Ah, the first week of July....

I'd like to know what Einstein decided that the first of July would be a good time to introduce new residents to their units. I mean, it's right before a holiday (this year's been especially bad, what with the three-day weekend), people are going on vacation, and patients always crump on holidays.

Always. It's one of those immutable laws of the medical Universe: if you have a person who's had, say, a minor bladder-scoping procedure, that person will choose a holiday (preferably one with a three-day weekend involved) to have something completely nuts happen that lands him or her on six drips and a vent. We once had a patient who came in to have a couple of teeth removed prior to some other surgical procedure who coded on the table: it was the day before Thanksgiving.

I mean, *really*? (Side-eye at Murphy and his laws.)

One good thing about having residencies that last at least five years, which is all of the ones that I work with regularly, is that you don't get too many bright-eyed, idealistic young medicos on July first. Most of the docs who rotate in and out of the units have been there before and have just been out doing research, or something. They're the same exhausted, cynical people we've worked with forever.

We do have one rather dashing new fellow ("fellow" in the academic sense, though he's also got XY chromosomes) with a Spanish accent and Italian shoes. He glided in yesterday, did a very thorough exam on one of my patients, then discharged her home without any fuss or muss. It's nice to see efficiency. I doubt the Italian shoes and silk tie will last through August. I hope the lack of drama does.

July is also the beginning of the yearly fiscal crunch for State-funded agencies here Deep In The Heart. Some of my colleagues have simply gone missing, laid off in the face of gazillions of dollars of shortfalls. Others are walking around looking tense about the possibility of losing their jobs. It's all Manglement positions that are being cut, no front-line staff, but that doesn't make it any easier. Nobody's hiring, either. What that means at the end of the day is that if you're working in research, you now have thirty more cats/pigs/rats to deal with in addition to the ones you were already taking care of. If you're a mid-level Mangler, you've got six more pages of audits and quality-improvement surveys to do every week, and no help.

Maybe they could get the residents to help with the audits. It'd at least give 'em a chance to sit down once in a while.