So I'm basically in my LAST year of medical school! I can't even believe that I'm this close to being a doctor, it doesn't seem real. Time really flies when you do a different rotation every month...the months seem like one long day and before you know it you're on to the next thing! I have a lot to learn in the next year ahhh!
Anyway, I'm going back to Kirksville, MO tomorrow for our last practical exam of 3rd year. It shouldn't be anything difficult, just seeing fake patients and writing notes on them. I'm not excited about going back to Kirksville, but I really do want to see some friends that are back there still. I'm only going to be there for a couple of days, just enough for me!
I'm pretty excited about the next few months though. Next monday I start my first Emergency medicine rotation and I can't wait! That's ultimately what i want to go into and I can't wait to finally be in an ER. I really need to get a letter of recommendation from an ER doc so I'm going to work really really hard and get the most out of it. I should def have some interesting stories from the ER in the next few weeks lol.
Also, in about 10 days I'm going to FL for a fun little triathlon on South beach. It's an ocean swim, which I've never done, but I'm excited to do it. I'm the most excited about the fact that my family will be there to watch me. Nobody in my family has ever watched me race or anything just because I've never done anything in FL lol. Also, the race is through the beautiful south beach and should be really flat and an awesome time. I'll miss a few days of the rotation but it's ok, it's totally worth it. I also get to go home and see my little abbey!! I miss her so much, she's most likely going to come back with me. :)
So the next few months are going to be fun, busy (not like that's anything new haha), exciting, and even scary at times I'm sure. And even crazier to think about, is that I'm going to know if I matched or not by Christmas! Ok i won't think about it yet because I can feel by blood pressure rising lol. But really, no matter what happens, i'm sure it will be fine.
Oh here are some pics of my most recent mountain biking adventure...we'll just say I took on the steep downhills and lost :)
So internal medicine is the aspect of medicine, other than EM, with the most variety. You see cancer patients, crazy patients, trauma patients, surgery patients (sometimes if the surgeons let you), the sickest of the sick, and even the guy with an ingrown toe nail. It really is interesting to learn every aspect of medicine, but sometimes it's a thankless job. Here are some of the things my intern and I have done over the past week...
- examine prisoners as we're getting whistled at by his "roommates", one of which literally was taking a dump on the floor for attention, it was nasty to say the least
- Sat with a 34 yr old woman with aggressive, stage 4, metastatic breast cancer and held her hand while she threw up nothing but bile for 20 minutes straight.. and when she was done, told her that her cancer was in just about every organ of her body and going to kill her before 3 months was over and we needed to talk about hospice. That was terrible morning.
- Convince an old lady with severe peripheral vascular disease, diabetes out of control, and an ulcer down to her heel bone, that it's better to live with one foot than be dead with both feet. Sounds kind of insensitive, but if she kept refusing surgery to take out the infections she was going to get septic and die. It was sad because she literally didn't grasp the concept that pills couldn't fix her mangled foot. Sometimes you have to be blunt to get their attention.
- Got yelled at by an angry old man who has been traveling to hospice centers around the country telling them he is a prostate cancer patient. Was told that I'm too young to understand medicine and I needed to learn how to treat my elders. Turns out he doesn't have cancer, he had a failed penile implant which resulted in urethral damage and the removal of his prostate. He's been getting narcotic pain meds for his "cancer pain" in 6 different states and has now landed in Phoenix AZ after following/stalking one of his hospice nurses. He was discharged real fast!
- Witnessed how powerful the bond is between latin families. I know first hand out close knit hispanic families are, everyone is involved in everyone's business. This can be good and bad. But in the case of my patient who is a very sick lady, in the hospital for 15 days now, previously septic with salmonellosis, c. diff, DVT, pneumonia, severe bleeding problems, and heel ulcers from crappy nurses, her family has literally kept her alive. I'm convinced that the medical intervention we provided was just important for her recovery as was her family. She literally had 5 people with her at all times (in a room with 4 other pt beds) and a daughter who fought to sleep in the room with her, on a wire chair. They may not have insurance or money or the knowledge to really know the severity of her condition, but they were grateful for us and everyday, no matter what happened or if they never slept. And they were sure as hell were not going to leave their mother alone. I love that, if only more families were that way.
2 more weeks of medicine left. I'm learning so much everyday and constantly blown away by people...in amazing and horrible ways.
This is my favorite Shakira song. It reminds me of one of my best friends. Fitting for my mood tonight...which is more difficult to handle, anger or sadness?
So thing's lately have been stressful. I know I tend to over react about certain things, but the most recent cause of my stress, politics and beaurocracy, are not things I take lightly...ESPECIALLY when they directly impact my future. Long story short, I'm being penalized for mistakes made by another student and being forced to stay in a rotation solely to "keep the preceptor happy" and maintain good rapport with him and my school. I've raised hell as much as I can, within reason, and fought for the principle of the matter. I've been so stressed about it and frustration with the system has given me motivation to keep fighting for what I know is right. Unfortunately, in the world we live in, and the context of this situation, I have to give in. It's incredibly frustrating to know this happens all the time, and it seems like it always happens to me. All because people are afraid of standing up for what is right and it's easier to fly below the radar than make a difference by speaking up. I had the same issue when I was in the AF. People are more worried about their image and "looking good" than doing the right thing. Unfortunately, as much as I hate to say it, that's the way it goes. In my situation now, I'm forced to give in. I'm just a student, I have no real pull one way or another when I'm up against my superiors. All I can do is cut my losses and realize that sometimes you have to know which battles to fight and which to leave as is (no matter how much it kills me!) I can just remember what it feels like right now and when I do have major pull one day, vow to do what's right, regardless of how unpopular or difficult it is.
Throughout this ordeal I've realized that I need to find a better way to really relax. I've used running, swimming, and biking in the past. It has for sure helped in the past, but here recently it's not working as well. There are other family issues that I've been dealing with also, in addition to med school stress. I hate complaining because I know A LOT of people have it much worse and I really am very very lucky. But nonetheless, I have had a lot on my mind and i feel like I haven't felt at ease for a while. I never really realized how much worrying/anxiety takes out of you physically. My run's have been slower and my muscles just overall felt weaker. I wake up every night at 2:30 and 4am for some weird reason. Hell, my mind is so all over the place that last week i forgot to eat and almost passed out at the rock gym! :(
So, I realize that I'm sounding like a whiney baby right now, and that sucks. BUT, i'm happy to say that today was a GOOD day. My frustrations with the school issue is resolved for the most part and I've mostly accepted the things I can't change and hope things turn out well, they usually do. I have some peace of mind now that I've decided not to re-take my USMLE (med school boards) again...a cause for a lot of stress considering my test taking abilities. And I'm starting to feel better now that things at home are calming down again and my family is stable again. As much as I hate the saying "things happen for a reason"...i find myself thinking that a lot. In the past when thing's have seemed to be going totally wrong in my life, it turns out better than I could've ever planned. And man, I am quite a planner!
So as to end this kind of Debbie Downer post on a high note...here are things that I'm super happy about:
1. I secured a international rotation in Bogota, Colombia at Fundacion Santa Fe de Bogota! Not only is this a sweet hospital, it's the same hospital my cousin's medical school is affiliated with! This was a total coincidence, it just worked out that way :)
2. My cousin is moving to Arizona in about a month! I'm so excited to live with her and explore AZ and the west coast with her!
3. Despite the stress, I'm exactly where I want to be right now! It's easy to be lonely and question the future and wonder if I'm ever going to meet somebody who is willing to accept my AF life decision, among many other things. But to be honest, I have so many other things occupying my mind right now that I'd rather not put energy into being lonely. One thing at a time...
So that's a long post! Next post will be less depressing, i promise.
Song for the night: Adele- Hometown Glory
"No and thank you please Madam, I aint lost, just wandering..."
So I'm back at Maricopa County Hospital...it's pretty much my favorite hospital in the Valley. It's a state hospital so it's ghetto, totally old school, and serves most of the valley's mexican population, prisoner's, homeless, and immigrants. For this reason, you see the most pathlogy and some of the craziest/sickest/grossest people in AZ haha. The system that the hospital uses as far as charting is pretty archaic and slow. But it's a great teaching facility and definitely has some of the BEST and SMARTEST doctors working there.
Here are some of the highlights from my first week:
- Man admitted for complicated UTI because he cut off his penis and testicles at home with a kitchen knife. The voice of God told him to do this 1 yr ago and he has major reconstructive surgery to "repair" the damage. He is now prone to UTI's.
- Met my first hoarder... she literally pooped, ate, peed, slept, etc in the same spot for weeks.
- I smelled MRSA for the first time. Was examining a homeless (hadn't showered for weeks) patient's wound (on his stump, below the knee amputation) and the attending asked me to describe the smell...i thought he was kidding...he wasn't. I also almost threw up in my mouth.
- Did my first lumbar puncture, completely solo! Interns screwed up the order from the previous day and the HIV doc (the pt actually had AIDS) needed more tests....so he asked if I wanted to do it....so I stayed an extra 2 hours waiting to do it! It was a bit scary knowing I could paralyze the guy by sticking a long needle into his spine. BUT...in the moment you forget about everything...and i got it first time! Not even any blood in the first tube :-)
- Realized that Internal Medicine is NOT something I want to do. I find myself being drawn down to the ED every chance I get. Medicine is interesting, but I don't like to follow up on people that much lol...I'm over a patient after a couple of days. Not that I don't like to see people get better, in some cases i like to follow their hospital course and see that my treatment helped...but I'm satisfied with being the first person they see and being done with them thereafter.
- Surgeons are still a-holes, no matter where you go.
- I'm amazed at how many people in this world don't actually use their brains. (i'm not talking about patients)
Ok well those are just the main points from this week! I'm sure i'll have more coming soon!
