In the Life of a Fickle Intern

October 26, 2010

Ophthamology

Filed under: Daily Lowdown — dailymedicine @ 23:08

The weekly rotations continue. Last week, I was on Orthopedic surgery. Apart from lectures on Monday and morning report on Tuesday, at which time they reviewed all the cases for the day, we were dismissed for the week. My five day weekend went by really fast, and I am not even sure what I did with all that time. I think that now that I have so much free time, I’ve become really lazy with it. The majority of my motivation to be productive has been lost because of these pressure-less, grade-less, stress-free weekly rotations. Nowadays, instead of learning and studying, I have taken up cooking and baking and working out, almost religiously. It’s almost as if I’m not a medical student. It’s great though I sometimes still get a pitting, guilt-driven feeling that I should be studying. I justify my laziness with the fact that I will have to sell my life to the hospital next year when I become an intern.

This week I am on Ophthalmology. With daily morning clinics and lectures, I feel a lot less guilty for being so free. I leave at lunch knowing that I’ve learned something. It’s amazing how different life is now than it was one year ago when I was working and studying endlessly. I love being a 4th year medical student! Gotta enjoy it while it lasts.

Interview season for me will start in a few weeks. I’ve been in complete denial about the whole process. I am not ready to sell myself quite yet. I’m still waiting to hear back from the majority of my schools, but I haveĀ  some interviews lined up. My travel/interview schedule will be finalized in mid-November. I’m making it a personal goal to see as many old friends as possible during the next three months of flying around the country. It’ll be fun, hopefully.

 

 

 

October 21, 2010

Choosing a Specialty

Filed under: Daily Lowdown — dailymedicine @ 22:43

October 19, 2010

Serving the Underserved

Filed under: Daily Lowdown — dailymedicine @ 23:31

With my now available abundant free time, I signed up for a new elective class called “Serving the Underserved” targeting medical students and residents. The course director, the founder of one of the largest non-profit clinics for uninsured patients in this area, reminded us in his opening speech that we were once normal human beings with normal fears and emotions. He stated that after 20 years of working, he has seen how medical school and residency brainwash us into being doctors – disease-diagnosing, acronym-spewing, medicine-prescribing robots who forget the basics of human relationships and see patients as their diseases rather than a person.

Ok, maybe he didn’t say exactly just that, but that was the gist of the message. And in a way, I think he has a point.

I came into medical school because I wanted to help people. Generic, but true. I was hopeful and optimistic. After three and a half years of rote memorization, test-taking, information regurgitation, and periods of physical, mental and emotional anguish, which may sound dramatic but I have had my fair share of crying myself to sleep from stress and anxiety, it just changes you. I can’t pinpoint it exactly, but I know that I have become more emotionally detached, skeptical about everything, and very disease oriented. Don’t get me wrong, I do my job and I do it well, but I guess that is the problem – I see what I do now as a job instead of a passion. I love what I do, but I love it when I don’t have to do it either, if that makes any sense. For instance, when my patient with the lung cancer passed away last week, my first thought was “Oh good, now he doesn’t have to suffer anymore.” That’s an ok thought, but it shouldn’t be the first thing I think, should it? The patient was no longer under my care, but he technically was my first patient to pass away. I had imagined this day countless times, but I just took a moment and then moved on to the next patient.

This is very unlike me. Somewhere along the way, I have learned to distant myself from my patients. I see them objectively rather than emotionally. The scariest part is that I haven’t even started residency yet!

Anywho, the point being, I think that this class will help remind me of some of the personal aspects of medicine. Hopeful.

 

October 17, 2010

Alumni Weekend

Filed under: Daily Lowdown — dailymedicine @ 23:08

I was actually relatively busy last week. Apart from having to do real work on Infectious Diseases, it was Alumni weekend at my school. Usually this does not apply to me, but this year, the focus was on Emergency Medicine and the health care reform. There were some important EM people in town and I had to do some major schmoozing, or at least I attempted to schmooze.

Emergency Medicine, probably not very different from other professions, is all about networking. Because EM is a new field of medicine, all the “important” people know each other – the residency directors, program directors, etc., so it’s very important who you know. I learned this early on during my first away rotation. The residency director there bluntly told me that because my school does not have an Emergency Medicine Residency program (hence no well-known EM physician acting as a student advocate), it is relatively unknown in the EM world and my chances of getting into a top program is significantly affected. Great. I was pretty shocked and almost offended, but in reality, he is probably right. I know that I have the grades and test scores to be a competitive candidate, but when there are hundreds of other students applying for that same spot with similar grades and numbers, you have to have something to make you stand out.

Recently, a relatively “famous” physician in the EM world joined our school as Dean of one of the programs, and he wanted to talk to students about Emergency Medicine. He was bringing four other EM physicians. Being one of the two seniors going into EM in town currently, I ended up playing hostess to our guests and arranging all the meetings and whatnot. Everything turned out fine, and he even threw in “If you need more interviews, call me” after one of our chats. I guess that’s reassuring? I hope I won’t need to call in this favor.

Apart from that, the weekend was also focused on the health care reform. There were panels of doctors and administrators discussing the pro’s and con’s of the new Obama plan. Apparently the bill is over 2700 pages! That’s ridiculously long! I am so glad that I did not go to law school, stuck with writing that bill. Anywho, the panel discussion was really helpful. The overall conclusion came down to several points:
1. Take the politics out of the reform. Health care is not a Democratic or Republican issue. Allow doctors to draft the bill. After all, we (loosely speaking since I am only a medical student) have to work under these changes.
2. Having insurance does not equate to having accessibility to health care.
3. People have to take responsibility for their own health.

There were a few other conclusions and suggestions that the panelists discuss, but I can’t remember all the details.

Anyway, I start a new week tomorrow – Orthopedic surgery.

October 12, 2010

Infectious Disease

Filed under: Daily Lowdown — dailymedicine @ 20:57

My ID attending is so cute. He looks like Santa Claus!

Even though I have to work more than 4 hours a day this week, I am really enjoying ID. The attending loves to teach and we have some crazy cases to learn from. Though I hate to admit this, I miss having to study. I got really excited when he assigned us topics to look up for discussion. (Please don’t tell my fellow ID student that!) I really enjoy learning, but when it’s not required for testing purposes, it is much harder to just learn to learn. Even though I am loving all my free time, I can feel my knowledge base dwindling away. I have a fear that I will forget everything by the end of the year. I’ve attempted to self motivate myself to read, but instead of scientific papers, I have been reading novels and books like a madwoman. (I’m on my 5th book since mid-September!)

However, with these assignments, I know I’ll be learning a lot this week. By being a medical student in this city, I will have a well-established foundation in infectious diseases when I graduate. Last month, my intern from Ohio told me that he had never cared for an HIV/AIDS patient before moving here. That’s so crazy! It seems like every other patient I have has some sort of immune deficiency or zebra infectious process going on. I guess that is not necessarily a good thing, but from a learning perspective, it’s great for students. I will learn. That is my goal for the week.

 

October 9, 2010

Love Story

Filed under: Daily Lowdown,Personal Ramble — dailymedicine @ 18:05

One of the new ICU admissions on Friday was a 76 year old man who got injured trying to save his wife from their burning house.

This couple had been married for who knows how long. The wife was wheelchair bound, but the gentleman was completely healthy. Not on a single medicine at the age of 76! That’s almost unheard of nowadays.

Somehow their house got caught on fire. The fine details of the story are unknown, but he went back inside the burning house to rescue his wife. She came out unscathed, but he had third degree burns over 12 % of his body and suffered from severe inhalational injuries to the lungs. He has been in the burn unit these last two weeks but isĀ  now being transferred to the ICU for further care of his lung injuries.

How amazing is this story!? It makes me feel warm and fuzzy all over. He’ll stay in the unit for a while, but I hope he gets reunited with his wife soon.

Speaking of love stories, off to yet another engagement party!

October 7, 2010

Academic Medicine

Filed under: Daily Lowdown — dailymedicine @ 22:11

Never ever before have I considered the idea of teaching of any sorts. I’m impatient; I’m easily flustered; and I am not that good at explaining, or so I’ve always thought. After 3.5 years of medical school, I’m almost positive that I want to stay in academic medicine and teach future doctors when I am done with all my training (another 3-4 years!).

Medicine is a very hierarchical field in every aspect, education included. Older students teach younger ones; residents teach interns; attendings teach residents. It’s an accepted and expected way of learning.

As a M4, I get to work with younger students both in the hospital settings and in required teaching sessions. I was a little skeptical about how I would handle the situation when I first started. The idea of being responsible for teaching people new concepts was a bit frightening. I am a relatively confident person but I still had my doubts about my ability to convey information in a coherent fashion. Surprisingly, I really enjoy attempting to teach. Maybe it’s because of the way the medical educational system is set up, but I have an innate desire to pass on everything I know, which unfortunately is still very limited. It is such an awesome feeling to explain something and see that person have an “ah ha” moment, when everything just clicks. This is not to say that I have induced that many “ah ha” moments, but I want to!

Though I am fickle and unsure of what lies ahead, I am pretty certain that this new interest in teaching will only get stronger. I’m kind of super excited about the idea!

October 4, 2010

Intensive Care Unit

Filed under: Daily Lowdown — dailymedicine @ 21:58

The worst thing about medicine is that sometimes there is just no hope.

One of my patients with Stage IV lung cancer from my Internal Medicine JI is now in the ICU. Stage IV lung cancer means that the cancer has spread all over the body and the prognosis is usually less than six months. When I discharged this patient home a month and a half ago, he was able to sit up and talk. He was going to get chemotherapy to try to combat the cancer. Apart from being paraplegic (unable to move his legs), he did not appear very sick. He was lucid, communicative, and so very optimistic. Though we all knew that his cancer would slowly overtake his body, I did not realize how fast this would occur.

When I saw his name on our patient list this morning, my stomach sank. I already knew that things were not good. Going in to see him, I was scared to walk into the room. From the door, I could tell that he was no longer there. On the bed was a fragile, wasted, quadriplegic man who goes in and out of consciousness unaware of his surroundings and unable to communicate to the world. He has lost all control of his body, including his ability to speak. The cancer has spread to seemingly every organ there is. This was not the man who talked to me about hope and faith and God. This was an actively dying person.

Life is so unfair. He was healthy until a few months ago. He didn’t smoke and only drank socially. He was just a normal guy. Now he is dying, and there is nothing anyone can do for him.

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