I like vets, (fairs and dogs, too) but still hate being an intern

So I switched rotations this week to internal Medicine at the VA hospital (Mather) outside of Sacramento. More on that in a bit. I thought I'd share some pics of the Cali State Fair that I attended this past weekend with Adeel and Brenden (woo-hoo for days off!!!!)

Brenden and me by the Golden Bear and sign
Adeel thought it was about time he tried a deep-fried Snickers bar

One of the serious rides they had there! They even had waterslides at this fair! Hard to believe!

Stunt jumpers who were fascinating to watch!

There was lots of animal life to be viewed!
Here is Adeel pretending to be a butterfly.
Cute floppy-eared bunny (yes, JB, that is its official Latin name)

A very Velveteen-y one I wanted to take home

Teeny tiny Japanese quail (this picture doesn't do justice to their miniature size!)

Piglets!!!!

..Which you could stand in line to pet. In contrast to my standing in the line at the MN state fair with a bunch of five-year olds (to milk a cow) I didn't do it this time, just to pet piglets. I did, however, have a very in-depth conversation with the animal expert by the cows about how the cows deliver their calves, malpresentation, cow placentas, cow c-sections, and more... :)

This is one furry pet I'd rather NOT have in my living room.

"This is how you correctly pet a chinchilla," the woman instructed me.

More neat news: Kate is in MN this week and next for her brother's wedding so I get to dog (and house) sit Lefty for at least a couple of nights, before he goes back over to Kyla and Ben's (they're both currently working nights). It's so nice having someone to come home to, even if poor Lefty has to be alone in the backyard for the whole 14 hours or whatever I'm gone! He wags his tail and is so excited to have company (as am I!). After VA signout tonight at 7 p.m., I rushed home to be with him, leaving my pesky discharge summaries to do while I have a furry friend next to me, after we went for a walk and played for a bit :) We'll see if he makes it onto the bed tonight :)

As far as internship goes... it still goes. I started at the VA on Monday. It was again a hard transition-- it's hard picking up patients (sick ones at that!) you don't know, to round on, come up with "plans" on, and discharge with summaries supposedly encapsulating their care during their hospital stay (which you were not a part of). We also admit every day, which gets very exhausting. Brenden, my co-intern, sits there amused as I constantly stress out about all the things I need to do... finish notes (all, even progress notes, are on the computer, which I haven't decided I really enjoy), call social work, call consults, figure out how to order labs (also all electronic which, at first, was very intimidating, but which I now like!), and the like. At the end of the day, it seems there are always admission notes and/or d/c summaries to work on and the day does not really end at 7 p.m. when night float comes on.

I walk around with a stressed look on my face saying, "I hate this. I can't do this. I can't spend another day working this long and this hard. I just can't. Why, why, why, why, why...." I do feel that time is so short that it's unfortunate I can't think more about these patients' medical problems... that you have to just do things via reflex. I think that being complete is getting sacrificed at the expense of efficiency and getting things done (I can't really think too in depth about patients' hypokalemia [low Potassium] but just have to replace it). Maybe as I get better, I will be able to *think* more critically.

I do feel as though we got a bit less "clinical" experience at Mayo (due to our third-year research trimester block), so I'm a bit lagging in knowing all the doses of things, ins and out of "hospital medicine," but I'm learning fast! Now, by day three, I'm feeling MUCH more comfortable-- with the computer system for one (although the labs are reported all funkily and not in my organizational style). Brenden actually did an intern year in CO before transferring, as well has spent the past two months of rotations at the VA so he has a bit of an advantage, I think, but that's why I go to him for all my IVF and electrolyte replacement and computer ?s! So far, I've admitted your run-of-the-mill cellulitis, CHF exacerbation, lower GI bleed, taken care of pts with pneumonias, HIV/AIDS, another who is undergoing chemo for metastatic b-cell lymphoma, and today admitted one 82-year old with new-onset painless jaundice, who, semi-predictably, has a big pancreatic mass suspicious for cancer. Yikes.

The vets are all very sweet, though. I came close to my first marriage proposal the other day :) It's kind of weird going from all women patients for really my first 2 months of residency, to all male vets (there is the occasional female/dependent that comes through the VA)-- from healthy pregnant (young) women, to men who have lived long, hard lives, and who often have substance abuse comorbidities, heart disease, and COPD (chronic obstructive pulmonary disease) amongst their 10-item-long problem lists. But, as it all has been, it's an adjustment. And I continue to learn.

As far as getting thing done outside of work: not so much of that going on. Still working LONG hours. But I have Friday off :). Trying to think of something fun to do. Maybe I'll finally get to Wendi's tag game. I can't really think of too many random, quirky things now that won't scare readers off and which aren't already common knowledge :)