Sunday, May 13, 2012

Clinics and perspective

I started my clinical rotations in January (2012). Here's a few random thoughts about what's been happening. I did 3 months of "Surgery" - 1 month of emergency medicine, 1 month of GI (Gastrointestinal) surgery, 2 weeks of plastic surgery and 2 weeks of orthopedic trauma surgery. I then completed 6 weeks of pediatrics (3 weeks inpatient at CHOP, 3 weeks outpatient at Cherry Hill), and now I'm about to start my second week of my OB/GYN rotation (which lasts 6 weeks as well). 

During clinics I've been completely awed by medicine. On the one hand I'm saddened by the limitations of medicine, but on the other hand I'm amazed by how much we can do and how many people we can help. It's just plain awesome - and it's amazing I get to be a part of it. I'm actually starting to help people now! In a very, infinitesimally small way - but hey we all have to start somewhere eh? This is something I've been working towards for a long time, and it feels great to see tangible progress. 

Recently on pediatrics I actually had one of these moments:


(I listened to and found many heart murmurs and accurately diagnosed them! Then again, the residents and attendings had already beaten me to the punch (obviously) - but it was still cool!)

At other times, I legitimately feel like this:


This was especially true during my month of Emergency Medicine. Obviously they don't let me do the initial triage of someone in severe distress, but one patient encounter stands out for me. He came in after passing out at a bar (he wasn't drinking, and this happened the day before too) and I got him to admit a history of cocaine use. While I was finishing up my initial questions, the EKG tech had just completed getting an EKG and I looked over at the strip as it was coming out... and rushed it over to the attending and said "room __, looks like a STEMI - atypical presentation" (the patient was having an ST elevation myocardial infarction - a heart attack. The cocaine use fit the picture because it increases your risk of having a heart attack even if you're young - which this patient was).

Love it. 

Medical school? Clinics? My initial response:


And I'm still going strong. High five for awesomeness.

Now having said that... there are many, many, many moments of:


This is how I feel when it comes to applying my (extremely limited) medical knowledge to the real world. And this is definitely how I feel when I take the Shelf exams (they are the "final exam" for a clinical rotation block). Clinics aren't all rosy. The patients can sometimes be difficult. The people you work with can be difficult - some bitch all the time, some have a bad day and decide to pick on you to no end. Almost like they are trying to prove how little you know. And, of course, some people are just plain mean - almost like they've forgotten how it feels to be in our shoes. Finally, the hours can be horrendous (4:45 am - 7pm regularly for multiple weeks). 

Often, this is how I feel like when my "higher ups", exams or patients ask me questions:


But for those who know me, you'll know I like to focus on the positives. There's crap to deal with in every aspect of life. 

The question is: is there a reason for to put up with it?

This is why I try so hard to remember why I decide to medicine in the first place. I want to help people. I am not here to chase a grade. I am not here to impress my residents or my attendings. Or that hot chick at the end of the bar (I've definitely tried that last one multiple times... being a med student doesn't work as well as TV says it would). I'm here to be learn as much as I can so I can be the best damn doctor I can be. Why? Because I want to save people's lives. I want to alter their course from just surviving from day to day to living each day to its fullest

People warn you that it is difficult to maintain that humanistic perspective as you go through medical school - especially clinics. Things conspire to beat your compassion out of you (not on purpose, but it is unfortunately what happens). Quite a few people are bitter residents by the end of medical school (but it seems to improve a bit when they become attendings).

Anyway... I digress. The main reason I decided to take some time out from "studying" and make this post? Because of a video I saw this morning. It's for the reasons depicted in the video that I work so hard. The reason why I'm here. Here's hoping I can help kids like this some day.



And in other news, a special shout out to my good friend Anna - we are all excited about your pregnancy and I wish & pray for the best for you. You and your husband are awesome people and I can't imagine a couple more deserving of a little bundle of joy than you guys.

Starting the Obstetrics part of my OB/Gyn rotation Monday. Let's catch some babies!

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