Thoughts from the CCU...

So it's pretty much over. The rotation dubbed, "the worse month of intern year"...is behind me!! Yay! Has it lived up to it's hype?? YES...and then some, or a lot. Mostly because we were intentionally understaffed due to the holidays thus making an already confidence destroying  and soul sucking month 10 times worse. I guess they don't want to be the main reason for the exponential rise of depression in more than 4 unlucky interns around christmas. So, I got to be one of the lucky few to experience the CCU during the holidays, how privileged I am. :)

So what makes CCU so bad you ask???

Here is my attempt to describe, with random details, the essence of CCU.

1. Cardiologistss obliviously speak their own language that nobody really understands, unless you too are a cardiologist, and even then its questionable. They presume that interns can speak cardiology the instant they graduate medical school. I mean, of course, how dare I have difficulty following what you're trying teach me right now...I'm clearly slacking since in my long 6 months of training, I don't know the intricate details of a subspecialty of a subspecialty of subspecialty lol. Shame on me.

2. Cardiologists actually believe that non-cardiologists, and possibly the rest of the world, can read their minds and know precisely what they are asking and what they want to be done. Don't forget that they are forever speaking in their aforementioned secret language.

Example:
The question they ask during rounds: "When did the patients chest pain start?"
What they actually mean: "I want you to tell me the results of every cardiac stress test, heart catheterization,  echocardiogram, and cardiac labs were back 5 years. Oh, and what they ate for breakfast on their 15th birthday."

3.  Cardiology is THE MOST evidence based specialty with hundreds, almost thousands of trials with stupid names like, "HOPE, MADE IT, SURVIVE, and BREATHING NOT PROPERLY"...seriously cardiology??? I have a hard enough time remembering the actual medicine much less the trials that proved it and how it was set up.

4. After listening to the various different ways "chest pain" can be described by the hypochondriac, psychotic, insanely old, blind and deaf, the guy who just wants to get out of his nursing home, the blissfully demented lady who probably can't remember she even has a heart, the 24 yr old kid trying to get out of the military, the cocaine addict, and the rare semi normal person that has actual cardiac chest pain, your idea that you actually knew what chest pain was, goes totally out the door. Bottom line: nobody knows what chest pain truly is, not even cardiologists though they pretend to and talk about all the different types using their language. Some days i walked away so confused about whether a person's chest pain was even in their chest. Other days my attending deliberated about the type of pain so much and went through all the possibilities and criteria that I wasn't even sure what a chest was anymore, or a heart for that matter lol. But seriously, after this month, when I hear/see the chief complaint of "chest pain" I have a feeling it's going to make me vomit or punch somebody in the face. Truth.

5. Congestive Heart Failure. Swollen testicles. Disgusting marshmallow people whose skin could potentially look like one of those egg crate mattress covers if you poked them enough. GIve lasix and wait for the urine to flow. More swollen testicles. There are no words to describe how much I hate congestive heart failure after this month. That's all on this incredibly boring and annoying aspect of cardiology.

6. EKG's. Finally starting to get the hang of it. Or so I thought. That little squeak of confidence was destroyed when asked to break down every aspect of a "difficult" EKG (fyi- a stone cold normal EKG at times can be difficult for me lol) in front of the whole team including the eletrophysiologist (best EKG readers in cardiology by the way)
It sort of went like this..

Dr. EKG: Dr. Ramirez, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul. 

Me: Okay, a simple "wrong" would've done just fine. 


(one of my FAVE movies ps)...But that's pretty much what happened.




7. Everything in cardiology seems to have like 10 different stages an subtypes and subgroups. For example: CHF stage C NYHA class III-IV grade II diastolic dysfunction.  Do people actually know what that even means??  Really??? You might as well say CHF stage furry class 5 subgroup 6 subtype 13 grade yellow. I mean I learned it and all. But so annoying. I prefer my patient's version of classifying her husbands end stage heart failure, (in VERY heavy korean accent) "He hart no wor so good".  So much easier.

...so as not to sound like the month was all bad, here are some last good things about CCU

8. You can actually burn a line i a certain area of a persons heart with an arrhythmia and it beats better. Thats just pretty cool. Seems counterintuitive, but it works. THose really good EKG readers are geniuses.

9. You get to electrocute people on purpose, with their permission. Also pretty cool. I noticed that I was actually really interested in the electrophysiology aspect of cardiology, more than I expected really. I usually don't like things having to do with electricity, but just the idea of the heart, floating in essential water, can have electricity flowing through it making it pump sort of blows my mind. If the heart can do it, i think we can find a way to make iPhones water resistant so I don't have to replace my phone so often. Seriously, get on it apple.

10. Learning stuff. I didn't think it was going to happen this month. Interns are mostly worker bees. We do as we're told and even if we do have an idea or plan or voice, it's usually ignored. That being said, i never had any ideas of plans on cardiology in the beginning because I had NO IDEA what was going on and what I was even intending to talk about (like the patients chest pain). Not to sound utterly clueless, but cardiology is such a specific specialty, you'd be a food if you thought you actually were good at cardiology prior to intern year or even during intern year. So considering that my initial knowledge of cardiology was close to negative ranges, I feel like I did learn a lot and could possibly be approaching about a 2 or 3 now...on a scale of about 827364872648762387. But seriously, i did learn and even got a few pimp questions right from time to time. And the best part of all, aforementioned genius eletrophysiologist guy that I was pretty much afraid to even look at for fear of my life gave me surprisingly good feedback on my last day. He even told me that he thinks I could be a cardiologist if I wanted to. He crazy. Or maybe he's doing the secret language thing again and that's just code for "you're a dumb silly girl."


So it's over. FINALLY. Can' say I enjoyed it, can't say I hated it. Actually yes I can. I hated it. BUT....i did learn a few things along the way and I'm always grateful for that, it's never time wasted. Looking forward to a more normal life now.

 I'm off to Peru. To find balance and perspective again.