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Geriatrics and Palliative Care Medicine

November 18, 2012 by Leave a Comment

That’s what this month has been all about.

Ok, so I did get a week of vacation at the beginning of the month, but after that I have been dealing with senior citizen patients, quite a few of whom are hospice care patients.

It has been strange — the palliative and home care side of things, that is. I feel like I have spent the last few years preparing for a career in which I do everything I can in order to help someone get better. And on occasion, we must get out of nature’s way and allow death to happen. However, this month I feel like that model of medicine has been flipped upside down — that my role has now shifted.

I feel like so many of the patients I see are desperate for help. They crave to die with dignity and with peace. And for that, they look to us.

It is different when the family members of patients come looking to you, not for hope in a recovery, but for hope in a peaceful passing.

I have a great deal of respect for physicians who choose to go into palliative medicine. I used to look at the specialty of Oncology/Hematology as the “saddest” of specialties. Yet it seems the field of Palliative Care is grimmer still.

Perhaps I am just not used to it.

But maybe I don’t want to get used to it.

Filed Under: My Life, Residency Tagged With: , , , , , , ,
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Month One

August 8, 2012 by 2 Comments

The first month of intern year is over. It was definitely a ride. For my first rotation I was assigned to the local county hosptial for a month of in-patient medicine. I have been told that the two hardest rotations of the intern year here are the months at county and the MICU month at the Universtiy Medical Center. Seeing as I’m still alive and breathing, and that I still have a job, I’d say that I survived my month.

The first challenge I encountered was just transitioning from a medical student to intern. I remember being asked things by nurses as a Sub-I (during my 4th year), or any other rotation. I could always fall back on the “I’m sorry, I’m just the student. I’ll let my team know” response. Even if I had an idea of what the answer would be, I couldn’t give any nursing orders.

And so the first challenge was transitioning from the one who could always defer (actually, I had to defer), to the one that now should be able make some calls regarding patient care without always running to the senior resident or attending with a “Can I do such-and-such for so-and-so” type of question.

Another part about transitioning from student to resident is that now I am a “doctor.” Now I have an M.D. after my name. Now my signature has the power to make things happen. Now I wear a long white coat (instead of the short one reserved for medical students). It was pretty trippy the first time I heard someone call me “Doctor.” Sure, I had had patients call me “doc,” or “doctor” as a student. But I always introduced myself as the student. Now, I introduce myself as Dr. W. and the nurses call me Dr. W.

They call me “doctor.” How weird is that? It was a weird thing for me when residency began. Heck, it’s still a weird thing for me if I pause and think about it. But I’m in this for the long haul. I’m not planning a career change anytime in the next decade. I’ll probably be called “doctor” for a long time — likely for the rest of my life. Might as well start getting used to it.

Filed Under: My Life, Residency Tagged With: , , ,
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Why I Can’t Do Emergency Medicine

November 29, 2011 by 2 Comments

I can’t do Emergency Medicine. I do not like the environment of the ED. I don’t feel comfortable there. It has nothing to do with the people who work there. It has everything to do with the system. Allow me to explain.

There are many great things about Emergency Medicine. For one, I love the shift work. It must be awesome to leave the office and never have to carry a pager or be on call. When you’re on, you’re on. And when you’re off, you’re off. The salary is also an overall plus for those considering it. I mention just a few of the positives of EM to make the point that there are things I do like about it.

But the reason I can’t go into EM is the system and how it is (poorly) designed. I realize that my impression of the system is based on my experiences while rotating as a medical student through local hospitals that include a level 1 trauma center and a county medical center. So the picture I have is probably not representative of all hospital EDs. But I hope to stay in the area. I would like to stay in academic medicine. So I think my sample size fits.

While rotating through medicine and surgery I would often be sent to the ED to admit a patient. While going looking for my patient, I’d have to walk through hallways and aisles lined by chairs and gurneys filled with patients watching my every move. They watched because they hoped that my eyes would meet thesis and that I would stop. I hated that feeling. I wanted to stop an help them. But I couldn’t. I had no idea what they were there for. And they weren’t someone I was asked to see.

Perhaps this is just a small thing. But to me it was huge.

The second reason I can’t see myself going into EM is that there are just so many non-emergencies. The system of healthcare we have leads to so many people coming into the emergency departments due to complaints that should be dealt with in the primary care setting — or even the urgent care setting. I can only imagine that I’d be frustrated dealing with this on a daily basis.

It may not be much. Some may see this and minimize my reasons saying that they are silly. But in the end, they are the reasons that pushed me away from emergency medicine. And it’s a personal process everyone must go through for themselves.

Filed Under: Medical School, My Life Tagged With: , ,
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Breast Cancer Awareness Month

October 12, 2011 by Leave a Comment

It’s been a while since I have posted here. It’s been stressful lately with application going out, asking for letters of recommendation, waiting for word from programs.

I’ll be happy when it’s over.

In the meantime, here’s a video I found and am sharing in honor of breast cancer awareness month — because early detection saves lives.

Filed Under: Medical School, My Life, Other Tagged With: , , , ,