On dim expectations (or the beginning of Neurology)

Thus far, I have enjoyed wonderfully low expectations.

My attending this week, with whom I worked in the past as a medical student, understands that I am a psych resident on their service. He does not pimp me, expecting esoteric neurology knowledge like a MS2 preparing for Step One. He simply asks me if I know something, I shrug, and he says “Look it up and put that in your note.”

We have a good working relationship where I do the expected: chart review, see patients, complete a neuro exam, and present to the attending. He expects me to form a basic outline of a differential. And while I might know the direction to pursue, he will correct me without denigrating my abilities. We chew through the consult list and thus far I have returned home with a bit of sunlight, perfect to playing with the baby.

It is nice to touch patients again. There is a soothing ritual to the neurological exam, simple games which allow physical contact and a sense of caring.

On the neurology service, I need to maintain vigilance over a whole suite of lab values, imaging, primary team notes that I could entirely ignore while on the CL Psychiatry service. While I do miss the days of skipping to the nursing notes and only looking at EKGs for a single value (QTc), I do enjoy the chance to flex my accumulated medical knowledge.

After all, if you don’t use it, you lose it, right? And I owe over a quarter million dollars in exchange for this knowledge. It does seem wasteful to immediately forget it all.

As of writing, Mackenzi will be leaving tomorrow to head down to Austin for a conference. She will be gone from Thursday afternoon to Saturday morning. It will be her first true few days away from the baby. Away from me! On her own, able to sleep unfettered by a baby suckling throughout the night. I truly hope she enjoys herself. Except for our road trip cross-country, we had the baby and entered residency before we could realize our dreams of wanderlust.

We will miss Mackenzi. I will miss Mackenzi.

And now, she has returned. She is sleeping upstairs with the baby for the morning nap. It is a gloomy and chilly Sunday morning. Perfect for romping around the leaf piles with the baby in the backyard. We have some items on the to-do list, however they range from the standard (movement) to the cheeky (watch Incredibles 2 for ‘research’).

The big season of change is slowing. It is not over, not at all, but I feel like we are settling into a new orbit. More change is coming, that is for sure. But for now, I think we can gather ourselves and enjoy the moment.

On the Education of a Physician

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