Attending to this, attending to that

Being a new attending the first time around was really stressful. I was a new generalist, at a lovely community hospital, so the level of acuity that I was seeing was low. Regardless, I remember worrying about every decision anyway. I felt like I had homework all the time because I would a) see a patient b) make an interim plan c) have them come back very soon - a few days, or a week, even for something relatively routine and d) run and frantically look up stuff and email attendings from my residency.

I wonder now if that wasn't so much "new attending-ness" as "new-situation-ness". That is, I probably would have been more comfortable in a place with a higher level of acuity and sicker patients (similar to what I had seen on a daily basis as a resident). I also was very worried about what other providers would think about me: that I was dumb, or lazy, or just a bad doctor. 

So I was really apprehensive about this new attending thing. And, shockingly, it's been actually mostly...totally fine. Sure, the patient with intractable eclamptic seizures that was in the ICU on my very first on-call night wasn't exactly relaxing, but we managed it (although I remain grateful that she actually came in to the hospital before my shift. Then I read a lot. Next time I'll be ready!) 

It helps that the faculty that has hired me seems genuinely excited to have me on board. They know me already, so I don't have that social/professional anxiety. 

I did a difficult cesarean with the residents - it went ok. I managed a complicated patient on blood thinners before, during, and after her extremely preterm delivery - she did ok. I spent a lot of time this week talking to women at 24 weeks gestation with little or no residual cervix about their options - and that felt ok.  I said to one of my attendings (excuse me, ahem, one of my new practice partners), "The truth is, every time I see a patient and I actually know what to do, I am a little giddy." 

I am braced for the patient with conjoined quadruplets and a rare platelet disease, but in the interim, it seems that I've actually trained well for the job I'm doing, with the people I do it for. 

I'm scrambling to finish a little geocoding study that I've been working on, as well as getting my thesis project published, and I find myself - as usual - oversubscribed. But not, for the moment, overwhelmed; and that is quite nice.