The Revolving Door

I'm back on medicine wards at the Palo Alto VA, a reprise of my second month of internship. At the entrance to the VA, there's a big revolving door, and given the frequency of visits by certain frequent fliers, we sometimes think of the whole system as a metaphorical revolving door - although we do our best to optimize our patients at discharge, they occasionally bounce back if they stop taking their medications, miss their appointments, or start eating lots of salt. And now it is my second month back here. It is oddly reassuring. The worst part of every rotation is the first few days, when I have to learn the system, write passwords on the back of my hand, and get to know half a dozen new patients. But this time, within a day, I've reminded myself how everything works, and I was lucky enough to inherit 3 patients (though I did start on call). Each time back here is easier. I'm starting to recognize call-back numbers (6-2200 is the intermediate ICU) and remember nurses' names. And after the first 5 months, I feel that medicine has suddenly become easier; I put things together faster, I understand how to cross-cover better, I am aware of a wider variety of medications, I have more confidence. Despite it being December, I think this will be a pretty good month.