I'm on the 21st floor now, O Best Beloved, with a panoramic view of Boston spread out before me, including some sort of domed building that I don't think is the library I saw on my earlier walk. The front desk concierge helped me move my stuff. He commented on my mouse - the mouse that Dave-from-Kansas sent me so very long ago, that I have been sleeping with whenever I sleep alone since I was a junior in high school - and I laughed a bit.
This is a nice room. There are pillow rolls on the beds, and it doesn't stink of cigarette smoke. Plus, as mentioned before, the view is amazing. I'd link you a picture but I only have my camera phone.
Before I go to dinner, I thought I'd mention that amazing Thursday I had.
Got in on watching a colonoscopy. Once they'd found the ileocecal valve (the valve between the small and large intestine), staff calls me over. "Here." She hands me the controls for the scope, explains how they work. "We want a good 360, so go slow, little movements." And they let me run the scope as the resident controlled the in and out. All the way to the end of the colonoscopy. I was ecstatic - hands-on, with good people helping.
Then it got better.
Thursdays at $residency are ultrasound mornings. I wanted to watch - they have their residents do OB ultrasounds. And as one of the residents was finishing up the ultrasound, staff mentions "You need to do AFI's." She looks over her shoulder at me, hands me the probe, and says "Nykki can do it." So I did. Sat down at the machine (which I'd seen used only that day) and started looking for pockets of amniotic fluid. Staff helped, but let me set my measurements and pick my pockets. And I got the measurements right!
It got better. As we were doing paperwork, staff scribbles on a little green card and hands it to me. "Give this to J. She'll start a file for you." It's a procedure card, of the kind that the residents use to track procedures. And they keep them for students who may be coming there. One limited ultrasound, check.
Then it got better.
Went back to watch a colposcopy. This, O Best Beloved, is what happens when your pap comes back all funny. We take you into the procedure room, stick a speculum in, and use a video magnifier to look at your cervix. Then we put vinegar on your cervix, and take more pictures. Then we put iodine on your cervix, and take more pictures. Then we take this horrible biopsy thing and clip little pieces out. Then we take another horrible curette (which is, essentially, a stick with a sharp edge) and scrape out the endocervical canal. Then we tell you you'll have a little cramping and some weird discharge from all the silver nitrate we're using to stop the bleeding from cutting pieces out of your cervix, and we'll let you know in a while how the biopsy report looks.
Here, they let you watch your own colpo if you like. It's on a video monitor, so this thing that normally is about the size of your pinky finger curled up like you're making a tight fist suddenly is 16" in diameter. It's scary. It's even scarier to see the big biopsy instruments with their teeth coming at your cervix. But some women watch.
I was going to watch. Then the patient was a colposcopy veteran and so laid back and the next thing I knew I was sitting in the chair, adjusting the speculum and the camera, asking for vinegar swabs. They let me do the whole thing, O Best Beloved, every last bit. And they said I did well. And I got another green card.
The preceding paragraphs do not adequately convey my ebullience. I'm not certain there is a way to adequately convey my ebullience. I love this profession, O Best Beloved, no matter how much I may complain or my feet hurt or I don't want to see another patient who needs better medications for her diabetes when if she would just eat right she wouldn't have diabetes. I love it. I love being able to talk with people, I love being able to make people feel better, I love being able to do the tests and procedures and looking down at my hands as I am operating a biopsy forceps that consists of a tiny pinchy bit on a foot-long handle and know that I am getting what needs to be gotten. I can get excited about clipping little diseased bits out of a woman's cervix and I can get excited about measuring parts of a growing baby. I can look at an ultrasound and see baby parts. I love it and it feels so very right for me to be doing these things.
And I love the idea that next year I'm not going to have to ask my patient to wait a moment before I do a vaginal exam so that I can get my preceptor. I love the fact that 90% of the time when I make a suggestion for a treatment plan my preceptors nod and agree, and the rest of the time there are very few changes being made. I love the steadily increasing autonomy and the confidence that being right is building in me, the belief that I can be a doctor and that I will be a doctor.
And I am scared absolutely spitless at the same time. And I think that's good. I think I should be scared because if I'm scared that means I know that I can make mistakes. And the best way not to make a mistake is to acknowledge that it happens, and act to prevent it.
I still have a long way to go.