Around the Bend

I have now officially made it around The Bend. I have successfully (more or less) completed my third year of medical school and have turned the corner into the much coveted and universally admired position of 4th year medical student. MS4. I am now a Senior, of the highest rank on the student totem pole, one of those people who I looked at in awe a few short years ago, because they seemed to have this swaggering confidence, this incredible grasp of medical knowledge, this enviable foresight into their own clinical futures. Plus they looked really cool in scrubs with their important little pagers hanging jauntily at their hips.

Now I realize that the vast majority of those people were faking it, and they were in reality bumbling through their last year of school, completely and utterly terrified at the idea that in one year - in literally less that a single year - they would become doctors. They would be responsible for patients. Which means that they would very likely soon be killing someone. At least, this is what I am assuming was their train of thought. Conjecture based solely on my own present newly 4th year anxieties.

But there is yet more. For I am attempting to be very clever with the double meaning of the phrase "around the Bend," for not only have I passed the 3rd year milepost, I am also currently in Bend, Oregon. Yes! BEND! That city in the high desert, named for the bend in the Dechutes river upon which it sits, home of the Deschutes Brewing Company, named for the river from which it got its name, is wear I am living RIGHT NOW! Ah hah, you say. No wonder she kept suspiciously capitalizing the word "Bend." It was simply very clever foreshadowing.

I am starting out my 4th year with a rotation in the Critical Care Unit (or CCU, often referred to as the ICU or Intensive Care Unit - same thing). At some point this seemed like a good idea. "Why don't I, instead of taking it easy after third year," I thought, "head straight into one of the most demanding, time-consuming rotations, which requires every-other-night call in attempts to care for the sickest of patients?" Or atleast, that's what I would have thought if someone would have been polite enough to pass along that the Bend CCU rotation is insane. Or atleast, it is insane right now. Apparently, in order to herald my arrival, the good people of Central Oregon decided to have heart attacks and car accidents and gun accidents in epic numbers, in order to fill every single bed in the unit. They are air-flighting them in from other hospitals, for pete's sake. One of the nurses was joking about calling in the national guard, because they had almost never seen so many people in here before. This is good and bad for me. I get to see a lot of stuff. But I have to be here for very long hours.

Dealing with the sickest of the sick is interesting. Exciting and terrifying (and sometimes monotonous). They are here because they are at serious risk of dying. And some of them do. One of my patients died last night. I came in this morning to find an empty bed in an empty room. It was so calm and sunny and clean, that room. Ready to accept the next patient, as if the person who had been fighting for her life in that bed for the past month had never even existed. But she did. And I got to be there to stroke her hair and interpret her feeble handwriting (she was intubated and unable to talk) and watch her father's lip tremble as he talked about withdrawing life support. This is what I am learning, in spite of the madness.