=/

So after getting my bearings on the Neurosurgery team last week, they started giving me some patients to preround on in the morning and then present on rounds. Here is a typical day on the Neurosurgery team:
4 AM--wake up at the hour I used to go to bed on weekends
4:45 AM--walk to the med center in the dark listening to Thom Yorke
5 AM--look up my patient's vitals, ins and outs, and lab results over the past 24 hours
5:30 or so--go wake up the patient, do a physical exam, chat
5:50 or so--write up what I found in the chart
6:15--Rounds. Neurosurgery has so many patients that they first tell the Chief Resident what they found, then they go around to the patients with the actual Attending OR go to the operating room after rounds.
This is where I'd "present" my patient info. It takes practice to even know what you're supposed to say and what they want you to say. Our rounds would start off great--lots of patient info. But then as we'd get to the end of the patient list, the chief would start getting antsy and just basically ask if the patient wasn't dead. SO when trying to practice presenting patients that were toward the end of the list, I'd start off with what you're SUPPOSED to say: "Mr. J is post-op day 1. No acute events over night, vital signs normal; max temp 37.2, current temp, 36.9..." and then I'd get the 'ol interruption and the chief would look at the resident REALLY taking care of Mr. J and say, "So is he going home today or what?" Frustrating!

But so when I saw Mr. J for the first time on Tuesday, I couldn't wake him up. Here was a little old man, DNR, who'd had a big brain bleed; and the family wasn't willing to give him a feeding tube. He aspirates most of everything he's given to drink too. He's on "comfort care" which somehow translates to not feeding him. That really pissed me and one of my senior residents off. Anyway, I asked an older med student to help me wake him up. Turns out you have to SHOUT at people and shake them to wake them up so you can examine them. And it's really unnerving; and Mr. J ended up falling asleep before I could examine his lower extremities' function. His exam was unchanged for days, and all the Neurosurgery team was waiting on was Palliative Care placing him in a home. So when he fell asleep before I examined his legs, I just let him sleep.

....

Don't worry, every patient I saw was seen by at least 2 other people within the half hour.

The rest of the day is spent as such:
7:15/7:30--Rounds end, the residents BREAK! And I go to the OR
8:00-4:00--watch/assist with various surgeries. A required Surgery class/lecture always interrupts the most interesting ones, and then I have to scrub out annoyed.
5:00-7:00 afternoon rounds.
7:00-8:00 eat something and VEG OUT.
8:00-9:30 pretend to study but end up just playing on the computer
Go to sleep, do it again!