intern blues

[migm]

I gotta say, block 9 of my intern year is about halfway through (in my 1st of two back to back ICU months) and I am dragging hard. I know the PD said this was to be expected back in July but I had no idea what he meant. Something between the 80 hour work weeks, the cold, not having seen my SO in days I have lost all ****s. Wondering if I can hear from some more senior residents or perhaps junior attendings that may have also experienced this and can describe what it is that turns the corner. Sorry to vent.

/bitchingmode off

migm

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[EMdoc10]

Sorry migm, that sounds rough. MS4 here, but I can try to imagine what its like. ICU is high yield but hours blow. Luckily, we get to learn from them and move on/reason we picked EM for a better lifestyle. Hopefully in the next week or so you can adjust to the painfully-long shifts. By the time you're back in the ED, weather will be in the upswing too. Hope you're not at a place with 12h ED shifts!

 

[SoCuteMD]

I gotta say, block 9 of my intern year is about halfway through (in my 1st of two back to back ICU months) and I am dragging hard. I know the PD said this was to be expected back in July but I had no idea what he meant. Something between the 80 hour work weeks, the cold, not having seen my SO in days I have lost all ****s. Wondering if I can hear from some more senior residents or perhaps junior attendings that may have also experienced this and can describe what it is that turns the corner. Sorry to vent.

/bitchingmode off

migm

Yup, you've pinpointed it. Long call month, no daylight, cold, no social life. I usually scheduled my vacation for February, which broke up the winter doldrums. It hunk they usually get better after the inservice, though - so just hang on another 6-7 weeks and you'll start feeling better.

 

[deleted547339]

I gotta say, block 9 of my intern year is about halfway through (in my 1st of two back to back ICU months) and I am dragging hard. I know the PD said this was to be expected back in July but I had no idea what he meant. Something between the 80 hour work weeks, the cold, not having seen my SO in days I have lost all ****s. Wondering if I can hear from some more senior residents or perhaps junior attendings that may have also experienced this and can describe what it is that turns the corner. Sorry to vent.

/bitchingmode off

migm

Preach.......pretty turned off from clinical medicine entirely right now. Rads actually sounds good. Thankfully, I'm back in the department next month. I'm hoping that will turn me around.

 

[gutonc]

I have nothing useful to add other than...you were warned...they were right...every intern goes through this regardless of specialty. It would be nice if everyone could take a vacation in February but that's just not going to happen.

Everybody gets their panties in a wad about getting Thanksgiving/Xmas/NY off but honestly, most interns would trade 5 days off in February for the rest of their vacation in a heartbeat...but not until they made it to February.

 

[shoal]

Residency is long when ur in the thick of it. I'm a second year but can share my experience. Things during ICU months are difficult to say the least. We have a total of 5 months worth during the first 2 years. Just try to stay positive things will pass. Do things you enjoy during your one day off and rest as much as possible when not working. One last piece of advice talk with your fellow residents you're not alone.

Sent from my Nexus 7 using Tapatalk

 

[Droperidol]

Off service rotations are career affirming months. Try to learn as much as possible. Realize you are being given extra grief because you are an intern. It will turn around. Be warned that second year EM can also be tough. As soon as you start feeling better you will hit second year and now you're the upper level on shift, mover of the meat, etc. It also means the target is less on your back though.

 

[RustedFox]

I had a bad case of it. Bad. 7 out of 8 of the SIG-E-CAPS symptoms, and I lived in dangerous proximity to lots of alcohol.

Was really close to calling it quits; transferring or doing something else (FM/IM/carpentry/philosophy/whatever). Intern year is long, a limited amount of it is spent in the ED (which is where you busted your ass so hard to get in the first place).

Remember: austerity breeds excellence.

Your second year is infinitely better.

Stay the course.

 

[WilcoWorld]

Yep, this sucks... and this too shall pass. I recommend napping whenever possible during a call day (3pm and notes are done --> hit the call room until sign out) and taking advantage of post call days to do at least one fun thing. It's a far cry from a normal life, but it makes things a little bit better.

 

[EMdoc10]

OP, are your two consecutive ICU months plain luck of the draw? I'd think programs would make certain no intern has it this way/make tweaks if needed...

 

[gutonc]

OP, are your two consecutive ICU months plain luck of the draw? I'd think programs would make certain no intern has it this way/make tweaks if needed...

S**t happens, especially in larger programs. And if you're off service, you might have a MICU month followed by a SICU month which sucks but happens. You nut up, power through, hope it doesn't happen in Jan/Feb and move on.

 

[gman33]

I had a bad case of it. Bad. 7 out of 8 of the SIG-E-CAPS symptoms, and I lived in dangerous proximity to lots of alcohol.

Was really close to calling it quits; transferring or doing something else (FM/IM/carpentry/philosophy/whatever). Intern year is long, a limited amount of it is spent in the ED (which is where you busted your ass so hard to get in the first place).

Remember: austerity breeds excellence.

Your second year is infinitely better.

Stay the course.

Pretty close to my experiene.
I had a block around this time when I was really checked out.

I had an overnight shift on a cold Saturday night.
Right before I went in I was watching The Shawshank Redemption.
The end when he went to Mexico seemed like the ideal solution.


On my way driving to work, I really thought about just driving away and never coming back.
Not just a passing thought, I mean I was really considering it.

This time last year I was really sure I wasn't going to continue in EM.
If the depression kicked in any earlier, I probably would have switched specialties.
It was just too late to get into the match again.

There were a bunch of different factors that I couldn't stand.

Fast forward to midway in second year.
I'm glad I stuck it out.
There are still things that suck about EM and residency.
I've learned how to deal with some of these things.
I have at least some clue about how to approach most things I see.
Procedures are so much easier.

Almost everyone goes through this at some point.
Try to find a trusted source to speak with.

It will get better.
Feel free to post questions or PM if I can help.

 

[gman33]

 

[SoCuteMD]

"Like a kidney stone, this too shall pass."
- A radiology attending to me during my PGY2 trauma month.

 

[Akail]

Count your blessings brother. There are worse things in life than a demanding career. Also, residency's supposed to be tough; everyone goes through it. You'll get through it too and 10 years from now you'll get a glimmer in your eyes telling the youngins how much harder it was for you.

 

[EvoDevo]

Count your blessings brother. There are worse things in life than a demanding career. Also, residency's supposed to be tough; everyone goes through it. You'll get through it too and 10 years from now you'll get a glimmer in your eyes telling the youngins how much harder it was for you.

Yup.

Just like the Marines taught me, it's one foot in front of the other. Rinse and repeat.

Remember, it's always darkest before it's pitch black.

And

BOHICA

 

[Birdstrike]

I gotta say, block 9 of my intern year is about halfway through (in my 1st of two back to back ICU months) and I am dragging hard. I know the PD said this was to be expected back in July but I had no idea what he meant. Something between the 80 hour work weeks, the cold, not having seen my SO in days I have lost all ****s. Wondering if I can hear from some more senior residents or perhaps junior attendings that may have also experienced this and can describe what it is that turns the corner. Sorry to vent.

/bitchingmode off

migm

I've been there. It'll get better.

I think by reading your post, you know what the cure is: The end off this 2 month block, the end of 80 hr work weeks, better weather, and seeing your SO.

Seems to me they're all within a countable number of days, no?

Start the count down.


Sent from my iPhone using SDN Mobile

 

[jbar]

I got to this point last year when I was pretty down, it was cold and dark and I was like "this ain't no fun." And then I hit a month on tox and an away month somewhere warm and came back a different person. Residency is chopy, you have good stretches and tough ones. You just keep pushing through, learn as much as you can, and figure out what it is that keeps you sane. Make time for those things (working out, going to dinner, playing guitar etc) as well as you can.

 

[deleted547339]

Yup.

Just like the Marines taught me, it's one foot in front of the other. Rinse and repeat.

Remember, it's always darkest before it's pitch black.

And

BOHICA

That's not encouraging, lol.

 

[Aesculapius]

It gets better.

 

[Bacchus]

I gotta say, block 9 of my intern year is about halfway through (in my 1st of two back to back ICU months) and I am dragging hard. I know the PD said this was to be expected back in July but I had no idea what he meant. Something between the 80 hour work weeks, the cold, not having seen my SO in days I have lost all ****s. Wondering if I can hear from some more senior residents or perhaps junior attendings that may have also experienced this and can describe what it is that turns the corner. Sorry to vent.

/bitchingmode off

migm

I saw this post on the main page of the forums. I don't wander into EM all too often. I will say, my post is as fellow intern, but in FM (please don't hate me right now :\).

We're halfway through. Let me say it again, we're halfway through our first year! And, you're halfway through your ICU hell. Gotta look at it positively even though everything is looking down. I haven't done ICU yet, but if I were you I'd most certainly be looking for the positives (procedures, procedures, procedures).

Whenever I bring up the concern of my ICU month (in 2 weeks :X) with my seniors they try to spin it into "think of the educational experience." No ****, obviously I'm going to learn a lot... and I should since I'm going to be there a minimum of 72 hours a ****ing week. But that doesn't make it any better for me. I DO NOT like being in the hospital. I'm preparing myself this way: "Bacchus, you'll have no clue what you're doing for the first month. Just keep your head down, do your work and try to learn something."

Relish in the fact that after residency you won't have to go to the ICU again. That's a positive. What rotation do you have after your 2 months? Are you back in the ED? On something less rigorous?

Try to remain positive: it will be getting warmer soon, sunnier and the days will start lasting longer. Plus, your SO will be there for you as he or she is now. Your life will be back (somewhat).

 

[fahimaz7]

Time is on your side my friend. T-28 months and you are done with residency.

 

[gman33]

ICU can be tough.
My program is ICU heavy. 7 1/2 blocks.
Intern year, I hated it. Really hated it.
Terrible hours. Terrible everything.
Now, the hours still suck, but I realize it may be the best learning experience is residency.

I'm back in the Unit next week, and I'm actually looking forward to it.
The unit experience will make you a much better physician.

 

[deleted547339]

ICU can be tough.
My program is ICU heavy. 7 1/2 blocks.
Intern year, I hated it. Really hated it.
Terrible hours. Terrible everything.
Now, the hours still suck, but I realize it may be the best learning experience is residency.

I'm back in the Unit next week, and I'm actually looking forward to it.
The unit experience will make you a much better physician.

You know, my MICU month was easily the most hours, but I didn't mind it. I actually really loves it. I'm ok with being in the hospital if I'm learning, have work to do and around people that aren't malignant. It's the off service rotations where there's not much education, a lot of scut and being around people that hate life that really gets me down.

 

[e30ftw]

it gets better. hopefully you have some vacation or an easy month in the spring.

Do you work less during pgy2/3? our ed shifts went to 10 hrs pgy2 after 12 hrs intern year and it was a huge life improvement. Now ED months feel totally doable and like a semi "normal" job rather than a recipe for burnout.

 

[dchristismi]

ICU is supposed to be tough. Intern year is supposed to be tough. I am thankful I didn't do both at once - we did our ICU rotations in 2nd and 3rd year once we sort of knew what we were doing, as you were expected to act as a senior.

Looking back, now that my life is SO much better (ah, attendinghood rocks), I can confidently state that of all the rotations I did, SICU and my community ICU month were by far the best rotations I did. (The community ICU being a 42 bed massive ICU with an open heart unit where I basically solo rounded for 24 hours straight, 24 on, 24 off... it was brutal. Hard a hell. Oh yes. Grueling. But I learned exactly how far I can go, what I can do, and how to manage that razor-thin edge of life vs death. ("Hm. She's on 4 pressors and a bicarb drip? Hm. What haven't I ever tried? Let's add that.") Oh, and wrote a lot of notes and saw some of the sickest patients of my career.

Plan a vacation. The beach was my salvation. But yeah, residency is a bitch. And this time of year is the darkest. February vacations rock.

 

[EvoDevo]

That's not encouraging, lol.

Foxhole humor is sometimes the best humor. Don't worry, it eventually gets better.

 

[EvoDevo]

ICU can be tough.
My program is ICU heavy. 7 1/2 blocks.
Intern year, I hated it. Really hated it.
Terrible hours. Terrible everything.
Now, the hours still suck, but I realize it may be the best learning experience is residency.

I'm back in the Unit next week, and I'm actually looking forward to it.
The unit experience will make you a much better physician.

For my money, the unit experience can only make you a better EM physician. Seriously.

My program had two months in the SICU, one PICU, and another MICU. If I could make any changes to residency, I might have added another unit month (probably MICU).

They were all incredibly demanding months (maybe on my family moreso) and I hated life during those months. Yet I am ever grateful for the training, even today in my community practice.

 

[SoCuteMD]

For my money, the unit experience can only make you a better EM physician. Seriously.

My program had two months in the SICU, one PICU, and another MICU. If I could make any changes to residency, I might have added another unit month (probably MICU).

They were all incredibly demanding months (maybe on my family moreso) and I hated life during those months. Yet I am ever grateful for the training, even today in my community practice.

I'm only in my first year as an attending, but I agree with this. My program had 6 months of ICU - 2 MICU, 2 CCU, 1 PICU, 1 SICU. Those unit months combined with the very high acuity ED where I trained have enabled me to stay calm when I encountered truly sick patients on my own. They were hell to get through, though. I think during PICU I started treating myself to a little "present" every week - nothing extravagant, just something bright to get me through the week because it was really really depressing. During MICU my (awesome) intern and I were essentially running the palliative-care-but-not-really-because-hepatologists-never-give-up service. Depressing and painful, but I learned how to put in a cordis in less than 60 seconds while being extra careful not to stick anyone and I learned that a blakemore works best when it comes straight from the fridge…

All that training really has paid off. I split my time (community/academic) and some of the people at my community site have commented that I'm super calm in resuscitations (I'm not on the inside, but I put on my outwardly calm face because it makes everyone else feel better).

 

[EvoDevo]

... and some of the people at my community site have commented that I'm super calm in resuscitations (I'm not on the inside, but I put on my outwardly calm face because it makes everyone else feel better).

Haha! I get this all of the time. Had two very sick kids come in recently (one 3 months and the other 3 years) and both actively trying to die. Resuscitated both and got them to the peds hosptial where both later went home just fine. Everyone later told me,

"Dude, you were totally calm. Thanks for being such a great leader."

If they only knew that on the inside it was more like,

 

[SoCuteMD]

Haha! I get this all of the time. Had two very sick kids come in recently (one 3 months and the other 3 years) and both actively trying to die. Resuscitated both and got them to the peds hosptial where both later went home just fine. Everyone later told me,

"Dude, you were totally calm. Thanks for being such a great leader."

If they only knew that on the inside it was more like,

As I walked out of a pedi resus (to colleague) "As soon as this kid is on his way to the big house, I'm gonna need a fresh pair of scrubs…and underwear."