Day in the Life: Sleep Medicine

This was my last elective in med school, and for some reason, it took a billion moons to find one.

I wanted to stay in California in the general vicinity of home for another 2 weeks. I looked for everything from Acupuncture to Occupational Medicine to Sports Medicine to Family Medicine to Nutrition to Physical Therapy (that last one would’ve been super awesome because one of my closest friends happens to be a physical therapist, and having an excuse to hang out in Sac with him for 2 weeks would’ve been pretty sweet…but alas, he’d just switched over to a new job and was going to be shadowing someone else to learn the ropes.

I found a rotation that seemed really promising, but it ended up not working out because the affiliation agreement didn’t go through in time (that and it was a very hands-on rotation and I…broke my hand). So I sent a pleading letter to Stanford to let me apply for a rotation in Sleep Medicine super late, and they actually approved my appeal!! (Thank you, Stanford! I heart you forever. <3)

Day in the Life: Sleep Medicine

A Typical Day

My days typically started at 8 a.m. I’d go to the control room with one of the fellows to read sleep studies til 9 a.m. If it was a wet read and the patient had any questions, we’d go talk with them, but otherwise, we’d keep chugging along til all of them were read.

From 9-5 (lunch somewhere in between), we’d see patients for various sleep disorders, but by far the most common one was obstructive sleep apnea. We’d ask each patient about their sleep habits/hygiene, symptoms, complaints, etc., then examine their airway and tell them about their sleep study results (if applicable). After staffing with one of the attendings, we’d all go back to discuss a plan.

There was a lot of time spent on counseling, which I felt was really nice, and helped to promote our patients’ understanding of their condition(s).

One of the behavioral medicine folks lent me this to thumb through while I was there!

I also got to work in a couple specialty clinics, namely Restless Legs Syndrome and Narcolepsy clinic. Med school is the prime time for med students to diagnose themselves with everything under the sun, but the only thing I’ve ever seriously thought I had was type 2 narcolepsy (mostly because of the sleep paralysis, hypnapompic hallucinations, excessive daytime sleepiness, and how quickly I can fall asleep and start dreaming…but chronic sleep deprivation can cause that as well, so go figure.

I got to see a lotttt of really rare cases (but only one true case of narcolepsy), including a textbook case of Kleine-Levin syndrome!

“That’s the second creepiest thing I’ve encountered today.”

First creepiest was during a morning in my second week, where I was following one of the fellows to see a new patient. Before we got to the room, we made a stop at the MA desk.

MA: Oh good, you’re bringing someone with you. You’re not going to want to be in that room alone.
O: Uh, why?
MA: This guy is majorly creepy. He has a serial killer stare.
O + F: …
MA: It’s good that you’re bringing Farrah. Don’t you know jiu-jitsu?
F: (brandishes splinted arm) But I’m broken!
MA: You said you still managed to choke your opponent out!
F: This is true, but what if I can’t do it again?
O: Can you hold him off long enough for me to press the panic button?
F: I guess so.

So off we went!

If you’ve ever watched Criminal Minds, this guy was of the caliber of the majority of those perpetrators. The room legitimately felt 10 degrees colder, and I felt extremely uncomfortable, and even a little scared to make eye contact with him for the fear that he’d remember my face. I’ve had a patient threaten to murder my preceptor before, and even he didn’t creep me out as much as this patient did. If ever there were a time for the use of the whistle I got at my last rotation, it would’ve been here. I think our attending felt the same way, and left fairly quickly, much to our distress (“Don’t leave us!”).

After he left, we exchanged worried glances.

O: …I feel like I’ve just been added to a kill list.
F: Nooo!
O: Did I tell him to follow up in 3 months, or was it 4?
F: You said 3 or 4, but you should stress 4, because you’ll be gone by then.
O: Good call, let’s change it to that.

We went back to the work room and, whilst casting glances at the closed door, attempted to try to find out how to see if someone had a criminal record.

O: Farrah, he didn’t schedule a follow-up appointment.
F: Isn’t that good?
O: What if it’s because he knows I won’t be around by then?!
(Other residents: What the hecks is going on?)
O: Guys, if I turn up missing one of these days, it’s because I’ve been murdered and he’s made a suit out of my skin.

Meals

I brought my lunches with me every day, usually in some variant of delicious home-cooked leftovers that my aunt and uncle would make extra of the night before. (My parents don’t really cook, so I was super overjoyed for all the amazing Chinese dishes I was bombarded with while I was home! <3 Chinese food generally isn’t my first choice because I’ve had it so often for the past couple decades, but I loved all the food they made!!)

All of us looked forward to Thursdays because it was…Boba Thursday! One of the guys would come in to take our orders for milk tea and deliver em’ to us around lunch time! :D! We talked a lot because he found out I could speak Cantonese and that my parents were from Hong Kong, hehe.

The fellows were super serious about their boba–it was kinda great.

• “Please excuse the noise. I’m trying to maximize my boba…extractions. …I wonder how many cases of boba aspirations there have been? They really shoot up there–it goes right for the glottis!”
• “Ooo, Jungle Book comes out this Friday! It looks amazing.”
  “I wonder how they found a talking tiger.”
• (“You’ve put some serious thought into your boba…”) “It deserves serious thought!”

A photo posted by Farrah @ fairyburger (@fairyburger) on Apr 7, 2016 at 1:07pm PDT

Parking

Yay for free parking (and lots of it)!

Housing

Hooray for still getting to live at home! :D

• Have you ever diagnosed yourself with anything?
• What’s your creepiest encounter with someone?
• Do you have any problems with sleeping? Check out my post on Sleep Hygiene!

Check out my other Day In The Life posts!