The Funny Current

is actually a current controlling heart rate.

What’s in a name

I’m in a waiting room and the nurse calls in “candida”. I feel bad for this woman.

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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.

Prescription Writing Adventures

Today I learned you can write a prescription for magnum condoms. In fact, you can specify whichever kind of condom you want.

/Headdesk

In a Jamaican accent, “Hemorrhoids” sounds exactly like “MRI”.

I thank God that Bates and several other old texts still use the term “piles”, because it had to get that far for me to get what was going on.

Babies and Nerves

Babies are just 4 limbs of perplexity. It makes me wonder about this “hard-coded” maternal instinct in women. I’m starting to think it doesn’t exist in my head because I see little children and I think:  What do I do with this thing? Why is it gurgling and making it difficult for me to hold them?!

I don’t think they’re particularly cute and I’m really more concerned with what’s wrong with them. Is this just another manifestation of my dislike for small-talk? “Hey, let’s fast-forward over darn this baby is so cute, and you just tell me if she’s been pooping, playing, and speaking?”

Babies cries are also just inherently so ….piercing. They’re almost the purest definition of noise. It’s sound propelled by all the oxygen they can spare. The only break you get is when they realize they’re not breathing. It’s impossible to ignore, which makes me realize that postpartum depression and neglect is that much more horrible. Nature, you are a fiend. Clever, but a fiend.

Another thing I’ve noticed is that neural development really does take a long time. There was a 6 year old running all over the exam room, but they were wobbling. I did a double take because I thought maybe there was some other pathology going on. But no, just a long time for everything to myelinate and get into working order. It makes me hate demyelinating disease and muscular dystrophies more. They’re literally just stripping your nerves and muscles, taking away years of critical development and training.

 

 

In and Out

Inpatient vs outpatient are totally different worlds. In layman’s terms, we’re talking about your go-to doctor vs the hospital.

Having urgent-care facilities and bloodwork done around the clock is really nice, but there’s always this crazy sense of urgency and the feeling you’re falling behind somewhere. We’ll see how the 2nd day goes, but on the first day of Family Medicine clinic, it’s so much more relaxed and friendly. Vaccinations are huge. It makes me regret never paying attention to what shots I was getting.

 

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.

mind blown

Is it sad that as soon as my mom enters the house, all studying atmosphere is completely blown to bits, never to return until the next morning 4 AM when everyone is asleep. 

I think in the back of my head, this is why I couldn’t deal with staying at home for my clerkships because you can’t get angry at your mom for being mom. 

On a related note, it’s really disturbing (but touching) when a terminally-ill patient tells you that they’ll pray for you to complete medical school and residency. 

Cute moment of the day was a woman with C.Diff infection telling us that she’s actually quite vain and wears a wig at home. She would have brought it with her, but was too sick. Gosh. I should have asked what color the wig was. 

Wow, trainwreck presentation has taught me:

Never depend on anyone’s previous patient History. The risk of being irritating by asking the same questions again is greatly overshadowed by being wrong in front of the attending.

Things learned from yet another orientation

  • The major disadvantage to transferring in is that no one cares about you. They see you lost and blissfully assume ignorance.
  • It’s possible to be ready “too early”. I called months ahead to call in a site preference…and now I’m being told I never did it. It won’t make or break me, but it’s irritating as hell.