there were about 40 patients on the combined General Surgery #1 & #2 Teams today. I would have had to write more, but fortunately I had two students and a second year surgery resident helping with the rest of the notes. After that madness was over, we again had the mad rounds. We didn’t start until 12 pm, and we were interrupted with surgery cases in between, so we again finished rounding at 4 pm! Between then and 6 pm, I discharged about 10 patients and took care of floor work for the others. It was so crazy. In order to get everything done, I did not even take a lunch break that day. I just made sure I had a nice dinner later (a vegan pizza that Ken Lim baked). Mmmm...

Despite the insanity of my weekend, I see how God has led through this experience. He sustained me when there was no way I could have had the energy to lift a finger to get any work done. He reminded me that I must lean fully upon His strength at all times. I was forced to pray for help, and He answered my feeble cry. I serve a great God, and I hope and pray that you have all experienced the peace that overcomes you when He is in control of your life. Hooray that another week on surgery is over! Just 6 more weeks to go! =)