Autonomy, How you Elude Me

If you notice my counter, today I have exactly 8 months until I graduate. That is less time than it takes to grow a baby in the womb..and we all know how fast that goes. I am not typically eager for time to fly by, but I'm getting to the stage where I want to be finished more than ever.

My rotation is still going well but some things just make me squirm. For instance, we had a girl come in on Thursday with an abscess on her arm (you know, the red bumps everyone thinks is a "spider bite.") So I went and saw her and told my doc it needed to be opened and drained (which it did.) Well, instead of letting me cut it open with a scalpel he opted to scrape the head of the abscess off with a needle and painfully try to milk the pus out. Not only painful for the 11 year old girl but painful for me to watch. Over my years in the ER and hundreds of abscesses that I have seen drained (and done a few myself), I have never seen this poor technique. Therefore, to finally get to the point, next year at this time when I see a patient with an abscess I can do whatever I want with it and not have to clear it with anyone. I can't wait to be autonomous.

Another point to bring up here is that we all have our strengths and weaknesses. My current preceptor has only been out of residency about 1 year now. There are some things he knows really well, like asthma, but there are certain diseases and procedures that I have more experience with than he does. I think I get more out of being taught by someone like him though because we are both still in the learning mode. Just because doctors go through mandatory residency training, there is still a big learning curve with they get out on their own just like when I am let loose next year. The good thing is that as newbies, we are constantly reading texts and reviewing diseases. Another plug here, don't feel like you are getting shafted if you have to see a PA or NP instead of a physician. It all depends on the individual and their personal experience. There are horrible PAs and NPs just like there are horrible doctors. This medicine thing is not all that difficult if you just realize that you will never know everything. It is simply a matter of "Do no harm" if at all possible and know when to get another opinion. We shall see how I feel in 8 months but I already feel competent enough to treat about half of my patients on my own. Thank the Lord, I really love my job.

Tip of the Day:

Cat bites are nasty. Literally about 50-80% of them get infected. Cats carry a bacteria in their mouth called Pasteurella multicida. This combined with the sharp fangs, it is like getting an injection of bacteria if you get bitten. Therefore, if you have cats around (gross) make sure the toddlers aren't pulling tails or ears. If you get bitten, you will need an antibiotic called Augmentin..so don't call me because I told you so.