In the Life of a Fickle Intern

August 31, 2011

Skepticism

Filed under: Uncategorized — dailymedicine @ 16:02

I’m not sure when it happened, or really even how it happened, but somehow, I have become very skeptical. This is very unlike me, and I’ve only been working for a few months. It is as if I automatically assume people are lying until proven otherwise, especially at three in the morning when they’re telling me they are having the worst pain of their life yet I cannot barely keep them from falling asleep as they talk to me, and not in the sense that they are getting somnolence from a medical cause. The worse part is that in my one-man attempt to stop the perpetuation of these drug seeking activities, I have become amazing stingy in prescribing narcotics, or so I would like to be more stingy than I actually am because my seniors and attending are all very liberal with their pain control. I understand their point when they say it is better to over treat ten people for pain to not miss that one person who is actually in pain, but I hate that so many people abuse the ED just for this reason. I guess I am still naive and not fully aware of how extensive the spectrum of pain really is. With this new found skepticism, I have two fears. One, in my biased point of view, I will under treat people for pain who really are in pain. Two, I will lose my skepticism and become indifferent to this drug seeking war and start just giving people what they want when I don’t think it’s necessary.

Oh, the dilemmas of narcotics. Hopefully with experience will come a systemic approach to pain management. If only people can be more forthcoming. I think I would appreciate them more if they would just outright tell me that they want some drugs.

August 23, 2011

Professional Relationship

Filed under: Daily Lowdown — dailymedicine @ 09:01

Going into EM, I already knew that I would not be the most popular amongst my colleagues for several reasons. Not only do we provide more work for other specialities by admitting patients to their services, we do shift work and actually have lives outside the hospital (or so I’ve been told.). However, I was blown away to experience the animosity that exist between EM and Cardiology, at least between certain people. After a month on the cardiac intensive care unit, I felt like I was berated almost daily for doing EM by the two Cardiology fellows that I’ve had the “privileged” to work with. Apparently EM physicians are very incompetent people and EM as a field is overrated and overpaid, per my second fellow who managed to literally lecture me for 45 minutes on why EM sucks on my last day of the service. The first fellow would make snide remarks about EM, but he never outright told me that how much he disliked us. And during EM conferences, I would hear stories about what the Cardiology fellow did or did not do and how much trouble it was to consult them because they were such cocky assholes. You would think that after twenty something years of schooling, people would outgrow these middle school drama tendencies, but as illustrated this month, maturity is not an innate process for everyone.

Though I tried really, really hard to be the better person in these “EM sucks” rants by just ignoring it, mostly because I am still a naive and impressionable intern, I definitely had moments where I attempted to defend my specialty. Unfortunately, that usually would just ignite their further ranting so I learned quickly just to ignore them completely as people and only interact with them on a professional level whenever my patients were involved. It was a bit passive, but it was the only I knew to do to not be unprofessional myself.

I wonder when this whole Cardiology vs. EM hatred started and if it’s only a problem at this institution or elsewhere too? The attendings that I worked with were so nice and awesome and they all knew that I was doing emergency. They would note things that I should or should not do in the ED, but I never felt that animosity as I did from the fellows. Who knows.

Nonetheless, I really enjoyed my month on this service because apart from the obnoxious fellows that I had, I really liked my residents and co-interns. In order to prevent this dislike to further perpetuate in my own mind, I should probably stop venting about this issue. It’s over and done with.

Back to the ED this rotation!

August 1, 2011

The Moment

Filed under: Daily Lowdown — dailymedicine @ 20:00

Though I technically have been a doctor for over three months now, I think I had “the moment” this afternoon when it all became real.  I’ve written hundreds of prescriptions so far, but I haven’t had a second thought about them. I dropped by a Pharmacy on the way home from work today to pick up a refill on a med that I take. My prescription had apparently expired. As I contemplated about making a new appointment or even asking some of my fellow classmates to write me a new prescription, the Pharmacist said, “You know you can renew your own prescription now, right?” And that, my friend, may be the beginning of the end. It all dawned on me; I never have to see a doctor ever again if I don’t want to! How crazy is that? Tempting as it is, I’ll try to set a good example and break the stereotype that doctors make the worst patients. I’ll start when I’m 35. 🙂

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