In the Hospital

 I've spent about a week and a half on my rotation now and it has been a great experience so far. I have been one of two hospitals in Heraklion. It is a main hospital for Crete and covers many of the islands as well. On internal medicine, our patients are very similar to patients I encountered during my rotations in the US. We have been managing anemia, fever of unknown origin, sepsis, heart failure, upper respiratory infections, and AKIs to name a few. Most of the patients are older, we even had a 98 year old patient who was quite spry. There are lots of co-morbidities like hypertension, hypercholesterolemia, and diabetes. We look at ABGs a lot and it has been great to refresh on acidosis vs alkalosis, metabolic vs respiratory, and anion gap vs normal. 

I have been working on improving my physical exam, especially stethoscope skills. I feel like I am getting better at picking up the differences in sounds. The residents are all very confident with their physical exams and learn a great deal about their patients that way. On my rotations in the US, I didn't have a lot of emphasis on this so I am glad to get some extra training now. 

The structure of the day is familiar, since we will pre-round with residents in the morning and then have our larger rounds with the attendings. Once a week there is the "grand visit" where everyone joins in and we see all the patients. I found ti quite interesting that there were 30+ of us all going into the patients' rooms. It is a little hectic, but also I think a great time to learn and seems to create more of a team environment. I could not imagine patients' reaction in the US if that many people walked into their room, but here it is just how things go. 

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