From yesterday. After looking through all the paper bits and scraps I had kept, I ended up with a few piles. [I'm a "pile-r" genetically. I get it from my Dad.] As I examined each patient sticker and my notes, I forced myself to commit it to one of the piles:
- "Must Write" - this was the collection that with just a few details, I could clearly remember the patient. See their face. Re-live the situation. On a couple, I even had the heart pounding, lump-in-throat sensation all over again. So obviously, these were the patients that even now -- had really meant something to me. Because of my visceral response, these are the ones who really need their stories told.
- "Stupid Stuff" - This pile evolved when I started to see a pattern that was best described as "Stupid Stuff That Kids Do". This further got broken down into "Bad Luck", "Bad Judgement", and what I like to refer to as the "Crap Shoot" category.
- "Interesting" - This was the pile that ended up with the unique patients. Like the one & only kid I saw who really had Menke's Disease. These were mostly the oddities, or interesting milestones, like my first "Champagne Tap". I think they were kind of cool -- but the rest of the world out there, maybe not-so-much. Regardless, I couldn't bring myself to trash these notes. So they became pile #3.
- & 5. were variation on the theme of "volume". I had kept all my pager & call flow-sheets from my senior resident calls. So these notes were filled with tons of admits for diarrhea, dehydration, RSV, asthma, etc. All the basic routine reasons that kids go into the hospital. Ultimately, this ended up being the biggest stack -- but I couldn't bring myself to trash this either. So it went back into the 2 gallon ziploc bag.
- more volume, even less interesting
- "Kuddos" - this was the very, very, very small stack of four pieces of paper that were "Atta-boys" or bits of positive reinforcement from three years of residency. I know I have a few others squirrelled away somewhere. But in general, praise was very far & few between in residency.... ["That which doesn't kill us, makes us stronger...."]
What I found very illuminating after this exercise was this:
- All together, I probably have at least 25 interesting patient stories to write. In someways, that's more than I thought there would be.
- I also am bemused by what I didn't find.
I started my search through reams of paper today, intent on finding one particular patient's information. Which I never did find. And as I looked and sorted and consolidated tonight, I'm remembering a few other stories and patients, and I still haven't found their notes. Which means they either fell victim to an earlier purge -- or I have more stuff squirreled away that I'll find in the future.
Regardless, it's been an interesting process going back through this stuff. I think I've finally recovered enough from the trauma of residency to cope. Time has blunted my responses enough, that mentally - I don't get "stuck" back in that time.
It turns out that I've grown-up enough as an attending, that I am very comfortable knowing what I know, knowing what I don't know, and knowing how to manage the rest. So I don't feel haunted by all the insecurities that went along with residency.
I already know that it's going to take awhile to get all of this written. It doesn't help that as I work on one story, that triggers memories of others. And we all know my strong tendency to chase down rabbit holes....
Have patience and check back soon....
Comments