Playing Doctor

 For those of you that followed me from the time I was writing on "Do They Have Squirrels in Buffalo?" you might remember that I left Minnesota to move to Buffalo and start an Emergency Medicine residency.  My first post about working in the Emergency Department included my saying, "I know eventually I'll stop feeling like a medical student and start feeling like a doctor again."  That was on September 12th, 2007.


Since I have to give my residency program a full 36 months, I will be in Buffalo until September.  All of my colleagues are gone and most will be working their "real job" starting this month.  So, I am working as the senior-most resident in the E.D. along with the new 3rd years.


It's been kind of interesting, and I've taken a bit of ribbing, especially from the attendings.  Today, my nickname was "pre-ttending."  I sometimes feel like I am.  While my third year started along with my colleagues, and I actually have done my 12 months of being senior resident, I think you really need to be on your own to make that final leap from resident to attending.


What I do notice is that I seem to go on auto-pilot a lot of the time.  I remember a case where a patient coded and the attending asked what I wanted to do next.  I froze.  Now, I run codes without thinking.  I guess that's where the training has come in.  Come in with chest pain, get chest x-ray, EKG, cardiac enzymes, MONA, etc.  Come in with abdominal pain, IV fluids and anti-emetics then plus/minus on the CAT scan.


While I still falter a little on the esoteric nuances of EKG's and multiple sclerosis, I think I am doing pretty good for the most part.  Another three months and I will be close to perfect... at least I hope so... for my patient's sake.