The Limits

Another exam this week. The amount of material we are supposed to cover and have some mastery over in the span of two weeks is ridiculous. The instructor has actually said to us several times, "I don't have time to teach you everything, so you'll have to cover this material on your own." Which. Don't even get me started on that. We had two weeks since the last exam. And in that time--four lectures, one of which was shortened by the last exam--we were supposed to cover the manifestations and treatments of congenital heart defects, the types of hypertension, venous thromboembolisms, disseminated intravascular coagulation, heart failure, coronary artery disease, acute coronary syndrome, myocardial infarctions, and atrioventricular dissociation. Four lectures--and since the instructor has worked ahead almost two weeks, by the time the test came around, we hadn't seen the material in a couple of weeks.

I say all this not by way of an excuse--I got an A on the exam--but by way of explaining my frustration with incredibly poor instruction from an incredibly untalented instructor.

I have two more exams on Tuesday, then another one the week after.

And then of course there were clinicals. Thursday, my phone started going off at 4:45 a.m. with text messages from another student. Could I please tell the instructor that she wasn't going to be there that day? I was, like, how is this an adult thing to do? Send the instructor a goddamned email before 5:00 a.m. like she told us to do if we were going to be absent. The same student today complained that she hasn't had the opportunity to do many procedures. And I was, like, maybe if you actually showed up? But to be fair, she was one of three students absent that day, only one of whom had a valid excuse.

My patient this week was a woman, nearly 10 years younger than me, who has destroyed her liver with alcohol. That takes time and dedication. Now she is dying from it and it's questionable whether or not she knows that. The doctors have always been able to "fix" her before. Or at least gotten her to the point where she could be discharged from the hospital, whatever that means. But now her liver is so far gone that it can't be fixed. I talked to her about it a little bit, feeling her out about what she understands. It doesn't seem like much. Any of it.

At the end of the day, we meet and discuss various things as we eat our lunches. Today I helped one of the other students--a Muslim man born in the Middle East and raised in Ghana before moving here to raise his six children--sell some Girl Scout cookies. This all came about because on Thursday his lunch was part of a box of Trefoils (my favorite kind of Girl Scout cookie) and I asked him if one of his kids was selling them and he said yes and I said I wanted to buy some and that I used to sell them when I was a kid and he asked if I had any pointers for selling them and I said tell her to send the order form to work with her parents and he laughed. I think he's kind of shy and his daughter is shy too and so today I helped to set him up with someone in the hospital who is going to take orders for him and then I announced to the group that his daughter was selling them and I passed around a sheet for people to sign up to buy some and he sold, like, fifteen boxes that way. That was my good deed for the day.

I'm exhausted, as always. I'm not sleeping well. For the last several nights, I've fallen asleep between 8 p.m. and 10:30 or so and gotten up at midnight--then gotten back to sleep around 2:30. My alarm goes off at 4:30. . .

Monday I went to my doctor, who is pretty shitty--she is just a shitty doctor who was assigned to me after my good doctor left town--and got a new blood pressure med. My blood pressure is...not good and it has gotten worse since I started school. I got the prescription on Monday but I didn't start taking it until tonight because I know it's going to make me sick when it drops my blood pressure and I didn't want to deal with that at school and the hospital, so instead I'm dealing with it on the weekend. At least I'll have a couple of days to adjust (even though it can take weeks). Tomorrow I have to go to get labs drawn because this stuff can screw up my liver and/or kidneys and my electrolyte levels, so they want a baseline to see just how screwed up things get. It's fun stuff, yes.

I'm so tired that I had to be very careful today to bite my tongue when necessary. I'm not good at that anyway and when I'm tired I tend to just not even bother. Today it was fine because it was an easy day, relatively, and I came home and got an hour nap. Then I got up and couldn't go back to sleep.

Dave had gone out to dinner but when he got home, we went out for a giant fizzy drink and I ate an order of mozzarella sticks, too because when I'm exhausted I will put anything in my mouth in an effort to stay awake.

But now it's just after 10 and I have to start fasting for the lab tests.