Today I woke up in a dark dark mood. It colored my world grey and dreary. It was a cloudy day outside, but the black cloud followed me indoors, relentless. One of the veteran doctors at the practice had broken his hip the previous weekend. Being an "Attending" he couldn't possbly have easy nice patients like a 4 month old well child check. Nope, he's got the 65 year old patient with multiple chronic illnesses, something wrong in each geographical location of the body. The same type of patient every 15 minutes, I should add. And I was assigned to him, or at least, his patients.
I mustered what energy I could dredge up and tried to be cordial enough to the first patient. Soon after that visit, my patience already began to wear thin, through no fault of the first patient at all. But then followed a trail of patients all belonging to the one category: Uncontrolled diabetes, uncontrolled hypertension, multiple somatic complaints of either joint pain or stomach pain (take your pick) and childish petulance, poor compliance with medication, and very bitchy attitudes. To top it off, each and every patient had repulsive feet, with nails long disfigured and discolored by fungal infection. But since each patient had DM, I dutifully did the monofilament test on each and every patient, expertly hiding my disgust behind a smooth mask of pure professionalism.
Don't get me wrong. I have a very high tolerance of blood and gore and all things nasty about the human body. I am not fazed too easily. It only behooves me to have to be so intimate with certain people who I find, from a purely personality standpoint, utterly annoying. So their fungus infected toes notwithstanding, it's more their personalities that were rubbing me wrong all day long.
Inside I wondered to myself. Did I really want to go into geriatrics? What happened to my bleeding heart for the elderly? For that matter, what happened to my overall enthusiasm for family medicine? Two weeks ago, I was crowing about the possibility of having found my field! Yikes, is that what I was in for, for the rest of my working life?? Picking up the feet of obese annoying patients with realy gross feet, as I do my best to maintain my empathy? I'm only a junior medical student and already, I feel jadedness creeping in.
Sometimes I want to tell these jabbering patients to shut up for a little and to listen and then I fantasize that I would say, "Patient, please, stop talking. Stop whining. Stop acting like a child. Help US help YOU. Take your medication, educate yourselves better on your illnesses and stop being your own worst enemy. Exercise! Eat right! Stop acting like you're entitled to some miracle medical intervention when you aren't picking up your end of the bargain. Take charge of your own life, grow up. Because you're headed in a bad place and you really have no one to blame but yourself, though you'd LIKE to think you had absolutely nothing to do with it."
Anyway, what a spiel huh? I know I know, as a doctor, I ought to develop more compassion and empathy, please trust me when I say this, I do realize and I'm still trying very hard to maintain it. But to quote a line from Grey's Anatomy, today I'm having a real bad case of the "dark and twisties" and my twisty thoughts have led me down this path.
Okay, now that's it's off my chest, maybe I can wake up tomorrow with a more rosy-colored lens.
Thursday, October 29, 2009
Tuesday, September 29, 2009
One of those days
wherein a series of unfortunate events befell our hapless heroine as she sets out for her first day of family med...
What was originally supposed to be a 24 minute drive turned into a nightmarish, head smacking against dashboard in frustration two hour and 15 minute ordeal. Jason had called me in the morning to inform me that I-76 was really jammed up. So what to do? I thought cleverly, never fear, GPS is here! But wouldn't you know it? I sat in the car for 10 minutes trying to get the GPS to work and feeling stupid when it just won't register that it's in PHILADELPHIA. I kept thinking I must be doing something wrong, when in fact, it was just the GPS being lazy and not wanting to report to duty. Since I knew no other way to get to this particular hospital, I resigned myself to the bumper to bumper traffic of the jammed interstate.
Then...while I proceeded to go on the interstate, the GPS woke up, realized it was in Philly and began directing me to my site. I was overjoyed, my friends! I quickly put into place the directions of avoiding the freeway and took an alternate route. I thought surely now, I can circumvent the monstrous traffic and navigate my way through local roads easily and breezily....or NOT.
Very soon, I found myself in a single lane road that appears to stretch to infinity, and despite never seeing signs for construction, repair, or catastrophic accidents, everyone is travelling at the hair raising speed of 0-10 mph. I just couldn't fathom the reason for the traffic!! I hated myself for entertaining the brief fantasy that it was indeed some major accident up front, so at least there is a CAUSE and REASON at the root of my suffering. By this time, I was running quite late and it being the first day of my rotation and all, I thought grimly of the evaluation I would receive. "Student reported late on her very first day. Shows lack of professional dedication to duties and personal sense of responsibility." Yes, my thoughts turned black, my friends, and a tad melodramatic, as I tend to do.
So after further delays, including having to wait for a freight train to pass, and additional detours when one of the roads was completely sealed and yet another road just ended for no good reason, I began to wonder if God wanted to keep me away from my site for some mysterious divine reason. In any case, I finally dragged my stressed and haggard self to the site, hungry (skipped breakfast) and in pain (my butt was starting to hurt from being in one position for two hours), and still tried my best to put on a bright smile to greet my new coworkers.
My first patient case went relatively uneventfully. I mostly watched, since I didn't feel comfortable sticking 18 guage needles in people's knee joints yet. When I got to my second patient, a cute 1 month old boy here for a well child visit, it all hit me at once. Things began to swim in front of my eyes. I feebly told the doctor that I was feeling a little lightheaded and she told me to sit down right away. So here I was in the patient room, and suddenly I felt like I had turned into the patient, the sickly one. I sat down, and felt nauseous, and feverish and with chills all at once. I ran to the bathroom, but owing to the fact that I had no breakfast, I only hacked up air, very miserably. Just before I ran to the bathroom, I remembered seeing three puzzled faces looking at me, the mother and her son and her little daughter. And I also remember feeling a bit concerned that I might get the baby sick if I was coming down with something, though I knew it was more likely just my blood sugar dipping too low. I also remember I was feeling too sick to care too much also.
In any case, I decided to go home early because I felt like under the circumstances, I seriously doubt I would do much effective learning. I also felt like, though the macho thing to do was to stick it out, dizzy and in pain as I had felt, I didn't see any point in such show of bravado. In the long run, I thought it would be kinder to my body to just come home and rest it off. And so I did. I came home, ate lunch, took a long delicious nap and woke up feeling a million bucks.
Tomorrow is another day and will bring its share of challenges, for sure, but I've definitely had my fill of stressors for today!
What was originally supposed to be a 24 minute drive turned into a nightmarish, head smacking against dashboard in frustration two hour and 15 minute ordeal. Jason had called me in the morning to inform me that I-76 was really jammed up. So what to do? I thought cleverly, never fear, GPS is here! But wouldn't you know it? I sat in the car for 10 minutes trying to get the GPS to work and feeling stupid when it just won't register that it's in PHILADELPHIA. I kept thinking I must be doing something wrong, when in fact, it was just the GPS being lazy and not wanting to report to duty. Since I knew no other way to get to this particular hospital, I resigned myself to the bumper to bumper traffic of the jammed interstate.
Then...while I proceeded to go on the interstate, the GPS woke up, realized it was in Philly and began directing me to my site. I was overjoyed, my friends! I quickly put into place the directions of avoiding the freeway and took an alternate route. I thought surely now, I can circumvent the monstrous traffic and navigate my way through local roads easily and breezily....or NOT.
Very soon, I found myself in a single lane road that appears to stretch to infinity, and despite never seeing signs for construction, repair, or catastrophic accidents, everyone is travelling at the hair raising speed of 0-10 mph. I just couldn't fathom the reason for the traffic!! I hated myself for entertaining the brief fantasy that it was indeed some major accident up front, so at least there is a CAUSE and REASON at the root of my suffering. By this time, I was running quite late and it being the first day of my rotation and all, I thought grimly of the evaluation I would receive. "Student reported late on her very first day. Shows lack of professional dedication to duties and personal sense of responsibility." Yes, my thoughts turned black, my friends, and a tad melodramatic, as I tend to do.
So after further delays, including having to wait for a freight train to pass, and additional detours when one of the roads was completely sealed and yet another road just ended for no good reason, I began to wonder if God wanted to keep me away from my site for some mysterious divine reason. In any case, I finally dragged my stressed and haggard self to the site, hungry (skipped breakfast) and in pain (my butt was starting to hurt from being in one position for two hours), and still tried my best to put on a bright smile to greet my new coworkers.
My first patient case went relatively uneventfully. I mostly watched, since I didn't feel comfortable sticking 18 guage needles in people's knee joints yet. When I got to my second patient, a cute 1 month old boy here for a well child visit, it all hit me at once. Things began to swim in front of my eyes. I feebly told the doctor that I was feeling a little lightheaded and she told me to sit down right away. So here I was in the patient room, and suddenly I felt like I had turned into the patient, the sickly one. I sat down, and felt nauseous, and feverish and with chills all at once. I ran to the bathroom, but owing to the fact that I had no breakfast, I only hacked up air, very miserably. Just before I ran to the bathroom, I remembered seeing three puzzled faces looking at me, the mother and her son and her little daughter. And I also remember feeling a bit concerned that I might get the baby sick if I was coming down with something, though I knew it was more likely just my blood sugar dipping too low. I also remember I was feeling too sick to care too much also.
In any case, I decided to go home early because I felt like under the circumstances, I seriously doubt I would do much effective learning. I also felt like, though the macho thing to do was to stick it out, dizzy and in pain as I had felt, I didn't see any point in such show of bravado. In the long run, I thought it would be kinder to my body to just come home and rest it off. And so I did. I came home, ate lunch, took a long delicious nap and woke up feeling a million bucks.
Tomorrow is another day and will bring its share of challenges, for sure, but I've definitely had my fill of stressors for today!
Sunday, September 20, 2009
I'm back!!!
I definitely took a looong hiatus from blog writing didn't I? And I used to enjoy this ever so much, so in the interest of bringing back something I enjoy, I've resolved to begin anew.
So lots happened in the last 9 months! I encountered and slayed the Step 1 Beast in June!! Well, maybe "slayed" is a bit of an overkill. I somehow managed to sneak by it, is how I really see that. And the big nasty troll somehow did not squish me to smithereens in the process. Sigh of relief.
I began my foray into the third year of medical school, aka junior clerkships and I started my clerkship with psychiatry. With few exceptions, I have actually thoroughly enjoyed myself at the rotation and really got into learning about the biopsychosocial aspects of the patients' lives. Most of the patients were sad sad sad. There was no question about it. Their lives were absolutely derailed by their psychiatric illnesses and other comorbidities. Still while I admittedly on occasion do feel a little critical, thinking to myself "why can't you pull it together already?" my overall sentiment towards these patients run more along the lines of "There but for the grace of God go I."
Now I'm on OB and finishing up in a week. It's been an interesting rollercoaster ride. One week I'm convinced I hate OB and I'm never ever ever going to go near a pregnant woman about to deliver ever again. Then the next week, I get to see really cool procedures or just even a really nicely done C-section by one of the hospital's coolest Ob-gyns and I'm smitten with the possibilities. Most of the Ob-gyn residents I've posed the question "Why OB?" gave me the answer that they liked the mixture of medical and surgical. And it's true, there is definitely a lot more hands-on procedures to be done as well as medical management. In that context, I can see why it's an attractive field. But I'm still struggling with my own inner convictions of where my true strengths lie. And whether or not I want to limit my patient population to only women.
Anyway, thankfully I have a little more time to chew on this dilemma but I shall soon settle on something I'm sure.
In other news - my good friend Viola got married last week! It was a rambunctious wedding chock full of entertainment and food and games and laughter and merriment all around. It was your typical Chinese banquet. That said, I also had a little interesting anecdote from that wedding. I caught the bouquet on the second toss, after it fell limply to the floor on the first try. Then later, Jason caught the garter among the single guys. How cool or how lame is that? You can decide. But then Jason had to do a funky dance to put the garter on me and I have to give him some credit, because he really pulled out some moves. I don't think I've ever seen him move like that, I hope it was caught on DVD. Kiss! Honey. It was one of my personal highlights at the wedding.
Alrighty, that was a whirlwind of words upon words. I'll be more concise next time, but it's so nice to be working the keyboard again, over a breakfast of fruits and a pomegranate green tea. A lovely morning and now off to hit the books!
So lots happened in the last 9 months! I encountered and slayed the Step 1 Beast in June!! Well, maybe "slayed" is a bit of an overkill. I somehow managed to sneak by it, is how I really see that. And the big nasty troll somehow did not squish me to smithereens in the process. Sigh of relief.
I began my foray into the third year of medical school, aka junior clerkships and I started my clerkship with psychiatry. With few exceptions, I have actually thoroughly enjoyed myself at the rotation and really got into learning about the biopsychosocial aspects of the patients' lives. Most of the patients were sad sad sad. There was no question about it. Their lives were absolutely derailed by their psychiatric illnesses and other comorbidities. Still while I admittedly on occasion do feel a little critical, thinking to myself "why can't you pull it together already?" my overall sentiment towards these patients run more along the lines of "There but for the grace of God go I."
Now I'm on OB and finishing up in a week. It's been an interesting rollercoaster ride. One week I'm convinced I hate OB and I'm never ever ever going to go near a pregnant woman about to deliver ever again. Then the next week, I get to see really cool procedures or just even a really nicely done C-section by one of the hospital's coolest Ob-gyns and I'm smitten with the possibilities. Most of the Ob-gyn residents I've posed the question "Why OB?" gave me the answer that they liked the mixture of medical and surgical. And it's true, there is definitely a lot more hands-on procedures to be done as well as medical management. In that context, I can see why it's an attractive field. But I'm still struggling with my own inner convictions of where my true strengths lie. And whether or not I want to limit my patient population to only women.
Anyway, thankfully I have a little more time to chew on this dilemma but I shall soon settle on something I'm sure.
In other news - my good friend Viola got married last week! It was a rambunctious wedding chock full of entertainment and food and games and laughter and merriment all around. It was your typical Chinese banquet. That said, I also had a little interesting anecdote from that wedding. I caught the bouquet on the second toss, after it fell limply to the floor on the first try. Then later, Jason caught the garter among the single guys. How cool or how lame is that? You can decide. But then Jason had to do a funky dance to put the garter on me and I have to give him some credit, because he really pulled out some moves. I don't think I've ever seen him move like that, I hope it was caught on DVD. Kiss! Honey. It was one of my personal highlights at the wedding.
Alrighty, that was a whirlwind of words upon words. I'll be more concise next time, but it's so nice to be working the keyboard again, over a breakfast of fruits and a pomegranate green tea. A lovely morning and now off to hit the books!
Wednesday, January 21, 2009
A successful day
Today was one of those days when I didn't get in my own way. Yes, the day started off a little bumpy, but I am so glad I didn't let the setback set me back too much. I woke up at 9, a lot later than I had told myself I would, but for some reason, I just kept sleeping and sleeping beyond the alarm. Anyway, I got up and quickly began to dive into my studies. I listened to over 6 hours of pharmacology. Then I decided to be the good samaritan and took out the garbage in my apt. The reason I felt like a good samaritan is because I've been doing more than my fair share of the household chores at home but I had three choices, 1. confront my roommate 2. be passive aggressive by refusing to take out the trash and letting it pile up or 3. just take it out. I chose option 3 and secured my peace of mind. I guess confrontation is always an option, but I hate making things awkward over petty issues.
Then I went to...gasp...work out! After my workout, I went to a stress reduction session and enjoyed it thoroughly. Then after that, I studied at the library for an hour. This today was pretty much close to my ideal day for a medical student. I was on top of my work and I didn't slack too much. And now I'm relaxing in front of the TV for an hour or two, which I felt like I actually earned, so I don't feel bad about it either.
It's a constant struggle for me to stay on top of my game, but today at least, my motto was "yes I can"
Then I went to...gasp...work out! After my workout, I went to a stress reduction session and enjoyed it thoroughly. Then after that, I studied at the library for an hour. This today was pretty much close to my ideal day for a medical student. I was on top of my work and I didn't slack too much. And now I'm relaxing in front of the TV for an hour or two, which I felt like I actually earned, so I don't feel bad about it either.
It's a constant struggle for me to stay on top of my game, but today at least, my motto was "yes I can"
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