Cheers to a truly amazing year. From getting our puppy Cusco, to Mike matching ophthalmology, working in the hospital together, to traveling the world. Everything is better together. Happy New Year everyone! • #2018bestnine #2018inanutshell #bettertogether #growalways #twogreendocs #couplesinmedicine #medlife #medicine #medlove #doctor #travel #justdoit #md #do #residency #internyear #match2018 #ophthalmology #exploretheworld
More holiday silliness from the MICU night crew to bring in Christmas morning. We may look festive, but it's all business when things go down. Having a team that works well together (and has a little fun too) makes all the difference. • Hope you don't mind a spoof poem based on one of Mike's night calls: • Twas the night before Christmas, when all through the floor, 🎄 Not a patient was active, not even pesky bed four; 🎁 “Our census is low” say the Interns with glee “Who comes to the hospital on a cold Christmas Eve?” 🎅 The nurses sitting at their station with naught but a hush, Hoping to avoid the 10PM dilaudid and Benadryl rush; 💉 Senior residents were nestled all snug in call room beds, While nightmares of social work danced in their heads; 🛌 When up from my pager arose such a clatter, I called back immediately to see what’s the matter. ❗️ “Ms. Smiths daughter wants to speak with the doctor right quick, Also bed three has chest pain and he looks quite sick!” 😷 Was Bed three here for pneumonia, or was it a fall? There’s so many patients – I can’t remember them all. ▪️ Then on my way to the floor and I hear overhead: “Code Blue, Code Blue!” the mechanical voice said. 🏃 I dash to the room and start CPR “Who’s running this code?” I hear from afar; 👏 When in steps my senior, looking impossibly fresh, She began barking orders, just a bit out of breath: ❄️ “Now EPI, Now BICARB, now CALCIUM, GET LABS! Resume compressions, More EPI, Pulse check, PLACE PADS!” 🗣 What’s the rhythm? Hang a bolus! Deeper compressions I say! What’s the pulse? We have ROSC! Let’s call it a day” 🤶 We wrap up the code, with no debrief in sight, When I look at my pager making me jump up with fright, 😱 I missed not two pages, not three, and not four, But eight, eight missed pages, and here comes one more! 😓 Three hours later and the night is half through, Finally caught up with the pages- well, except the last two. ✌️ I’m completely exhausted but I wish with all my might: MERRY CHRISTMAS TO ALL, AND TO ALL A GOOD-NIGHT!🎄🎄🎄 • #christmaseve #micu #happyholidays #chistmas #iculife #icu #criticalcare #criticalcarenurse #medicine #medlife #hospitallife
▪️ED: We have a patient for transfer to MICU. Young male of indeterminate age BIBEMS s/p fall from elevated ledge. No pulse when EMS arrived. Patient was intubated in the field, and ROSC obtained after 6 minutes and 3 doses of Epi. • ▪️ICU: How'd he fall? • ▪️ED: Fall was unwitnessed, though patient noted to have elfin fascies so possible chromosomal abnormality vs EtOH as eggnog was discovered near the scene and patient found in festive attire. BP now 70/43, HR 106 • ▪️ICU: Okay. Let's save this kid. Let's start hypothermia protocol and start pressors to support his BP. Something tells me the cold will do him some good... • Just some holiday silliness to lighten the evening. 🤣🤣 Thank you @kristincandelarioo for the hilarious setup! • #elfontheshelfideas #elfontheshelf2018 #micu #tistheseason #elffellofftheshelf
Those who have no time for healthy eating will sooner or later have to find time for illness. -Edward Stanley • I know it's it's technically Tuesday, but this amazing spread (if I do say so myself) was made on #mealprepmonday . At first, cooking large quantities can be jarring (mason jar pun 🤣), but having easy to grab dinners and breakfasts is a lifesaver on busy rotations. It's a lot of upfront time, but I think you save more time, money, and (most importantly) calories by making it upfront. • This week we made our go-to Buddha bowls with quinoa, crispy brussel sprouts, roasted carrots, and baked tofu. All easy set it and forget it dishes. Paired with our breakfast oats- oats, Greek yogurt, fresh fruit, and walnuts - we have easy, healthy meals at a moments notice. All in all it only took about 2.5 hours to make 10 meals (working out to less than 10 minutes/meal). Not too shabby! • With how many hours we work its easy to make excuses and eat out most nights. I rarely have the energy/motivation to cook after a long day. But to be honest, I spend at least 10 minutes deciding what to eat, ordering, and dealing with delivery/take out. I just spend the time upfront instead of spread out over the week. As an added bonus we save a ton of money 💰 eat much healthier 🥒 and it's delicious! Win-win-win! • #growalways #twogreendocs #veggielife #veggielovers #mksap #studystudy #nightfloat #doctor #pagerlife #internalmedicine
With great power comes great responsibility. -Uncle Ben • One of the biggest and scariest changes that comes with being a second year ("senior") resident involves carrying a pager. Not just any pager, mind you, but THE code pager. While carrying this small hunk of beeping plastic, you are responsible for leading the resuscitation efforts for any cardiac arrest (also called a Code Blue) in the hospital. You are expected to know not only WHAT to do, but also be able to lead everyone else as well. 😱😱 • If you've ever been involved with a code blue, you know the organized chaos that goes into the resuscitation. Sometimes there are over a dozen physicians, nurses, respiratory technicians, and others all working together to bring a dead patient back to life. And if you're holding this pager then they are all looking at you for leadership. It's both terrifying and exciting at the same time. • And if you couldn't tell by the quote, the new Spider-Man movie has been on our minds lately. Mike is trying to coerce me into seeing it with him, but I'm holding out for the promise of 🍿 and 🍦!!!
Big Brother is Watching You. -George Orwell, 1984 • When you're taking care of the sickest patients in the hospital, it's immensely comforting to know that you always have backup. The tele-ICU is a team of physicians and nurses who monitor all the data coming in from ICUs throughout the hospital and serve as backup during emergencies. They see every vital sign, every order, ventilator settings and even check in on patients with cameras in the patient rooms (it's not creepy, I swear). During "code blue's" (ie sudden cardiac death) the tele-ICU team helps make sure everything runs smoothly (or at least as smoothly as it can be 🤣🤣). • Our program allows residents to rotate through the tele-ICU, and I finally had my turn. Yes, we use 8 monitors to keep tabs on everyone. I must admit- It was a little overwhelming at first 😰😰😰 • I feel like I didn't get my system down until near the end of my first week, but once you get it down it gets a lot less stressful. In this picture we're reviewing the management of a septic patient who was deteriorating. Being able to look at the imaging (upper left side), cardiac monitoring (top right) and lab values (center) at the same time makes it much easier to manage. • I'll be sleeping much better knowing that this amazing team of doctors and nurses have my back the next time I'm in the ICU.
There is no force equal to a woman determined to rise. -W.E.B. Dubois 💪💪💪 • I couldn't be more proud of my partner and best friend (and love of my life)- Nicole. • On top of board studying, the crazy hours of residency, and putting up with my nonsense, she manages to find time every week to work on research. For months she has been spending hours working on this paper, and it was just published (with her as first author no less) in this months issue of #Cardiology In Review! 🎉🎉🎉🎉 • I think this is proof that a few mins of dedication every day WILL lead to results. #alwayshustling #cardio #research #residency #pgy2 #medlife #medicine #internalmedicine #hospital #academics
Just spent the last two weeks with the best medical ICU team in the land. The 8 of us battled 24 hours a day to keep some of the sickest people in the hospital going (only made possible with the amazing ICU nurses, respiratory technicians, and nursing assistants). • A lot of people don't realize that the sickest patients in the hospital reside in the medical ICU (at least in our hospital). 💪💪 Popular opinion would designate the trauma ICU with this title, but at the moment of writing this post, the highest 3 severity scores are all MICU patients. We prop up the Septic Shock patients, the liver failure, and sick cancer patients. • Anyways, it was an honor to work with these folks, and moreso an honor to treat the patients we've had these weeks (even though most of them were sedated and will never remember me 🤣🤣). #criticalcare #critcare #icu #medicalicu
While it was technically over the weekend, our hospital celebrated World AIDS Day today. I'm proud to wear the red ribbon to raise awareness of the impact this terrible pandemic has taken on our patients. • Over 37 million people live with HIV worldwide. It's a treatable and manageable disease. Know Your Status is not only the theme of this year's World AIDS Day, it's also the smart thing to do. Don't fear getting tested (like many of our patients are)! • Support pedaids.org on their battle to end pediatric HIV in over 19 countries! #worldaidsday2018
For some reason, no matter how exhausting of a week I've had, I always find enjoyment in cooking. It's not the eating part that I look forward to (though that's pretty awesome). In fact, when there's no one to cook for I rarely do it. I think it has more to do with working with my hands to help someone else. It probably has something to do with why I enjoy procedures so much. • We've been craving smoothie bowls for a couple of weeks now, despite the cold weather. 🤷♀️ But why pay $9 a bowl when we have all the delicious ingredients right here? Add in some miraculous post night-float insomnia and these beauties were made • The bowls themselves were easy: a frozen banana, some frozen berries (Costco is amazing for frozen produce) and some almond milk. The real surprise was the homemade granola. • Recipe: 1️⃣3-cups rolled oats with two handfuls of almonds and some cashews roasted (dry) for just under 20mins at 350 degrees 2️⃣ while roasting, mix 1/2 cup honey with 3 tablespoons oil of choice (we used avocado oil because 🥑 🥑 should be in everything). Add in some cinnamon (we love it so I used a lot) and a dash of salt 3️⃣ remove roasted nuts and oats. If it doesn't smell amazing, you've done something terribly wrong. Mix honey mixture into the oats and mix until everything is coated. It'll look like it's not enough honey, but trust me - it'll be enough. 4️⃣ place mixture on a wax paper lined baking sheet and bake again for 5 more minutes then turn off the oven and leave the oats in there for another 5-10 mins (or for as long as it takes to chop the fruit and nuts) • And that's it! We topped our bowls with banana and strawberries, the warm granola, some walnuts and chia seeds! 100% the best way to start our day off. • What's your favorite recharge recipe? #vegetarianfood #smoothiebowls #postcall #recharge #plantbaseddiet #medicine #medlove #medlife #residency #internyear #internalmedicine #medicalschool #medschool #breakfastideas
My motto is to never waste an opportunity to take a silly picture. As Oscar Wilde said, "life is too short to be taken seriously." • Our program has an amazing simulation lab, and it was our turn to run some patient scenarios that we frequently face in the hospital. Needless to say, most of the issues involved serious topics such as delivering bad news or addressing medical errors with patients. Despite the grim conversations, the feedback was helpful and we got to hear concerns from the patient's perspective. It was an awesome experience. • However, after all the doom and gloom we needed something to lighten the mood. An instant of silliness in an otherwise somber day. Thank you to all the actors who spent their time making us better physicians. • #simlab #medicine #residency #internyear #internalmedicine #growalways #twogreendocs #medlove #medlife #medicalschool #medschool #standardizedpatient #constructivecriticism #motivation #silly
One of the rarest events in all of residency occurred for us last weekend. No, I didn't write the perfect discharge summary, nor did I make a flawless presentation to the Attending 🤣🤣. But three very unlikely things came together for a trifecta of amazingness: •1️⃣I had a golden weekend (one of 6 non-vacation weekends all year) •2️⃣Nicole had a golden weekend at the same time (which will only happen 1 other time this year) •3️⃣ the weather was amazing! • I feel like I should buy a lottery ticket with how lucky we were over the past few days. • This is my favorite bench at sunset at one of our favorite hikes. It's a long 9 mile loop, but worth it for moments like this. We actually didn't make it back to the trailhead before dark and had to hike the last 45 mins shivering with our phone lights 😥. But I'd do it all over again to experience these 15 minutes at the perfect spot with my two favorite organisms (Nicole, and Cusco is there if you look hard enough) • #internyear #residency #goldenweekend #rockefellerstatepark #trek #trekking #medicine #medlife #medlove #growalways #twogreendocs #medicalschool #medschool #newyorklife #escape #wellness
In learning you will teach, and in teaching you will learn. - Phil Collins • Here we have Professor Nicole teaching one of her interns (me 😎) some of basics of bedside trans thoracic echo for a patient with a possible pericardial effusion. • One of the upsides to working night float is having an hour or so every night (usually between 2-3am) that can be used for studying, teaching, or catching up on procedures (or 😴 😴 if you can get the chance). Nicole chose this night to go over some basic views with the ultrasound. • Teaching is an important part of residency. Passing on your knowledge can help solidify the information, help identify what you don't know as well as you thought you did, and help your colleagues grow. • Have you made time to teach this week? #residency #internyear #nightfloat #medicine #medlife #medicalschool #internalmedicine #internalmedicineresidency #twogreendocs #growalways #medschool #medical #ultrasound #cardiology #cardiologia #teaching #medicaleducation
Night float is bittersweet. On the one hand, I can't imagine it could be safe to work 36 hours straight (the old system). I know that I become pretty much useless after 14-16 hours of straight working, so I usually feel that discreet night coverage is better for everyone. But on the other hand... living like a zombie for two weeks is taking its toll. • Luckily Nicole and I were miraculously scheduled for nights on the same block. Usually, when one of us is on nights we barely see each other. Sometimes I catch a glimpse of her as we walk past each other in the hospital parking lot, but usually it's just two weeks of minimal interaction. • However, for the past two weeks we've been battling the nights together, and it's been an intense experience. We've had a few brutal nights where we were scrambling to keep multiple patients from crashing. But overall I think we grew as doctors and as partners. • Couldn't imagine doing this beside anyone else. • #residency #residencylife #medicine #nightfloat #longcall #medlife #medlove #medschool #medicalschool #internyear #growalways #seniorresident #ladyboss #shestheboss
The end of a rotation is always bittersweet. On the one hand, I'm 6-weeks closer (yes I've had 6 straight weeks of floors 👎) to being done with intern year. On the other hand, it has been awesome to work with such an efficient and fun team. • I was even pleasantly surprised about how helpful and amazing our medical students have been. I doubt I was anywhere near as competent when I rotated as a student. • Highlights of the last 6 weeks: 1. Having a restrained schizophrenic patient spit a banana at me for trying to auscultate him (he did not succeed, I heard that darn murmur). • 2. Being on the chest compression team for a 40 minute code and sweating through my shirt and white coat before 8AM. • 3. Moving a social work mountain on a holiday weekend to get a dying man back home on hospice so he could spend the rest of his time surrounded by his wife and children. • 4. Seeing a patient that is growing three different bacteria and three different fungi in one bone infection. • Anyways, I'm rambling now so here's to the end of another chapter in residency 🍻🍻🍻. #medicine #residency #internyear #medicalschool #growalways #pgy1 #scut #loveit #whitecoat #stethoscope #medicine #wards #houseofgod #teamworkmakesthedreamwork #sillyface #workworkwork
Sometimes you gotta sneak some Goofy faces on an otherwise hectic day. #goofball #coulplegoals #medlife #medlove #stethoscope #twogreendocs #growalways #residencylife #pgy1 #medschool #medschoollife #lovehim #whitecoat #internyear #goodvibes #rainytuesday #couples #medcouple