Wednesday, January 29

medicine wk 4, day 24

feeling a little down and the beginnings of desperation . . .

i'm coming home too late, too tired, and things are piling up. taking care of my own patients, helping my team by doing grunt work for THEIR patients, i've fallen behind in too many things.

on top of working from long hours, i have give a presentation tomorrow, and a 10-12 page write-up is due tomorrow. and i need to squeeze in studying time . . . working is hard enough. studying on top of that is next to impossible.

pts complain all the time about doctors. how docs see them for 10-15 min per day, how things seem to be progressing so slowly. what they don't see while they are lying back in bed, watching tv (you have NO idea how enviously i look at them, while they are watching tv or reading the newspaper....), is their doctors scrambling non-stop. making phone calls to get consults, getting labs done faster, arranging for care post-discharge, pretty much overthing under the sun. above and beyond what they are supposed to do. no offense to those in these professions, and i'm sure it's not like this everywhere, but in this area, doctors have to scramble to cover the slowness/laziness/inadequacy/non-concern of nurses, social-workers, etc (most ancillary staff) to make things happen for their patients.

i wish all pt's could see what a day in the life of their doctor is like...
gulping a sandwich in minutes (literally, snarfing in maybe 2 minutes, tops), often missing lunch altogether. the incredible pace that doctors walk in (fast paced even for a new yorker). the incredible stress that is heaped on them on a daily basis.

and yet, somehow, most of the doctors i work with have incredibly maintained their sense of compassion. it is distinct and striking. especially when things get crazier, i expect them to snap. but during those moments, they take the time to do something so small as warm their stethoscope in their hand before examining the patient, so that the patient doesn't feel a cold metal thing on their skin.

though it was absolute chaos in the doctor's station, even after being yelled at, or doing some yelling to get ppl to do their jobs even semi-adequately so that pts can be taken care of, the doctor will slow everything down when he is with the patient. he takes the time to listen to some minor, insignificant, trivial complaint. i half expect the doctor to start laughing crazily when he hears these things and compares them in his mind with weightier things.

it's like complaining to a soldier who is about to go to a losing war that there aren't any tostidos chips in supermarkets. after the soldier has been deeply thinking about war, life/death for wks, such a comment would set him off. in laughter or anger. good thing that these docs always respond correctly. i've yet to see a doc break down the wrong way.

*****
today, saw a patient with terrible de cubiti (sp, steve?). basically, he had open sores about 4 inches in diameter, 3 inches deep, in his bottom. it was filled with pus, smelly, and shocking. it's pretty much a HOLE.

as terrible as the sores were, i was more saddened after speaking with the pt. because mentally, he was 100% there, unlike many of our patients. he knew full well what was going on, how it was going, and how it was NOT going. it's a little easier to not deal with when the patient is out of it, not fully THERE. but when he is so completely lucid and intelligent, it's.... just much harder.

speaking with the relative was even worse. because he felt so bad and responsible for the state of the pt. he had been doing all he could. but all he saw was his father with these gaping sores. he spoke fast, panicky, almost. with searching eyes, afraid that we might accuse him or reproach him for falling short in the care of his father. he needed a pat on the back. his eyes were bloodshot, his hands were trembling, and his voice was about to break. how long had he been this wired?

my attending was admirable. calmed the son down. told him that his efforts were admirable, reassured him that he was doing his best, and that we would do OUR best. just calmed everything down. and made things happen, got things moving for this patient. you could see the strain draining away. it was great.

*****

so much more to write about, but there's too much to do. hence, the super long post.

i get asked all the time, "how do you have time to blog?"

i don't. i have lots of things to do. too many things to do. many times that i don't want to post. but i'm not blogging just for kicks. not to pick up girls (although, wouldn't THAT BE SOMETHING?! hahaha... sorry, had to throw that in there...) not even just to report to my friends that i hardly see anymore.

i started this thing to record my 3rd year of medical school. i knew it would be a rich experience, and it HAS been. wilder and crazier than anything i've ever experienced, nor likely to ever experience in the future. i am not the most faithful blogger without reason. :D

randomly: I MISS YOU, my STORMIES. every single one of you. i haven't seen you in such a long time. too long. when you have a moment to spare, please pray for me. i will do likewise for you. looking forward to the day that i will see you again.





yakob at 11:56 PM

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