I’ve notice among my fellow residency bloggers, that there tends to be significant posting drop off sometime during the second year, and I’ve really tried to not let that happen, but indeed it has.  Maybe it’s that not every single thing is all shiny and new anymore, maybe it’s that I like to think about things other than work when not at work, maybe it’s this or that, who knows.

Regardless, time has been chugging along. Hard to believe that I’m more than half way done with residency at this point.  This year up to this point, has been pretty great, I have to admit.  I feel that I can walk into most any room and have a pretty good idea of what to do. I don’t claim to know it all, by any stretch, in fact, I have a pretty good idea of how high the mountain of knowledge is, still looming above me. But, I feel like it this point, I know how to find the information that I don’t know, if that makes sense.  And this has been something I’ve been actively working on, trying to find answers to new problems, problems I may have never have had to consider before, without just asking my attending.   I do this intentionally, knowing that when this is all said and done, I’ll probably end up taking a single coverage job is some small ED somewhere, somewhere that might not have a lot of backup readily available.

I’ve seen the way I approach patients change as well, over the past 1.5 years, and over this 2nd year especially. I no longer get frustrated by drug seekers, sickle cellers, gastroparesis and what not.  I’ve realized that getting mad, playing bad cop with them, doesn’t actually do anything to fix their problems or relieve their burden on you. Given the wide variety of places they have us work as resident, I’ve seen how many different institutions and doctors have dealt with these types of patients, and are using these as models to develop a strategy that I feel good about personally, while striking a balance between treating the patient and feeding an addiction. “Nasty” patients, still do get under my skin, they still make me mad and frustrated,  but I think that’s a good thing quiet frankly. I’d be more worried if these type of people didn’t upset me from time to time.

And yes, I still loathe nosebleeds. I don’t think that’s ever going to change.


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