*scrubs

3

SOMETHING CAME HOME WITH ME FROM THE SHOW, and it was not a russian rat snake :’)

She’s a captive bred yearling Tanimbar scrub python, produced by Andre Mondin, and I purchased her from Mike and Erika Renau! I actually just wanted to hold a scrub python, and they had three… they told me she is the most docile and let me hold her- she’s super flighty at first, but calmed down in a minute. I came back like 2 hours later to ask more about her and then bought her. I had a set up all ready at home to begin with for a snake I might (*coughs*) bring back from the show and aaaahahaha

So just to specify, this is Simalia Nauta/Morelia Nauta, which is a small locality (or is it technically a subspecies…) of amethistina, since I realized people might have thought I bought myself one of the giant scrub pythons. Simalia nauta maxes out at only 6~8 feet for females, very thin, but most of it is just long skinny tail and neck. While morelia amethistina is its ancestor, and is the giant snake that most people know scrub pythons as. Morelia Nauta is also known to be more docile and flighty, rather than defensive and bitey haha.

  • Christine, to Jenna: When Jeremy and I first started going out, I was afraid he was more in love with his best friend than with me.
  • Jeremy: Christine, they've got those lemon biscotti that Michael loves. Can I have some money to buy him one?
  • Christine: No, you bought him a present yesterday, remember?
  • (Later)
  • Christine: Alright, let's go... wait, where's Jeremy? And where's my purse?
  • (Elsewhere)
  • Michael: Thanks for the biscotti, Jeremy.
  • Jeremy: Anytime, buddy. Anytime.
That Fleeting Feeling

My intern year has progressed in distinct phases. For the first three months I lived in a state of perpetual fear. Each time a nurse would call about something, like Tylenol, I would rewind in my head every possible contraindication. Did I know this patient’s liver enzymes? How much had they already had today? Could they have an unknown allergy? I would freeze up with the constant worry I might unintentionally injure someone.

This uncertainty trickled into everything I did. My admit notes were many paragraphs long, just in case the fact that a patient had a rabbit as a pet in first grade might be useful to the diagnosis of their community acquired pneumonia (#alwaysruleouttularemia?). My exams were extensive and thorough, but I worried about documenting findings or exam signs others had not. I would look at consultant notes and worry that perhaps the boiler plate “regular rate and rhythm without murmurs, rubs, or gallops” meant that the murmur I heard wasn’t actually there.  

Slowly I learned that patients were much more resilient than I had been led to believe by standardized tests. In the coming months I gained some confidence in making decisions, making my own diagnostic judgements, and note writing. My admissions got smoother as I figured out what to ask and how to document it. My orders became less complex as I figured out to properly do a med reconciliation. I began to see complex patients as an entire entity rather than the sum of each problem on the problem list. Perhaps most important for my patients, I began to gain a better understanding of pain medications and my fear of them began to abate.

As we passed the new year, I began to feel like a well-oiled machine. I could knock out admit notes and progress notes without issue. I called all my own consults. I began to have enough procedures logged to be signed off. I was beginning to peak as an intern. Wards became something that was fun instead of frightening. I had time to read about my patients and do some teaching for the medical students. As the weather warmed for spring we began to get off work earlier and earlier.

Then April hit and attendings began to make seemingly innocuous comments like, “I think you are ready to be a senior,” or “you are really operating at a senior level.” Slowly the terror drifted back.

Originally posted by collegerunningprobs

Holy shit, I have to be a senior resident soon.

In just two months I will be responsible for twice as many patients. I will have 24-hour call. I will have two clueless and terrified interns who can’t even prescribe acetaminophen. I will have to stay late for them to finish their 4 page long admit notes. And I will have to answer for their mistakes.

I feel like another intern year might be beneficial. I was just getting the hang of being an intern and I want to hold on a little longer to this feeling of competence.

It is interesting how medical training always works like that. Just as you get comfortable in one setting you are whisked away into another and put back into a situation where you are uncomfortable. Whether there is much intention in that, I am not sure. But that is what seemingly makes medicine such a difficult profession. There really is no such thing as mastery. You just progress up the chain and hope that each year you get better.

An attending recently told me that there will never be a time you can rest and stop studying. If you are practicing right, you will always face new challenges that force you out of your comfort zone.

Dang. I really like this fleeting feeling of competence.  

Ya know, sometimes I think that I can be a normal person then I suddenly remember that at one point someone drank a redbull and got so upset that it didn’t actually give him wings that he sued the RedBull company and won the case and also if you drink Pepsi cold and Coca cola warm it will taste the exact same.