Anyone else have days where the sky is pretty close to literally falling? You're firing in multiple emergent EVDs between which you have about 5-10 minutes to explain to a family that their young previously healthy loved one who was exercising for fun is now a vegetable and best case scenario might overbreathe the vent and flinch to noxious if everything goes well.
Before you can even process the immense sadness and heaviness of that situation the fucking PACU is hammer paging you to change some outpatient procedures orders in a completely arbitrary way because it's somehow slightly, but not functionally, incorrect.
While you're trying to put that in you get a consult for cord compression with a dude who woke up this morning and can't move his legs and is pissing and shitting himself for the past 3 hours.
While on your way down to the ED you get another call that a 80 yo male on aspirin, plavix and eliquis fell and now has a huge acute SDH requring Stat OR but will probably die anyway because grandma obviously must have angered the all mighty God.
Not to mention the 500 other bullshit consults that are essentially NTD call me never please but the medicine attending is demanding a formal consult just to have neurosurgery "on board".
Then you get phonecalls from attendings about pts you've never heard of needing to be preoped with clearence from 7 different services by tomorrow for a first start and it's 4pm
But now one of your EVDs has clotted off and you need go flush it but it won't fucking drain because the dude has b/l hematomas instead of ventricles so you eventually decide you need to soft pass a new drain but it's 9pm and you haven't eaten and you're fucking starving.
Sometimes I feel like I'm just numb, I see some of the most depressing fucked up shit in the world while I drop bombshells on families all day.
But I never have a minute to even process. I walk out of the hospital with a 1000 yard stare just to repeat it all again. It almost doesn't feel real sometimes.
Am I alone?
(11-23-2018, 11:04 PM)Anonymous Wrote: Anyone else have days where the sky is pretty close to literally falling? You're firing in multiple emergent EVDs between which you have about 5-10 minutes to explain to a family that their young previously healthy loved one who was exercising for fun is now a vegetable and best case scenario might overbreathe the vent and flinch to noxious if everything goes well.
Before you can even process the immense sadness and heaviness of that situation the fucking PACU is hammer paging you to change some outpatient procedures orders in a completely arbitrary way because it's somehow slightly, but not functionally, incorrect.
While you're trying to put that in you get a consult for cord compression with a dude who woke up this morning and can't move his legs and is pissing and shitting himself for the past 3 hours.
While on your way down to the ED you get another call that a 80 yo male on aspirin, plavix and eliquis fell and now has a huge acute SDH requring Stat OR but will probably die anyway because grandma obviously must have angered the all mighty God.
Not to mention the 500 other bullshit consults that are essentially NTD call me never please but the medicine attending is demanding a formal consult just to have neurosurgery "on board".
Then you get phonecalls from attendings about pts you've never heard of needing to be preoped with clearence from 7 different services by tomorrow for a first start and it's 4pm
But now one of your EVDs has clotted off and you need go flush it but it won't fucking drain because the dude has b/l hematomas instead of ventricles so you eventually decide you need to soft pass a new drain but it's 9pm and you haven't eaten and you're fucking starving.
Sometimes I feel like I'm just numb, I see some of the most depressing fucked up shit in the world while I drop bombshells on families all day.
But I never have a minute to even process. I walk out of the hospital with a 1000 yard stare just to repeat it all again. It almost doesn't feel real sometimes.
Am I alone?
Welcome to neurosurgery. We all break at some point.
(11-23-2018, 11:47 PM)Guest Wrote: (11-23-2018, 11:04 PM)Anonymous Wrote: Anyone else have days where the sky is pretty close to literally falling? You're firing in multiple emergent EVDs between which you have about 5-10 minutes to explain to a family that their young previously healthy loved one who was exercising for fun is now a vegetable and best case scenario might overbreathe the vent and flinch to noxious if everything goes well.
Before you can even process the immense sadness and heaviness of that situation the fucking PACU is hammer paging you to change some outpatient procedures orders in a completely arbitrary way because it's somehow slightly, but not functionally, incorrect.
While you're trying to put that in you get a consult for cord compression with a dude who woke up this morning and can't move his legs and is pissing and shitting himself for the past 3 hours.
While on your way down to the ED you get another call that a 80 yo male on aspirin, plavix and eliquis fell and now has a huge acute SDH requring Stat OR but will probably die anyway because grandma obviously must have angered the all mighty God.
Not to mention the 500 other bullshit consults that are essentially NTD call me never please but the medicine attending is demanding a formal consult just to have neurosurgery "on board".
Then you get phonecalls from attendings about pts you've never heard of needing to be preoped with clearence from 7 different services by tomorrow for a first start and it's 4pm
But now one of your EVDs has clotted off and you need go flush it but it won't fucking drain because the dude has b/l hematomas instead of ventricles so you eventually decide you need to soft pass a new drain but it's 9pm and you haven't eaten and you're fucking starving.
Sometimes I feel like I'm just numb, I see some of the most depressing fucked up shit in the world while I drop bombshells on families all day.
But I never have a minute to even process. I walk out of the hospital with a 1000 yard stare just to repeat it all again. It almost doesn't feel real sometimes.
Am I alone?
Welcome to neurosurgery. We all break at some point.
You are not alone
I'm quitting. I came to clip aneurysms, not be at fucking MRIs beck and call for shunt adjustments. Fuck this shit.
Sorry, you don't get to clip aneurysms as an intern. You need yo work your way up. Hence a 7 year residency. Have you listened to the Dr. Death podcast? The only starter job at the top is being president. Try Radiology. You can read films from day 1.
check out : "Building Resilience in Neurosurgical Residents" by Gary Simonds/Wayne Sotile
simple book discussing in detail the aspects of neurosurgery residency that make it not only often the hardest residency but perhaps hardest job on the planet (all things considered physical/psychological/time/stress)
it discusses in more detail much of the same scenarios the OP wrote about. Has some helpful suggestions, but is kind of just helpful to commiserate
Try crying some more. Your training is ten times easier than your attendings. Snowflake
(11-24-2018, 03:11 PM)Guest Wrote: Try crying some more. Your training is ten times easier than your attendings. Snowflake
Comments like this I always find amusing. They are typically made by some medical student or over zealous resident who is so insecure with themselves that they feel empowered by calling people a snow flake or referring to how it used to be harder in the old days. I assume you are not an attending, because if you are and you spend your time commenting on a website thats mostly aimed at medical students applying to our field, I can safely assume your career didn't quite turn out the way you wanted it to (hence the insecurity).
Regardless, neurosurgery was and continues to be a very difficult field. The issues faced by residents now are similar to what they were decades ago. We have a high morbidity and mortality associated with our field, and we are humans ourselves. Any resident who does not at least in part agree with the above post, or cannot associate with one of 'those days' of just getting hammered from all ends of the hospital, is either lying to themselves or truly has come from a fuck-around program where you certainly shouldn't be making the claim that things were harder in the olden days (because you don't know... you were not there).
As technology advances, we get better at treating the same problems, our patients do better. They live longer. They actually leave the hospital. The census becomes higher. The patient turn over much greater. Hospitals/programs are treating a lot more patients. These patients aren't just ruptured aneurysms or standard 'blood in the head' cases and they are not just dying like they used to. Spine surgery technology has exploded, more people are getting surgery. Endovascular is likely a large component of every residency at this point and contributes to case volume, as does GKRS. So, taking all of this into account, we are treating a shit ton more patients now and the EMRs haven't necessarily made it easier (nurses demanding a slightly different order because they aren't used to the one the intern entered).
So to the original poster, you are not alone. Any neurosurgeon who is worth talking to would share in your pain with these kind of days, we all had them. I certainly did a few years ago in my junior rotations. It gets better. You learn more tools to treat people and get more autonomy to do so. You won't be flushing that EVD forever, and one day that consult 'to get neurosurgery on board' will translate into $$$ and you will LOVE IT. You just have to hold on for 7 years. They can always make it harder on us, but they can't stop the clock. Good luck, you're in a nobel profession that makes a difference, never forget that.
(11-24-2018, 04:06 PM)Guest Wrote: (11-24-2018, 03:11 PM)Guest Wrote: Try crying some more. Your training is ten times easier than your attendings. Snowflake
Comments like this I always find amusing. They are typically made by some medical student or over zealous resident who is so insecure with themselves that they feel empowered by calling people a snow flake or referring to how it used to be harder in the old days. I assume you are not an attending, because if you are and you spend your time commenting on a website thats mostly aimed at medical students applying to our field, I can safely assume your career didn't quite turn out the way you wanted it to (hence the insecurity).
Regardless, neurosurgery was and continues to be a very difficult field. The issues faced by residents now are similar to what they were decades ago. We have a high morbidity and mortality associated with our field, and we are humans ourselves. Any resident who does not at least in part agree with the above post, or cannot associate with one of 'those days' of just getting hammered from all ends of the hospital, is either lying to themselves or truly has come from a fuck-around program where you certainly shouldn't be making the claim that things were harder in the olden days (because you don't know... you were not there).
As technology advances, we get better at treating the same problems, our patients do better. They live longer. They actually leave the hospital. The census becomes higher. The patient turn over much greater. Hospitals/programs are treating a lot more patients. These patients aren't just ruptured aneurysms or standard 'blood in the head' cases and they are not just dying like they used to. Spine surgery technology has exploded, more people are getting surgery. Endovascular is likely a large component of every residency at this point and contributes to case volume, as does GKRS. So, taking all of this into account, we are treating a shit ton more patients now and the EMRs haven't necessarily made it easier (nurses demanding a slightly different order because they aren't used to the one the intern entered).
So to the original poster, you are not alone. Any neurosurgeon who is worth talking to would share in your pain with these kind of days, we all had them. I certainly did a few years ago in my junior rotations. It gets better. You learn more tools to treat people and get more autonomy to do so. You won't be flushing that EVD forever, and one day that consult 'to get neurosurgery on board' will translate into $$$ and you will LOVE IT. You just have to hold on for 7 years. They can always make it harder on us, but they can't stop the clock. Good luck, you're in a nobel profession that makes a difference, never forget that.
People like this above poster are worth their weight in gold
(11-24-2018, 03:11 PM)Guest Wrote: Try crying some more. Your training is ten times easier than your attendings. Snowflake
This...
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