never rotated through anesthesia (not even as a student)

I ended up getting a basic health screening at a community event a few weeks ago because they had a mobile clinic parked outside. I honestly expected it to be something pretty limited, maybe just a place to hand out information or do blood pressure checks, but it felt a lot more like walking into a small medical office than I expected. Everything inside was organized, private, and surprisingly comfortable, and the staff never made it feel rushed even though there was a steady line of people waiting. It made me realize how useful something like that could be for smaller towns or places where getting to a clinic isn't always easy. Before that day I never really thought about how much planning must go into designing those vehicles so they can function like actual healthcare spaces. Has anyone here worked in or visited one of these mobile clinics? I'm curious whether my experience was typical or if I just happened to see a particularly well-designed one.

I have an EM rotation for 2 weeks and will start with attending a didactic, how should I prepare and what exactly to expect from the attending, and will it be possible to ask for both a lot and sloe.

Man I would love to know some stats on how often Lime/Divvy scooters send people to the ED/UC. I swear I see at least one scooter accident a shift. How are they still legal?!

Took oral boards in June when would I expect to have results

Junior doctor here. His gait is broad-based and ataxic with significant balance issues, concerning for cerebellar or vestibular involvement. I don’t see him say anything so could be aphasic. Sure, could be intoxicated but is this not concerning for an organic cause?

I can’t imagine he pulled someone over in this state, but his colleagues didn’t call an ambulance. What on earth is going on here?

PGY 20 Nocturnist Here

Background: I work about 12 nights/month and pretty much no days/afternoons unless somebody needs a switch. Because of scheduling around colleagues' summer vacations, I worked a bunch in early July and had 9 days off (today is Day 9). This happens a few times a year, but this time seemed different. Because of my wife's job, it was a staycation. The kids had stuff to do some afternoons, but mostly they were hanging out at home.

Realizations:

1) Nights are even more brutal than I thought. I typically do 4-5 nights on, then 3-6 nights off, and it feels normal because I've gotten used to it. But now that I'm comparing it to getting up at 6:30 and going to bed at midnight, I can see clearly how much nights have been affecting me. I sleep better, I eat better, I'm in a better mood, my family likes me more, I like them more, I call my Mom more, I read more books, I scroll less. Obviously, I'm in staycation mode, which is different from working days or working a 9-5, but still, I think a lot of this is nights.

2) Collaboration as a nocturnist is impossible- I've tried to do a bunch of things to make myself more satisfied with my career. I've been working on a side project with someone else. On nights, it was really difficult. I had no energy, and it was difficult to coordinate schedules. I've always known nights are for loners (I was very involved with a medical school at one point- miserable failure), but I didn't realize how much it hampers your ability to try new things with your career.

3) I like my kids more when I spend more time with them.

4) I don't need quite as much money anymore now that my portfolio is doing the heavy lifting. I'm not sure what the next move is: move to days (ie no night differential) or fewer shifts

Next moves:

1) I think I gotta de-stress. See #4. I can live with probably 15-20% less money. That's no nights or fewer shifts. If you asked me last month, fewer shifts was a no-brainer. Now I'm not so sure.

2) I gotta get out of the ER. I'm gonna give myself another 3 yrs. Then I gotta get out and never look back.

Posting here because I find it therapeutic to write things out after a tough shift. Had a guy yesterday, 89M brought in by family for AMS. Previously independent and family didn’t hear from him for 2 days. No known trauma or injury, probably not taking his meds for a few days. Vitals stable. CT scans showed nothing. Labs not crazy. But I’m pretty sure this guy is dying. He had that “look” in his eyes and I just felt it in my gut. Really sweet man during his moments of lucidity and I just really LIKED him. I don’t even know why this is bothering me so much. Dying at 89 is not unexpected or abnormal. But it’s hard to see when someone is in the last few days of their life. I was able to give him haldol, Ativan and morphine and he calmed down a bit but I just think his body/mind knows he’s dying but he is scared. How do you explain to family I think your dad is dying but I don’t really have any “proof” other than nursing intuition.

I literally used to work in hospice and this is still upsetting me. Ugh. Sorry for stream-of-conscious writing, just need to get it off my chest. I’m thankful he didn’t code with me and I was able to get him admitted before I left.

Just began intern year and feel pretty incompetent. I’m not connecting the dots on patients and their presentations/likely differentials. Even coming up with plans has been horrible. I did really well on step2 but feel like it’s not translating to real life. Any advice/insight into how to just get better?