Trauma

Excited for TRAUMA!

For med students at Maryland, rotating at our world famous R. Adams Cowley Shock Trauma Center (Hopkins aint got nuthin on STC) is a rite of passage. Wearing the hallmark pink scrubs, taking overnight call every third night with the residents, running up to the helipad, doing chest compressions on a dying patient, scrubbing in on urgent surgeries in the middle of the night, were everything I was looking forward to during my two weeks leading up to spring break. And while I did see a bit of everything I wanted to, the whole thing felt a bit anticlimactic--and needless to say, the novelty of staying up all night wore off on hour 18 of day 1.

On the helipad

Even though we do two weeks on trauma during our surgery rotation (2 months total), the rotation was actually much more centered on emergency medicine and ICU medicine. Most of the time we were on the "floor" managing critically ill patients, many of whom just had major surgery, were on ventilator support, couldn't wake up, or were intubated. It was my first exposure to how to manage these patients who didn't have just one problem, they had problem with every major organ system and were staying ahead of death one day at a time, a real eye opener for sure. Then every third day, we were triaging new patients in the TRU (Trauma Resuscitation Unit), basically a glamorized ER where every traumatically injured patient in the DMV was brought in. I expected to see GSWs, stab victims, lots of car crashes, maybe some drownings or burn victims, some TRAUMA for cryin' out loud--but luckily for the residents of Maryland, those were few and far in between. I saw a total of 3 GSWs and 2 were self-inflicted in acts of stupidity and/or suicide attempts. The one real GSW was dead on arrival and after 5 minutes of CPR, was too far gone to attempt any further resus. Instead, we got a lot of falls, falling from standing, falling from wheelchair, falling from ladders or stairs, and one case of a lady falling from a moving truck (she ended up getting brain surgery and was still in a coma when I left). 

Not my pic, but this is what it's like when they first wheel a patient into the TRU. We would be the people gowned and gloved waiting for the patient to be moved to the bed. 

Most of the time, I had no idea why these people were transported or flown to Shock Trauma, when they would have been fine being managed closer to home, like car crash victims who were transferred to us 12 hrs after their accident who were entirely stable, or a lady who jabbed herself in the eye with a wooden pole and cracked her orbital bone but who was fine otherwise (hint, if you can walk into the TRU, you do not belong in Shock Trauma). In the event of a "priority" victim though, shit got real. We would gown up, the lead resident would assign tasks to the doctors (e.g. you put in the central line, you do the chest tube, you intubate) and everyone would swarm around the patient when they were wheeled in, making sure they could breathe, putting in lines, and assessing the amount of injury. As a medical student, my job was to do the FAST (focused assessment sonography for trauma) exam so we could quickly scan in the abdomen to check for internal bleeding, check pedal pulses, help take off their patient's clothes, and otherwise get out of the way when all hell breaks loose. Sometimes they would "reward" us by letting us sew up lacerations! Whenever they wheeled a new patient in, my partner and I would start scoping them out for lacerations because we knew we could practice sewing them up. The last day I got to put in 12 stitches on a leg by myself! 

Pure madness when a "priority" comes in. A sea of doctors and nurses swarming around the patient. 

Like much of medicine, there were really exciting moments and then a lot of sitting and waiting around for the next patient to come in, even in trauma. If there wasn't something going on, somewhere between 2 am and 5 am, I would lie down in the call rooms for a bit, and was actually able to get an hour or two of sleep a night, which isn't bad by trauma standards. It wasn't this constant never ending stream of dying patients that I imagined (although it may be busier in the summer, when more people are getting into trouble). Hence, my partner and I would take a food break like every hour, and get ice cream every call day. Froyo = trauma life. 

Call day diet

Team A froyo break

Vday brunch

Is this what a normal weekend feels like? Sleeping in, cooking (epic) brunch, and then watching TV for the rest of the afternoon? I had wholly forgotten what it feels like.

Even though I had to work (a shift in the psychiatric emergency department, not as dramatic as you would assume, though I am probably desensitized to what is dramatic and what isn't), the rest of this weekend has been refreshingly undemanding. I caught up with friends, went to the gym, shopped at IKEA, started House of Cards Season 2 (dat first episode....), scavenged for bacon and maple syrup on a Sunday morning in Baltimore (everything is closed), and cooked brunch for some of my favorite couples and J for Valentine's day. The beautiful roses decorating our apartment were from my roommate's fiance. I was in charge of the banana bread, scones, and potatoes; my neighbors A&W brought breakfast tacos! 

Best banana bread I've ever made courtesy of Chocolate Covered Katie: Chocolate Chip Chai Banana Bread. Even though I normally love chai, I think this would have been just as good without the cardamom.The only substitutions I made were adding 1/2 cup of mini chocolate chips instead of nuts (I sprinkled some more on top before baking for 35 minutes) and using half whole wheat, half white flour. It was still just as moist with the whole wheat flour. 

Blueberry lemon scones were from an old recipe I got from my sister over the summer. Again, I used half white and half whole wheat flour. Even though they looked like gargantuan Frankenstein scones, they were a hit! 

C also made french toast and "bacon" (aka bulgogi)

I love getting up late on weekends and making breakfast so I was so glad to have opportunity to host an epic brunch for some of my best friends here in Bmore. And not spend it alone even though they never make me feel like the 5th wheel =)  

Snow day!

As a third or fourth year medical student, there is no such thing as a "snow day." When grocery stores, offices, schools, and the government are closed, hospitals are always open, and thus essential clinical staff have to make it in come snow, sleet, or ice. Gone are the days of first and second year when we would feel like giddy grade schoolers after getting the text alert saying school's closed the next day. This year, I don't even pay attention to when it's supposed to snow until I get a blast of snow in my face out the front door. I bitterly ignore the "school's closed" texts because most days I'm already in the hospital at 6 am and halfway through rounds. 

Not today. Chalk it up to a combination of being on a chill rotation (psychiatry), having the nicest resident ever, and a forecast to get up to a foot of snow, and I got my first snow day this year! My resident told me to enjoy the days off when I still can though, because in just a short 1.5 years, I'll be the one on call and the one who has to drive in with a foot of snow on the ground (though I'm thankful I don't live in Chicago or Minneapolis or something). 

I spent the entire day just taking my time waking up, eating my breakfast and drinking my coffee, working out, cooking, and eating with neighbors. And even got a little studying done because I find psychiatry. I actually love what I'm learning on this rotation but finding it difficult to take care of the patients because they're literally crazy. And so even though I find the pathophysiology and presentation of schizophrenia, bipolar disease, depression, and various personality/anxiety disorders fascinating (I've never seen such a wide range of human behavior in such a short time), I couldn't go into the field. I do really enjoy this rotation though because it will give us a good foundation for seeing these patients in a medical setting (apparently 20% of all visits to a PCP are for psychiatric complaints)--and then refer them to our psych colleagues. 

Here's last month's parade of Things I Ate. Went out to a hip new restaurant with my girls (Fork and Wrench in Canton) where we saw Julia Louis-Dreyfuss (filming Veep in Baltimore; apparently the cast of House of Cards visits the restaurant all the time too), but I thought it was a bit overrated, like many other "new American" restaurants. I prefer Woodberry for hipster food when I'm feeling decadent. 

 Bone marrow and animal crackers for starters (also had an escargot bun, not pictured. I think I'll take my bao zi with pork in it again next time, thanks)

 Steak Frites 

Proof we actually get out in third year!

C's family was kind enough to invite us over for Chinese New Year! CNY = friends, family, and lots and lots of dumplings. 

 

 And at this party, green tea macarons! Macarons are notoriously difficult to make and C's sister E is a macaron making monster. Don't they look store bought? I'm obsessed -- I've already commissioned her to make a macaroon cake for my (who knows when) wedding. 

 Mani's and macarons with the roomie. Once again, her sis' Earl Grey tea and rose water macarons. 

My college friends recently moved back to Baltimore and invited me over to their adorable apartment for some tea and scones <3 

 Bacon milkshake @ Paper Moon Diner. Had to try it. 

 Fancy schmancy drinks at the 13th floor of the Belvedere

 Current accessories

 My roommate's sister's handiwork again. Mango/raspberry cake for Vday. 

Snow day potluck! Chicken satay pasta and cauliflower crust pizza. 

Tomorrow's Valentine's day and I have some fun plans with friends this whole weekend. I'll be sharing some recipes next since I've had so much more time to cook lately! Trying to pack as much into this month as possible before I start SURGERY (my worst fear) next month.