Whew. What a crazy two weeks. I have been working in the ICU at my hospital, which from a medical standpoint is incredibly interesting, but from a big picture standpoint, sort of depressing since well over half the pts are dying. The hardest part for me is seeing the families in with their loved one. Friday we withdrew care from at least 6 pts and put them on hospice. The team I have been working with is incredible. The attending is a genius and just knows everything, which is pretty impressive since critical care medicine is so complicated. I loved both of the PAs I was working with, and my interns and residents and student were super nice too. We had two respiratory therapists who were great at explaining ventilator settings to us as well. I got pimped all the time and although I couldn't answer any of the attending's questions, I did ok with some of the questions from the other team members. I actually had one patient to follow throughout my time. She was an 86 yo lady with end stage kidney disease and a history of other heart problems who started having chest pain after getting dialysis, went to the emergency room and was having a NSTEMI (heart attack). She was discharged to the stepdown unit, and lost consciousness, and they had to intubate her. She spiked a 103 fever and went septic (infection in the blood), and they eventually did an echo of her heart and she has infectious endocarditis with vegetation growing on her tricuspid valve and the leads in her pacemaker (this is very bad). They also tried to wean her off the vent and she failed. She's not going to make it, and when I left on Friday they had just made her DNR and were going to take her off the vent and put her on hospice. So sad.

Next week I am following an electrophysiology PA for two days, then an endocrinologist for a day, have one overnight shift (9p-9a) that should be interesting, and then it's crunch time before my end of rotation exam! We're expected to know how to manage 330 diseases, and at this point I could probably do 30 of them. Yikes. I gotta get moving :)