Rotation roundup: Cardiology

Could it be?  Am I caught up on my roundups?

Three cheers for productivity!

It’s true, in the midst of the CaRMS interview madness, I have actually managed to finish my roundups, the second draft of my script, and most of my LEGO project.  It’s been an awesome couple of days.

But I digress.  The internal medicine of 4th year consists of a few weeks of selective time – i.e. choose what you’d like to do (in theory, anyway).  I ended up on the cardiology service for a wonky couple of weeks, thanks to the post-Christmas scheduling.  Which means I didn’t get to see dermatology, GI, endocrine, infectious diseases, etc., etc.  But it was a great few weeks nonetheless!  I spent a few days on CCU (coronary cardiac unit), a week on the wards, and a week on consult service.  Each brought a slightly different flavour of cardiology, from the interventionalist to the internist to the consultant.

Do read on, avid follower.

The where:  Mazankowski Alberta Heart Institute

The good:  Needless to say, there’s a wide variety of experiences to be had on the service as a whole, and I loved the breadth of it.  I spent time in emergency, in the cath lab, on the wards… I think diversity is becoming a bit of a running pattern, ja?  I certainly didn’t expect to see the huge array of pathology that I did.  The running joke was that the cardio unit was, in fact, a nephrology unit in disguise, with the number of patients of dialysis we had. (Never mind all the neurologic emergencies we dealt with.) The teaching is really well done as well, from the infamous physical exam rounds to resident teaching.  I had the benefit of an extraordinarily intelligent and kind preceptor on my consult week, who taught and taught with every opportunity.  He made me re-examine my thinking and how I approach patient encounters as a medical student.  But kindly.  I can’t emphasize that enough.  So often, getting the answer right in those rapid-fire drilling sessions trumps the actual learning.  Not so with this gentleman.  Every piece of feedback was useful, direct, and honest.  An absolute pleasure, working with him.

The not-so-good:  As I mentioned, many emergencies arose during these few weeks.  It was emotionally exhausting, to say the least.  And while I’m told it was a bit unusual in terms of volume, this is very much bread and butter stuff for cardiology, especially interventional work.  I just didn’t expect it to be so heartbreaking.  Seeing your first unsuccessful code blue leaves a mark.  On a less important note, the ward work was extremely busy (which may have something to do with the fact that I was on the wrong ward for a whole week, oops…), which just added to the fatigue that was building that week.  Hell, I’m pretty sure I’ve lost 4-5 pounds from this rotation alone.  Not good.

The verdict:  The structured teaching was fabulous, though I’m glad to be taking a break from hospital work for a bit.

I leave for Halifax very, very early tomorrow morning, heaven help me.  The bad weather seems to be abating, but please keep me and my travelling classmates in mind these next few weeks!

 – Atalanta

Image courtesy of: cooldesign | FreeDigitalPhotos.net

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1 Comment

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One response to “Rotation roundup: Cardiology

  1. Having been in on several code blues (and cared for many, many terminally ill patients who have died and were obviously not coded) I can understand that it’s not always an “easy” thing. The sad reality is that we lose the majority of patients that we code. I’ve seen patients who have coded and died from a ruptured aortic aneurysm, a suspected stroke, and a GI bleed. I do recall 2 patients that we saved – one had a respiratory arrest (not sure why; bagged him for 2 hours before we sent him out as we had no ventilator available) and the other had a cardiac arrest – again, I’m not sure why. This is why making sure that you have good support available to you, and practicing good self-care, are very important when you work in areas where death is common.

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