The Funny Current

is actually a current controlling heart rate.

Category: personal

Ob perks

I giggle inside a little bit everything I think of the fact that all the males in my track have period tracker apps on their phones.

To Do

It’s amazing how quickly showers fall to the bottom of the To-Do list

As cliche as it is…

Man, I have to remember that time is passing whether I’m in a bad mood or not and I need to really live in the moment.

That’s a No and some philosophical regurg

As the end of 3rd year creeps insidiously closer, there’s an overwhelming pressure to figure out exactly what you want to do the next 5 years of my life. It makes me want to have taken philosophy classes so that I could just sit down with some candles and meditate to realize what I want do–who I want to be.

Is this why medical school is traditionally so hard to get into? Because not only do you need top marks, but you have to have done all your soul searching at a tender age?

I’ve been mentally crossing things off my career list, but so far it’s been hazy. I stutter on an off with Surgery and sometimes I go back to the thought of Family Medicine even though I was so scarred by my experience I immediately swore to never go back there. A lot of attendings say that you just know when something clicks, and it’s only happened during this rotation I realize I absolutely loathe Pediatrics.
I’m not even sure what bothers me because I love that they discharge patients so quickly and kids are generally innocent. They don’t scream at you to eat your shit and lie through their teeth. But I just feel like I’m in this constant haze on the floors. And when I get out I feel like I just escaped from jail. So definitely not a good fit.

I’m also not feeling any kind of kinship with my team. Even though surgeons are generally considered assholes, I trusted and enjoyed their company a lot more. (Masichistic much?) I think I also hit the wrong chord with a classmate when I told her my first thought witnessing a c-section was not the beauty of life, but a commentary on the construct of civilization that we humans have set up and how this birth just destroyed it for me.

Time passes too fast. Rather I wish time would just pause for a weekend or something. I haven’t gotten much ahead of me before I need to actually think about who I can ask for letters of recommendation. Jesus, sometimes I’m scared of what kind of person ill be once I won’t have to prostate myself to exams and evaluations.

Dust to Dust

It seems like you can take on 1 of 2 attitudes when you’re working in a hospital– either good that you’re helping people, or a bit morose because you’re really being faced with an existential crisis everyday.

The first patient I was responsible for at this current hospital arrived as a very sick man. He was unlikely to do well purely because of a flagrant cancer that hadn’t been responding to treatment. Amazingly, he’s stuck around for almost 2 weeks, but at this point we’re discussing how to make his last moments peaceful. Having to go in every morning to check on this man always made me think of how we’re all ultimately going to die. Dust to Dust, right? No matter how high you “ascend” in life with your wealth, status, power, it doesn’t mean anything because when you get sick, you’ll be just as unkempt, smelly, undignified, and ill as anyone else. You start to go down the line of, “what’s the point?” And this must be what severely depressed people think about all the time.

(I can’t help but think of this funny story told at a contest… a man is describing how he and his friend always go to Pizza Hut, obviously for pizza. One day, he goes and asks for his usual, and the waitress says, “I’m sorry, but we’re out of pizza today”. The man just looks at her, completely side-lined, and takes a good look around the room, seeing a multitude of people similarly confused. And he starts to ask himself, “Why am I here? Why are any of us here … ” )

On the other hand, you’ve got people boasting about saving the day, or salvaging a lab value on a patient. Maybe they’re at peace with the idea that death is a great equalizer and you don’t take anything with you when you’re on your way out. Or is that a result of not thinking about it too much? It wouldn’t surprise me that there is a subconscious protective reflex built into us.

I think I’m just noticing this more because I’ve never had to spend any time in a hospital as a patient. Hospitals are kind of grisly. Yes, there is a lot of healing and miraculous recoveries, but ultimately it’s a place where for sick people. Another plus for Preventative medicine.

Choosing

3rd year is all about figuring out what field you want to devote your life to. And as an inexperienced student, I find myself liking rotations where the preceptors are sharp and good-teachers. So I’m getting a really mixed experience right now, which is unfortunate, since I had Family Medicine on my radar, and as the rotation draws to a close, I find myself…shifting away from it.

Time is definitely a big problem. The schedule can be messed up for any number of reasons, ranging from patients being late, doctors being slow examiners, or being bogged down by having to confirm labs or radiology reports. The end result is that you get frustrated and are constantly watching the clock or bemoaning your extra hours. Logically, the only thing you really want to do after that is just get done and leave. But if you think about it retrospectively, you’d feel awful because you’re valuing your personal time over other people’s health.

So purely from a student POV, I had better structure in Internal Medicine (where you’d expect to be busier), because I actually got out of the hospital when I was supposed to. Here, it’s varies between 5-7PM. This pattern for however long I’m going to live doesn’t really appeal to me.

Existential medicine. Putting a stopper in death

I’ve realized that change is what’s scary. I’m thinking in particular about this patient I ended up talking to a lot partially because I had to translate.
They’re in end-stage renal disease (among other things), and it’s established in the back of everyone’s mind that this person is going to expire pretty soon.
It didn’t spook me as much when they were animated enough to have a conversation, but when there was a sudden change in their condition, the whole atmosphere became charged with this sense of nausea and impending doom. Rationally speaking, nothing has actually changed. The prognosis is the same and we all knew what the profession of events would be. But I guess this is where denial comes in, the last image I had was of a pretty cheerful person who made their spouse buy me coffee as a thank you. You’re mind tends to run away with you and you imagine someone in a hospital gown skipping away in fields of gold. Or the ridiculous idea of a “peaceful” end. I don’t think anyone really just dies in their sleep without looking horribly worse or being in some sort of distress.
Anyway, when I saw how much worse they got, I was thinking, “holy –, this person is going to die. They’re going to die. What am I doing? What can I do? Is my face right? Should I be more emotional, less? No, no crying, there’s enough wet eyes here to water a garden”.
And now, at the end of the day, that sense of essentially freaking out has subsided and I’m sort of thinking of them as gone. And that doesn’t bother me as much because its just something you can’t alter. I’m off for the weekend, and I said hi/goodbye to the couple, and I got this sense that I was leaving them in a static field of purgatory. One of them is hovering between life and death. The other is between a splintering point in their life. Right now, it’s tenuously held together. On Monday, the world is going to be different. I can almost imagine a whiteboard eraser going over their name on a family tree. It’s…some word between curious and morbid.
I’m going to make a pop culture reference. When Harry potter was really big, my favorite character was Snape. But at the second to last book, I decided to stop reading the series because I knew Snape would have to die in order to be redeemed. That was my version of time travel. Just stop right there and that canon never would have happened. This is the same thing. And I don’t know if I should hope/pray for them to last a little longer, because it really wouldn’t change anything.

Then again, I suppose We’re all postponing the inevitable.

Musings

I read somewhere a long time ago that (oh look, I found the link: NYT ) that the first-born child will have a higher IQ than the siblings, and if the first-born died, then the next one in line would reach that IQ or have an increase in IQ. The theory being that with the cover of the first child doing all the trail-blazing, the younger ones didn’t have to work/think as hard.

In my experience so far, that seems to make sense. When you’re on your own, you have to suddenly pull all your resources together and do a lot more research. I feel like I got to do a lot more in Tucson just because I wasn’t under the protective wing of my family or under the stress of school. Almost paradoxical since I had practically no method of transportation. But I felt like I got more things achieved there in all arenas of learning, pleasure, and soul-searching. ( I get this crazy sense of gratification every time I get to show-off I know the new pap smear guidelines even though I wasn’t on the wards. Which is insanely dorky. )

Man, if I were with my family, I wouldn’t have taken a lot of the risks I did. But now that I’m back, it’s become a bit of the doldrums. I just want to get out in the wild again. The relative-wild, I’m still a city-girl at heart and can’t deal with mounds of caterpillars or mosquitoes.

I can’t believe I wanted to bike to the hospital one morning and accidentally went into the freeway. Or that I made a 4 day trip into the Grand Canyon on my own. My bike brakes also snapped off while in the middle of the road. Miscellaneous hiking. Walking for 90 minutes to get to a swimming pool.

There’s probably other things to add to the list that I can’t think of right now.

This phenomenon reminds me of when you go out to a party with your friends. The purpose was to meet new people, but you end up mingling with the people you already know. Familiarity has a big draw that can really cripple a person. I got to meet-up with some Tucson friends tonight and it was different because I think I made more conversation with new people than I usually do.

And I think I’ve been bitten by the biking bug. I want to ride around just a little bit, but I’m afraid if I get one, I’ll use it so little it won’t be worth the purchase. Dear Mayor, in your ridiculous extended term, I hope you are expanding bike lanes. And repaving roads. Especially in Brooklyn.

 

Culture Clash

I shadowed an ER doc last week and it was a kind of bizarre experience. All throughout my undergrad/grad school so far, I’ve had primary care principles ingrained into me. Going to work on the Mobile clinic was pretty similar. Now I’m in this environment of screaming, bleeding people who get the shotgun approach and probably aren’t see again by these physicians.

It makes sense. I’m not saying that emergency care is the devil that’s draining money from the healthcare system. Aside from never letting it happen in the first place (impossible), how else are you supposed to respond to a true emergency? Of course you’d take several blood samples and stabilize them quick as you can, then make a long list of possible culprits.

I thought I’d be squeamish around blood, but it really doesn’t bother me. (check). But I felt a bit dumb next to these guys, it’s very on-demand, “what do you think’s wrong with this guy?” and I go “uhhh…. ketoacidosis…. or alcohol poisoning…. or….(insert 5 minute pause here)”. So that’s really impressive, the ability to think really quickly on your feet.

I had to do a bit of translation for a very very drunk man, where I learned, you have to be forceful sometimes. Just let go of any inhibitions and social conduct rules in your head. You have a mission to get information, and you can’t just use the same line of questioning over and over again. Don’t worry, it’s not as brutal as it sounds.

I find it weird that an ER doc doesn’t follow up with their patients. Once again, makes complete sense, that’s not their function. Is it that I’m particularly nosy that I want to know what’s going on with people after they pass through my hands? The whole culture is different. I felt that with Primary Care, you’re building a growing relationship with the patient. Here, there was no real relationship, just quick in and hopefully out. I don’t know how connected you could become with a patient, I would guess not at all. Does that add to burnout? In its simplest form, it becomes a job by the hours. Sure, you’re saving people’s lives but what if it feels meaningless because they pass out of your hands so quickly?

You’re a Future Leader

I don’t understand all these ads pushing you to become a leader. Leaders are bad team players, they’re always trying to delegate to each other and think they have the best idea. It should really be about being a good team player and picking up slack.