Monday, August 17, 2009

The Double Life

The other day my neighbor saw me biking home at 8:00 AM. It wasn't that I'd been up all night working a shift a the Yale emergency department. I'd actually forgotten my lunch. Wednesdays are when the formal teaching in my residency occurs. We have 5 hours of lectures starting at 8:30 AM. Sometimes they are all in the same cavernous lecture hall at the Yale Medical School. Last week, we split up into small groups and did some simulation cases before two hours of standard lectures. (In the sim session, I resuscitated an 83 year old woman who was toxic on her digoxin heart medicine and who also had a gastrointestinal bleed. My feedback consisted of, "You have the best bedside manner I've ever seen for a plastic mannequin.") But I digress.

My point is that residents' schedules are known to be strange. It was natural for my neighbor to ask me yesterday if I was coming off a shift when he saw me biking in spandex and toting a full backpack away from the hospital. He was on a morning walk with his wife and young son. In fact, Wednesday was the only day that had a semblance of 9-5 for me. The rest of the week, I worked 4PM to 2AM. The carrots and hummus on my kitchen counter would be no good staving off the hypoglycemia (low sugar) antecedent to nodding off during the lectures. I did worry I'd be late for the first session when I turned around. Fortunately (for me AND everyone else in the program), I had plenty of time to change out of my spandex for the first small group. Emergency physicians are intent on being on time at shift change, but organizing a large group of night-owls at 8:30 AM takes more than coffee...

The same neighbor was washing his car while I was turning up sod for a new garden. We chatted about work hours, the economy and generally of making lemonade out of lemons. (He gets to prepare for his classes and spend time with his son more than he did when business was booming; I always have interesting patients to see in the ED.) We've only lived in New Haven for two months, and have not met many people, but it's nice how often we see those who we have met. We see them when we work in the garden, or when they are walking dogs, or commuting, or on evening strolls... it's nice to live in a neighborhood. I'm not intent on figuring out how to reside in it during normal hours. But even an off-hours resident can connect without that much work.

Tuesday, August 11, 2009

On Being A Resident

All of my posts thus far have focused on the municipal understanding of the word resident, specifically in the City of New Haven. It's time for me to address the other side of the pun. I am a newly minted M.D. who works in the Yale hospitals in New Haven and Bridgeport. Therefore I am a New Haven Resident.

Most of my time occurs within the venue I've chosen to spend my career: the emergency department. I'll be rotating in other areas of the hospital as well, but for the next few months, I'll be an ER doc. The ED has a schedule not shared by other specialties. The emergency room is open 24 hours a day, therefore doctors must work around the clock. Few docs prefer to work nights all the time, so the shift schedule tends to cycle through the circadian cycle. This is why I am at my computer on a Tuesday morning typing away. And why you might see me jogging on the local high school track at 2:00 in the afternoon, and why I sometimes come home at 3:00 AM. The so-called "shift work" done by emergency physicians is often maligned by other specialties as making the field less serious. If those other specialties have a better idea about how to staff America's health care safety net, I'd love to hear them!

So far, I like having the flexibility of having free time during business hours, and so long as I have access to a little bit of caffeine, I think I'll be able to handle the schedule. The information however, is another story. If you can imagine a fire hose of information coming at you when you just want a sip from the drinking fountain, that's medical school. Residency is like a burst water main. Which brings me back around to the New Haven resident pun. Perhaps I need to report this hydraulic emergency to the City of New Haven. It's easy to find at the Northeast corner of York and Howard. Look for the sign that reads, "Emergency."

Tuesday, August 4, 2009

SeeClickFix New Haven

When we moved in to our new home in New Haven a few weeks ago, one of the first things we noticed was the preponderance of pot holes on our street. One was so big, my wife's car could fit in it. It was only a couple of inches deep, so was more like a specially recessed parking space, but other smaller craters were nearly 8 inches deep. With all the rain we've had this summer, the array of street defects created a veritable Chain of Lakes for the length of the small street. (A deliberate nod to my NE Illinois readers.) Whether I drove or biked, every time I was on Eagle street, I felt like the driver in Moon Patrol. Fortunately, there are no enemies shooting at me. I understand there are other regions of this city where that could be an issue.

Anyway, I found a thread of complaints about this very issue at a website called SeeClickFix. There are actually three posts about potholes on Eagle St.: here here and here. The third link has some juicy vitriol; potholes bring ou the worst in people. Anyway, I don't know if it's because of the website, or that I emailed my alderman to complain (and ask for voter registration cards!) a few weeks ago, but I incredulously watched a work crew of two fill in every last pothole on the street last Friday. And they only fixed the stretch that goes past my house. The next block - equally riddled with holes, but not as complained about - received no repairs.

So perhaps this SeeClickFix business works! It's a Web 2.0 (user created content) interface that uses GoogleMaps to start and maintain threads. The site's history is connected to Yale and started in New Haven, but has spread to such foreign lands as Seattle and France; it is less used in those places.

Here's a map of the region of New Haven I live in. East Rock is where many grad student and medical resident Yalies live. It's pretty close to the hospital, has great shuttle routes (to Yale), is a quiet but still dense area, has a few little groceries, delis and pizzarias, and is close to freeways if needed. There is plenty to complain about, too. Look at all of those orange conversation balloons!

According to my alderman, the City of New Haven uses this tool to track municipal complaints and requests. Perhaps your municipality can use it, too! The site is looking for what they call SideClicks to spread the use of their website. It seems like unpaid digital evangelism to me, but if other cites catch on and use the system, maybe it's worth it.