Medicine Week 1: Awkwardness to the nth power (where n = infinity)

On Mon, July 6th at approximately 9:30am (after a brief introduction by the course director), 11 or so hapless, naive and incredibly awkward 3rd year medical students (yours truly included) were thrust onto the floors of the general medicine department at New York Presbyterian hospital to help take care of patients. With no inkling as to what to expect and what to do about not knowing what to expect, important questions began to arise:

1. When the team is going around (rounding, if it pleases ya) seeing patients first thing in the morning, where is the medical student to position his or her person so as to provide the least amount of interference with on going proceedings? In other words, how can I stay out of their way, yet remain visible?
2. How many times is it appropriate for the medical student to ask "Do you need any help?" before the energy and time required by the attending/resident/intern/physician assistant to respond, "Thanks for asking, but not right now." greatly exceeds the benefit of said proffered assistance?
3. What is the role of the medical student, exactly? Is it appropriate to be seen sitting at a computer and checking one's email?

It all seemed so hopeless. However, much can be accomplished in the space of 5 busy days. I am on a team made up of an attending (the lead doctor ultimately in charge of patient care), a 3rd year resident in internal medicine, a 2nd year resident in internal medicine, a physician assistant and two interns (first year residents who have to fulfill basic requirements before they can focus on what it is they are doing residency for). And me. Of course.
Since the same basic pattern repeats itself every day, it became easier after Wed or so, to get a sense of what was going on and then, at least, in my opinion, to make myself useful.
I get to the hospital at around 6:30am, check up on any events that transpired with the patients over night, taking special care to ensure any patients I am in charge of (2 - 4) aren't in critical condition and that I know exactly what state they are in. This is important, both for my own education, and in the event that I get pimped by the attending and lose points by Not Knowing My Patients (my evaluations are a big deal, thank you!).
At 7am, the team, sans attending, goes around and checks on the patients (about 20 or so) to find out if anything is pressing and how the patients feel. We then sit down at 8:30am with the attending so that the person who was on call (stayed through the night to provide continuity for patient care) describes in detail what happened to each patient during the night and if there are any new patients admitted.
From 9am - 10am, we round with the attending, checking on any new patients as well as those who are in critical condition. This is the point when the team comes up with a plan for patient care, with the attending deciding if this plan is appropriate. Since the attending is under pressure to get the on-call person home, so as to avoid exceeding the 'work hour limit', that person goes home at 10am.
After all the rounds are complete, it is time to get down to the nitty-gritty of patient care - paper work, writing notes in the patient charts, calling other doctors to call other doctors so that specialists can come in to see patients and other such scut work. In my case, I help my team as much as I can, and focus on the 2 - 4 patients I am in charge of: from examining the patient and writing a note about their progress, making sure medication is being given, that tests are being sent and carried out to mopping up patient vomit.
Usually, I have a class at 12pm - 1pm. When I come back from that, everything repeats itself. At 6pm (medical student official going home time) my feet are screaming for mercy and my stomach is yelling blue murder. However, this is a critical moment. It is tempting to rush out the door without a backward glance in order to eat and begin studying, but it is important to ask everyone on the team if there is anything that I can help with. The fact is, there is always something, so I am guaranteed another hour or two of work. As such, I usually get back from the hospital between 7pm and 8pm too exhausted to think about anything beyond food and sleep. If I got a new patient that day, I practice my presentation on them for the next day's rounds and read about their disease. If not, I read up as much as I can about all my patient's diseases and their treatment. Not a great substitute for hard core studying, but I have weekends for that.

So far, I am still eating healthy, getting some exercise (5am - 5:45am, if you can dig that) and sleeping no less than 6 hours a night. Let's see how long that will last.