A Day in the Life of an Intern on Arrhythmia Consults
Mornings typically start with the annoying and familiar buzz of the alarm clock. Then there's the typical internal debate about whether to answer the call or simply smack the snooze button for that worthless extra 10 minutes of sleep. In reality, what I really want is to just pull the plug and crash back to sleep for as many hours as I possibly can. Then there's the eventual realization that no matter how many times I hit snooze, and no matter how many 10-minute micro-naps result from it, I have to give in and start my day. Rotation to rotation, this is the constant early morning routine that starts the day. What differs is at what time it occurs.
Currently, I have been blessed with a month on Arrhythmia Consults, during which I have the luxury of showing at the hospital around 08:30 in the morning. This is significantly different from my experiences on OB, ED, and especially NICU. On my current schedule, I am afforded the opportunity to sleep in until around 07:00, at which time I have the parental obligation to wake my two children and motivate them for another day at school. Prior to my time on the Arrhythmia Consult service, my wife assumed this duty as I was typically out of the house by 06:00 if not earlier.
One important lesson I learned early on during this intern year is how to be flexible, because each rotation places different demands on your time, on your schedule, and on your availability to the outside world (in my case, my wife and children). There have been rotations already where I spend far more time at the hospital than I do at home, and there have been call nights and night shifts that make my schedule so different than that of my family. This is the life of an intern...Constant adjusting and adapting and making due with what you have available to you.
Currently, I have a schedule that is dependant on the number of consults placed. This has been a new experience for me as I have never before worked on a primarily consult-based service. The library has become my office, and, for the first time all year, I have down-time during which studying (or napping) has become a very real possibility. My only regret is not planning ahead to get step 3 out of the way this month.
My day at the hospital typically starts by checking in with the Cardiology Fellow with whom I'm working, and finding out if any new consults came in overnight. Typically, one or none is routine in the morning, and the max has been three. If no new consults are up, then I head to the patient wards and follow-up with patients we have already consulted on (read ECG's, Telemetry, new Echocardiograms, etc.). Write a quick follow-up note in the computer and then it's off to the library to await a new consult. There have been days when my pager remains silent, and I check it periodically to see if the battery has died just in case. At times I even sent a "test page" to myself because I was concerned maybe the pages were not coming through (this is very different from other services where pages can come in so fast that you can't even finish reading one, much less respond to it, before another rolls in - there are times when you literally have to "triage" your pages). The moral, consult services are a feast or famine phenomenon. We are either busy and consulting like crazy, or there is absolutely nothing going on at all.
I can't say the same for other rotations that I have experienced, nor for the ones I have yet to experience, but Arrhythmia Consults is a welcomed change of pace in the busy and demanding schedule of intern year.
Kyle E. Johnson, M.D.
PGY-1 - Anesthesiology