Thing's I've done on Internal medicine..

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.