July 1

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June 29, 2013 (2 days before start of intern year)

Tomorrow is July 1.

And, while most people are figuring out their holiday weekend plans, a subset of the population is figuring out how not to poop their pants tomorrow.

Or, at least that was me on July 1, 2013.

I picked up pagers at 7:30 am and remember thinking they might have to call a medical response team on me if they went off before my seniors got there because I had not the slightest clue as to what to tell anyone if anyone asked me a question. I felt like a huge fake; I didn’t even know how much motrin we usually gave patients! And, that’s an over the counter medicine. How were people calling me doctor when I didn’t even know how much of a non-prescribed medication you give?! I felt a lot lot Bambi wandering around in the forest…

Spoiler alert – the pagers do go off, you do figure out how to answer them, and you learn how much motrin to give someone.

So, dear interns, I survived….and you will, too!

Just don’t drink too much coffee on day one – your heart rate will already be high enough and you’ll be shaking even without it.

A couple of things to read about internship, July 1, and “the July effect:”


“Singular Intimacies” cover story

http://danielleofri.com/july-first-part-one/ [definitely listen to this one!]

My top tips for surviving July 1 as an intern:

  1. Be organized
  2. Ask questions. No one will fault you for not knowing. In fact, they expect you to know nothing.
  3. Be nice to nurses, scrub techs, PCTs, etc.






I’m Really Laid Back…Until I’m Not

Hello, friends!

Anyone still out there?

I meant to write more about my experience at ABC, which I talked a bit about in my last post. Then, I got swept into a work-life vortex and haven’t been able to look up much since (besides the obligatory exercises classes).

To keep it brief, since I got back from Costa Rica, life went from one impending deadline or project to the next. First, it was getting my research project finished both for a conference and for presentation at graduation (aka “Resident’s Day”). Thereafter, it was fellowship applications (that’s right, it’s time for the matchmaker to make me a match again, hopefully) and then prepping (slash obsessing) over two presentations I gave at Resident’s Day. This all came to a culmination last Friday and then I promptly went into 14 straight days of work, which will end on July 1.

In the background of this, I was, of course, working. After my ABC elective, which was incredibly enlightening, I started on GYN Oncology, where I spent a month doing a lot of robotic hysterectomies and striving for a “PR” for that case (thus far, 38 minutes, not including “closing the cuff”). Perso-professionally (this is a term I’m coining for personal development in the professional world….you can quote me on that), I felt like that month was a really big growth period for me in feeling more confident in the OR with “big” cases and being “in charge,” since I was technically the “Onc chief” and since my fellow went on maternity leave (congrats, Melissa!) so the other fellow was “double covering” both hospitals (a job I do not envy!). I actually felt ready to be a “chief” (fourth year resident) after that month. I also have to give a huge shout out to my junior (but not so junior in her skill level) resident, Foley, who made my life 1000% easier and I’m pretty sure made me look a lot better than I actually am.

So, all of that is to say that life got nuts and, as of last Friday, I “moved up” to my 4th year of residency! Insane, right? Its amazing to think that I was writing this blog well before I even applied to residency.

I’ve only spent one week as a chief, but I’ve already noticed that I’m a really laid back person….until I’m not.

That is to say, I like things neat, organized, pretty, and color coded and, if those criteria are met, I’m “go with the flow.” So, in reality, it appears I’m not “go with the flow” at all.

Right now, I’m the nights chief. Here are the few things I’m struggling with.

First, I’m so used to “running” things and thinking out loud, that I just start telling everyone what to do. You might think that since I’m the most senior resident, that is my job, but the goal is actually have the 3rd year resident to start to take over a bit more. It appears I’m not so good at doing that. Mostly, because I feel incredible lazy if I’m not either directing or doing and, rather, overseeing.

Second, I have a slightly unnatural obsession with “writing on the board.” (Or maybe is is a penchant for my own handwriting).

The “board,” for those unfamiliar is where we write and keep track of all the laboring patients. It is also where we write the “to-do” list for the night, which was my favorite part of being a third year (shocking, I know).

It appears I have a pathologic obsession with writing on the board. I can’t seem to give it up. Sometimes, I even ask my third year if I can do it and/or re-write messy things on the board (1- because I can’t stand it and 2- it needs to be neat so everyone can read).

You could see this as having control issues. I blame it on being a first born.

That is all I have to say for now.

Must shower and go to the trenches (work).

Until next time…

Daily coffee tally: TBD




Good Morning, America!

Hello World!

Does anyone still read this?

To the 5 of you who are, welcome back! Thanks for reading.

So, for inquiring minds (again, approximately 5 people), life has been pretty great lately. I have a new “gig” this month that involves delivering something different than babies.

News, people! I’m delivering news to the world! You can say I’m like a young Katie Couric. Or Diane Sawyer, since I’m blonde.

Well…..not quite. You should not expect me to be on your TV tomorrow at 7 am telling you the latest headlines.

But, I am working at ABC News this month as my elective [we get elective time in our 3rd and 4th years of residency].

This has been especially cool for me because way back when I was just a young pup, I wanted to be a news anchor. Mostly, I wanted this job because I love asking people questions (and still do). Ultimately, the allure of talking to people all day led me to medicine, but I still harbor dreams of interviewing people for a living. That is, interviewing that doesn’t involve asking about your medical history.

What does this job entail?

So glad you asked!

Primarily, we (the residents) help to read the latest and greatest studies (“embargoed,” meaning not released to the general public, yet) and help to vet them. This means you must first read for medical content and evaluate the strength of the study. Second, you need to read the study in terms of “newsworthiness” or entertainment value. Ultimately, some of these studies get picked up for stories – either online or on television. Its somewhat cool to see a story you “vetted” end up on Good Morning America or World News Tonight!

We also help research background for certain pieces and we participate in the Twitter chats Dr. Besser (ABC News Chief Medical and Health editor and all-around extremely smart and nice guy) holds each week.

[Shameless plug – next week we are hosting a chat about infertility! Join us! Comment below if interested!]

And, if you’re really enthusiastic, you may even get to “produce” a video piece! Yes, Mom – I’m a producer! I just learned what “B-roll” is so I think my film career is really on the up and up.

[Just Kidding!]

I’ve learned to turn my writing upside down (turns out, you have to ditch your flowery, academic writing sometimes), have kept up with politics more than I ever have (how many  more super Tuesdays are we going to have), and learned a lot about a totally different arena than medicine.

For those of you who work in the cubical/office world, hats off to you. I always thought that  if I had a desk job, I’d go outside all the time because I wouldn’t be tied to babies about to deliver. Turns out, you can’t do that all the time. While babies may wait for no one, the same can be said for the news.

Second, I had no idea most of the world worked with TWO computer screens (and, at ABC, millions of TVs!). At first, it was overwhelming. Now, I sort of like it.

That’s all for now. 🙂


First, I would start with how they got “their voice.” Second, I would ask them what is the most important part of their job that the general public probably has no idea that they do. Third, I would ask them how they hope to contribute to the field of journalism and how they hope to differ (or be similar) to the predecessors and contemporaries. Fourth, I would ask them their favorite form of exercise and coffee. Hard hitting news!

Daily coffee tally: 3

PS: Before my elective, I went to Costa Rica for a week and learned to surf. I recommend that you do this. Doctor’s orders!





Day(s) In The Life

People often ask about “what is like to be a resident.’ So, here’s a play by play of three different days – one in clinic, one in the OR, one a little mix

Enjoy. Don’t get too bored.


[during sleep, get text that 2 patients admitted overnight]

6:45 – wake up, rush to get ready because of two new admissions, decide not to shower, get to hospital by 7:30

7:30 – round on the two new admits

8 – pre op conference, discussing cases for the next 2 weeks, simultaneous eat breakfast and coffee #1

9-12 – colpo clinic, do lots of looking at cervixes/cervices (I’m not sure what the plural is of that), have one patient tell me I am warm, gentle, and a “beacon of light,” that is nice to hear, even if I’m pretty sure its not always true!

12-1 – eat lunch, review emails, update floor stuff from afar, worry about making sure all the cases for this week and next are being cleared, coffee #2

1-5 – in clinic seeing patients while simultaneously making changes to the OR schedule from afar i.e. in between patients (many no shows due to snow) calling the coordinating center to see if they can call patients, switch dates, etc. then make appropriate changes to my spreadsheet, have semi-nervous breakdown that not everything will happen, also try to get patients some new imaging and there are no appts for such so also have a semi breakdown begging people to overbook for me, I offer first born children and blood to no avail,

5-6 – wrap things up for day

6:30 – leave, not too long of a day!

7-8 – physical therapy

8-9 – eat, respond to emails, freak out about research and how I’m behind, wonder if I should get a golden retriever as a residency therapy dog, or maybe just a massage

9: 24 – writing this

10:30 – hope to be on 2nd dream


6:40 – In to round

7 – conference, eat breakfast and coffee #1

8 – first case, cold knife cone

10 – 2nd case – a TLH! (total laparoscopic hysterectomy as surgeon!)/BSO/PNLD (bilateral salpingoophrectomy, pelvic lymph node dissection), 4 hours total

2:30 – eat lunch, dream about another coffee, don’t do so due to its diuretic effect

3 – 3rd case – radical hysterectomy assisting, do lots of kegels whilst doing so, i will not have incontinence! kegels in the OR and having IUDs are some of gynecologists favorite little not-so-secrets, 5 hours total, dream about water

9:30 – leave hospital, first order of business is buying a giant seltzer

***there was no time for more coffee


8 – get to work, late day, this a dream, cover labor floor from 8-12 for a co resident getting a recertification, field GYN stuff rom labor since that is my actual team (i.e. floor stuff, consults, etc)

1 – help finish a more complicated consult

1:30 – give instructions to intern for rest of afternoon, run to clinic

2-4:30 – onc clinic

4:30 – onc clinic is weirdly close to done, go back to wrap up things on floor

6- sign out to night team

6:30 – leave for workout, do 1 mile warm up, 4 x 1 mile at 7:15-7:20, 1 mile cool down, was really hard, workout mantra “NOTHING IS HARDER THAN BGYN” (bgyn = bellevue gynecology), 6 miles or so total

9 – dinner, work, read, emails, things of that nature

11- dream land

That is all for now…




On Hysterectomies and Running

I never understood why senior residents obsessed over hysterectomies until I became one.

First, we do have to have a certain number of each type (abdominal, vaginal, laparoscopic) to graduate.

Second, they are more fun! Bigger cases! Exciting stuff!

Unfortunately, no one seems to want her uterus taken out right now. My booking block thus far has been a bust in the hysterectomy section.

I guess I should consider myself lucky. My first booking block I did at least one hysterectomy a week, sometimes up to three.

I liken being the booking resident to being a hysterectomy or other “big surgery” vulture. You feel like you’re always on the prowl, searching for good cases. And, then you feel kind of sick being like “I’m obsessing over wanting to remove organs” or finding a good prolapse or laparoscopic case.

Whatever, that’s why we’re surgeons, right?

Anyways, moving on….

Running, er “training,” has been going pretty great. As great as it can go when you work 60-80 hours per week! A few things to note:

  1. Mile High Run Club: Excellent option for winter/snow and/or to get speed work in as most of the classes involve hills and speed work. In fact, I almost died (in the good, track workout way) yesterday. [see below]
  2. Rebecca Kennedy’s A.C.C.E.S.S: It’s an active recovery class that I really like. It forces me to do things that I should do that I don’t do. I feel a lot looser and ready to run after I take that class.
  3. Physical Therapy: Seriously, Amanda (running buddy turned PT) has helped me get back on the roads (or treadmill, depending on the day) and actually train. Amanda, my right glute and sanity thank you! [Check out Amanda S or Abby B at Spear!]

If you want to get your butt kicked, go take the “distance” class at Mile High.

Its an hour of running, which I like. Usually, an hour of running on a treadmill (ok, ANY running on a treadmill) is mentally daunting to me. The class format makes it much more tolerable and actually, dare I say, enjoyable.

Running on a treadmill is hard for me for two reasons. First, the clock/mileage staring at you makes 10 seconds or 1 mile feeling like an eternity. Second, you can’t hide on the treadmill – people will see if you walk or stop (or fall off, which you probably would want assistance, in that case).

I’ve like trying the workouts at Mile High because it forces me to focus, pick a pace and stick with, and not give up so easily this early in my training (when I’m not entirely fit like I hope I am come March 20).

Last nights work out was as follows:

  1. 5 min warm up jog
  2. 7 min hill – 2 min @ 4%, 2 min @ 5%, 1 min @ 6%, 1 min @ 7% [truth be told, I was all “a 7 min hill doesn’t exist in real life!” when we started, but I’m sure one exists out there]
  3. 4 x 4 min progression (3 min at half marathon pace, 1 min faster) with 1 min rest
  4. 3 x 2 min hard/1 min rest
  5. 10 min hill starting at 6% and working down every 2 minutes while increasing speed every 2 min
  6. 5 min cool down

It was really hard for me; harder than last week’s workouts. I spent a lot of time in the pain cave.  But, that’s running. Some days it just feels really hard even if you have no explanation for it (less sleep, for instance). You just always hope it pays off in the end to see the workout through.

The girl on the treadmill in front of me  was absolutely killing it (home girl looked like the whole thing was a breeze) so I tried my best to use her as motivation. Whatever you can do to make it, right?

I then went home and drank a lot of La Croix seltzer. And some birthday cake. #optimalrecovery

That is all for now.

Daily coffee tally: 2





You’ll Never Find A Group More Inclusive Than Runners

In general, I find that most runners are really nice people.

Maybe its the endorphins. Maybe its a self selecting process. I don’t know if its the chicken, the egg, or just a case of “true-true, but unrelated,” but I’ve met fast runners, slow runners, fair-weather runners, die-hard runners and I’ve never met a mean, snobby runner. There is no mean girls “you can’t sit with us” mentality in running.

Well, at least the kind of runners I’ve come across.

I’ve had the good fortune of being coached through a 5K by someone who was 7th in the world in the discipline and paced by a professional marathoner and jack-of-all trades runner during my marathon. 

In return, I’ve run with people through first half marathons and paced a 9 year old to her 5K PR (who is now 13 and way faster than me).

As someone who grew up playing a more “exclusive” sport [tennis], I love that in running there is no front row, no sign ups, no lessons needed. You just have to put some shoes, show up, and try. I think all runners respect that it [running] is never easy; putting in the work is hard. Maybe that’s why its such an encouraging, supporting group.

I hate to say running changed my life, because I didn’t have a bad life before I started running. But, it sort of did. I’ve met my best friends through running, made awesome connections with great people, led me to the career I’m pursuing….

What brings all this up? Well, I did a long run tonight (11 miles) with some “fasties,” as you might call them. Of course, I was a bit nervous like “can I keep up with these guys?” Of course, because runners are usually great people, they were more than welcoming and, thankfully, I kept up.

Training is [surprisingly] going pretty well for this half. Right now, I’m on a pretty running friendly rotation where I can actually have enough time and adequate rest to do workouts and long runs. My next rotation [Bellevue GYN] won’t be so great. I’m worried my training will fall behind, not that it really matters. However, I’ve been weirdly motivated lately to “put in the work.” It’s “weird” because for the majority of my residency, I’ve had a pretty lax attitude towards training for races (rightfully so, in my opinion). I guess that last half I ran in October planted a little seed that maybe with a smidgen of training I could do even better this spring. I guess that’s what got me up at 5:15 in the morning the other day to do a 6 am workout.

The good news for my psyche is that I have no attachment to any goal for this half. Sure, I have numbers I’d like to hit. But, when I consider the possibility that it won’t happen, its fine to me. I’m taking the “expectant management” or “wait and see” approach for this half. I’m just going to put in the work that I can and see what happens. Its like going to labor and delivery without a birth plan; I’m just going to follow directions [from a training plan] and see what happens.

Alright, I have to go to bed, because I have a test from 8-3:30 tomorrow. College and med students out there — IT NEVER ENDS.

Here’s to looking at a computer screen all day tomorrow! At least there is free food.

Daily coffee tally: 2




Oh Hey Friends…

Hi there.

Winter showed up.

That’s a bummer.

Part of me is sad that I’m sad about that, because I know I should be more cognizant of “fake winter is bad for our environment,” but I was really enjoying fake winter.

This impending snow storm is really giving me anxiety over my long run this weekend (of undetermined length, maybe like 10-12, we’ll see how far the spirit takes me).

Its weird to be worrying about long runs again.

If you’ve read this blog long enough, you’ll know that back in my pre-residency days, I followed training schedules to a T. And raced. (relative term).

And, then residency hit, and I got into classes mode, because it became really nice to have someone tell you what to do.

Recently, some running spirit hit me and I’ve gotten all into “training” again. I put this in quotes as its sort of a mix of the old and the new. I’d say I used to go to classes more than run, and now the opposite is true. I’ve tried to do a workout each week. And, I’ve been doing long runs.

Its like a real training schedule!

I don’t know what’s gotten into me. Maybe its realizing that I can sometimes come up for air from this whole residency gig and work “hard” at something else.

Now, to be clear, what I’m doing now PALES in comparison to what I did in my med school days. And, I’m sure as we get further into this training block (and onto Bellevue GYN), I’ll skip a track workout or long run.

But, running and training, its nice to be back. At least for now.

I even brought out a WATCH. I had to dig it up from the ashes. And, remember how to erase old splits.

One thing I’ve recently discovered since winter hit and foiled some of my running plans (darkness+ 20 degrees+ running alone as a female = asking for trouble is Mile High Run Club. I’ve taken the “Distance” class twice, which is the 60 min running class (the longest they offer). It’s great! You can tell the instructors (well, I’ve taken the same one twice – Luke L) are runners. Its a very well structured work out. I get at least 6.5 miles in and some threshold work, which is great.

Also, I have to give big props to Luke. I had to leave Monday’s class a whole 15 min early since I was on call and had to be a work by 7:30. Luke was super understanding and even helped me tailor to workout to the 45 min I did run. Runners understand runners. Runners are nice people.

And, subsequently, I had one awesome, endorphin filled call!

Anyways, what’s all this training for? The NYC Half! I’m also raising money for Every Mother Counts for this race. As an OB/GYN resident, its a cause really close to my heart. See link if interested in helping me out. –> https://www.crowdrise.com/EveryMotherCountsNYCHalf16/fundraiser/meggiesmith

One suggestion to Mile High — have a 90 min class this Saturday so I can do my long run on your awesome treadmills?! Thanks, in advance, seeing as it might snow.

Also, in residency world – today was booking clinic and we thought we had 6 patients scheduled. Psych! There were like an additional 7. Funsies!

At least we got some cases.

[x] book cases

That is all for now.

Until next time!

Daily coffee tally: 3