PGY-2.

Hello.

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This is Hermès

Instead of multiple insightful posts throughout my 2nd year of residency (“insightful”…haha) I have but this single entry to offer towards the end of the year.  A slow accumulation of random thoughts and useless rambling — 11 months worth.

Residency is hard, but we all knew that already. I have definitely changed; hopefully all for the better. I have learned A LOT (well that’s good). I can’t remember all the personally profound moments but there are some that are undoubtedly more sticky than the rest:

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I’ve become just a tad bit meaner. (Sorry not Sorry)

It happened. The one thing I had sought to prevent and was keenly aware of prior to Residency. The one stereotype I wanted to prove wrong — and one I’d still like to disprove, albeit on a lesser scale now. Over time I have become more direct, more succinct, and have become fairly shameless when interacting with others in the hospital. Small talk has become a painful annoyance that I try to avoid (at least as much as is allowed while still maintaining some ounce of human decency).

I’m unapologetic…because I have to. The slow surrender that I’ve accepted is that providing 24h Neurosurgical coverage (emergent and otherwise) at an academic level 1 trauma center means near complete sacrifice of social norms and inefficiencies.

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“I’m sorry that you’re going through a divorce but this man is dying from a brain bleed.”

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“I completely interrupted you because you’re wasting time
and this patient needs to get into the OR.”

Again, none of this was a surprise to me — as with most things, I just didn’t have a full appreciation until I finally dove in….head first…straight into the fire (mmm nice and toasty). I still do my best to be respectful, courteous, and empathetic. I take great pride in representing my small but highly visible department well — it’s most gratifying when people express disbelief at how “smooth” or “easy” it was to work with Neurosurgery.

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Represent.

In the end I’ve definitely been worn down, but I don’t believe I’ve changed at my core. Speed and, oftentimes, cold efficiency is necessary to make sure people stay well and alive. You are constantly working, vigilantly, because you never know what the ER or Trauma Bay is going to bring you next. I know I can come off as detached and robotic at times and I just appreciate all the nurses, techs, and support staff that put up with me; hopefully realizing that:

  • It’s not personal.
  • Sorry for the awkward silences, trust that I’m just quietly prioritizing in my head.
  • I’m pooped.

I am appreciating the small things more and more.

Nothing is more stress-inducing than the sound of my pager going off. Every time I hear the beeps a tiny piece of me dies inside and all the world’s puppies get sick. The onslaught from every nook and cranny of the hospital is relentless — the relief I get when I’m able to turn off that pager is pure bliss.

The good thing is that any free time I do have (not very much) is time that I value and cherish more than I ever have in my life. Sitting on the couch and watching TV. Going #2 at a relaxed, leisurely pace (and on your own toilet). Catching up with friends and family is no longer a chore but an awesome reprieve and privilege. When you are essentially a slave to the pager and the hospital it bestows a very harsh perspective and my priorities and beliefs have changed accordingly.

Wearing normal clothes and not scrubs is weird but refreshing. Eating something other than cafeteria food is a rare blessing — actually having time to eat at all is the true gift. Sleep is more valuable than money, fame, or power. Sleep is king. I don’t like being extreme and dealing with absolutes (for that is the path to the dark side) but I rarely, if ever, take anything for granted anymore. Just like becoming a little bit meaner I didn’t fully realize what I’ve had until recently when my freedoms are stripped from me in 24h increments (every time I’m on call). I always try to stay positive, however, and I tell myself this is part of maturing and growing up. Grown up life is hard.

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Neurosurgery is still cool.

They say the PGY-2 year is one of the hardest in Neurosurgery. You are no longer an intern so there is less leniency and no more “free passes”. Additionally, you are the absolute lowest person on the totem pole and must accept the most tedious and painful tasks. Even with how grueling and draining the past year has been, it’s comforting that I still can’t imagine doing anything else. Even when we see some of the sickest patients in the hospital I still find meaning and purpose in a specialty that deals with death and despair on the daily. I have seen multiple lives saved and have witnessed enough full recoveries to still be in awe at what Neurosurgery can accomplish. I lose sight of this often. It’s really hard to see the light at the end of the tunnel but it helps to catch flashes and glimmers here and there. Rare snippets of praise from my attendings. A care package from mom. Gratitude from patient’s families. Dinner with my new fiance. Cleaning my dog’s poop. The small things keep me going. They keep me alive. Writing like this also helps so I hope I can do this more. No matter how much I complain or vent I know that I wouldn’t be satisfied if the stakes weren’t so high. You appreciate the good times so much more when you remember the hardships you’ve overcome. The darkest nights reveal the brightest stars.

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Neurosurgery or bust. Holla.

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One thought on “PGY-2.

  1. Omg bravo! So
    1) I didn’t know you write or had a blog.
    2) You write really well, and I hope you do continue to write a little sooner than in 11 more months (but I have the same problem so I have no room to talk) lol. But even as infrequent as the posts may become or even if the posts are more of a giant repository for random thoughts, they are such a fun way to look back and see how much you’ve grown as a person or how quickly life changes – especially as we get older.
    3) AWWWWWW to Hermes and “dinner with my fiancee”

    Like

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