Ms. B...

So this surgery month, that is almost over, has been quite demanding of my time and patience. I don't necessarily get pimped a lot, but I am held responsible for almost everything...even when the OR lights burn out. That's clearly my fault. Not to mention my surgeon isn't the biggest "people person" with his attitude that no patient encounter should take more than 5 minutes and time=money. He's a very great surgeon, but his people skills are kind of iffy. So being around him and scrub tech's that hate their life and have a negative attitude towards everyone and everything has sort of sucked me in a little bit.  I found myself today staring at the clock as a patient was talking realizing exactly when the 5 min mark was up, getting bitterly angry at people for continuing to smoke and not control their diabetes which forces them to us for toe/foot amputations, feeling disgusted with morbidly obese people for smelling like they crapped themselves, etc. I guess I was just caught up in being bitter with my patients in general. (maybe it has to do with sleep deprivation?) Anyway, I was in the ICU today seeing a consult, homeless guy, found down in a park, bleeding from nose, mouth, rectum...needed surgery for perforated gastric ulcer and esophageal varices from years and years of drinking.  In the midst of being mad at him for drinking himself into the ICU, i walked by an old pt of mine who has been in ICU for 15 days now.  We took some of her colon out because it had twisted on itself and was necrotic and she later got pneumonia and had to be intubated. She's been intubated for over a week now and I've stopped seeing her daily because there's nothing for us to do anymore. She's slowly bouncing back and forth from getting better to doing worse with her pneumonia. But today, she was awake. I saw her looking out of her room, tube in mouth, holding this super soft pink little stuffed dog she's had since the first day i met her. Before she was intubated, she was always the sweetest lady and called me "love", well, i guess she still is sweet, she just can't talk. I hadn't seen her in a few days so I walked in to her room just to say hi and look at her tummy and i was sort of shocked by her reaction to me. I grabbed her hand first and then she just latched on like there was no tomorrow. It really caught me off guard because she was wide awake and i guess just wanted to hold my hand. After a few seconds she grabbed it and pretended to kiss my hand, around the tube in her throat of course. It just really moved me and made me sad because I hadn't been seeing her daily and it seemed like she really needed somebody to just be there and for once, not look at al her tubes, holes, drains, etc.  I stayed as long as I could but before I knew it I could hear my name being called from the hallway to hurry up and get moving, actually the surgeon calls me "girly", not even by my name lol. But Ms. B sort of made my heart sink and put things in perspective for me.

I was getting caught up in being angry and bitter, just like a lot of people in the medical field. You always run across these doctors that are just genuinely happy people and have a great attitude, but more often than not, they're bitter and hate people...I don't get it? Didn't they have to actually WANT to help people at one point? What happens in the course of residency and then years later that makes the love and compassion for people completely disappear? I can imagine that it's the "bad eggs", so to speak. The ones you see repeatedly for problems they cause themselves. The people that despite surgery after surgery, infection after infection, don't quit smoking, don't lose weight, don't take care of themselves. It's the ones that feel entitled and demand you fix what they have been doing to themselves for their entire lives in a few days. The ones that say "you're the doctor, fix it." I'm not naive and I'm not saying that I'm never going to be jaded and bitter, of course I am, it's already happening!  But I can at least acknowledge it and make the decision to not let it overtake me and lose sight of the reasons I started on this crazy journey to become a doctor, reasons like Ms. B.  Why do we allow ourselves to be bitter all the time and let the "bad eggs" leave a lasting mark. Why isn't it people like Ms. B, the great, sweet lady who got unlucky and is fighting to live, that leaves the biggest impression on us?? I know there are more bad eggs than good eggs, so it seems, maybe because the good eggs are healthy and don't need hospitals?? But the good ones definitely outweigh the ones that make me bitter. And for every 20 bad ones, 1 good one is enough for me to realize the choice I want to make.  The choice to take more than 5 minutes, let people talk a little longer, try to see their side and despite my surgeon, call patients by their name, and not, "cancer girl" or "stump man". (yes he actually calls them that, not to their face, but he doesn't know names.)  I just can see that if you let yourself fall into the bitterness black hole, then no matter which kind of people you see, eventually they will all be "bad eggs" in your eyes.  And who wants to live that way? I guess the bottom line is there are MANY, too many, bad eggs out there. Care for them, be compassionate, and even get angry at them, it's ok. But don't let them drown out the good ones, keep your eyes and heart open for them... they're the ones we started this whole battle for in the first place!

Ok now I'm off to study and sleep before 9pm. I have 1 case tomorrow and then get the rest of the day off!! woot! :)

The beat goes on...

Semi quick update on rotation:

I've been really busy the past few weeks! I'm on a surgery rotation that actually isn't as physically demanding as my last surgery rotation, it's more of a mental game. My doc is great, tough on students and makes us work hard, but still great. The 3am wake ups followed by mostly 12-15hr days, 5 days a week is kind of tiring. But the worst part of this rotation has been dealing with the personalities in the OR. My day consists of quietly rounding on my own from 4am-6am on about 8-11 patients, making sure the charts are all in order and everyone has been checked on before doc get's there at 6am...no big deal, despite the fact that I'm not entirely awake and looking closely at colostomies and freshly amputated stumps isn't the greatest smell that early in the morning.  (not that its ever a great smell!) My real work starts around 7am when the first case begins and I assist on surgeries while dodging bullets from the scrub tech (hands instruments to doc) and first assist (a nurse that helps the surgeon operate). It seems like no matter what I do, or how great I do something, they always have a negative comment or something to scold me for. I'm not a sensitive person in these situations and i can take a scolding without letting it get to me pretty dang well, but when people who have 1/3 the education I have start yelling at me...I have a problem. Not only yelling at me, but the scrub tech actually stabbed me with a suture needle when she was yelling at me and yanked it out of my hand! I'll just say that we had some SERIOUS words right then and the day after, and since then, she's been fine. :)  I just don't tolerate blatant disrespect and people taking their problems and bad attitudes out on me. ESPECIALLY from a menopausal scrub tech...sorry you're having hot flashes lady, deal with it!!! But all in all, I'm enjoying the rotation. My sewing skills are improving and i'm learning lots of different techniques.

What I really wanted to write about tonight was how things change.  As in a change of heart, change of perspective, and i guess just how things can just change in the blink of an eye.  I'm pretty sure that everything changes in some way or another. People always say "Time change everything/everyone", and for the most part, I think that's true. But I just get amazed at how certain things, beliefs, ideas, goals, etc can change seemingly overnight, taking no time at all. Maybe it's just that the gradual changes don't affect us as drastically.  An example, our last case on Friday was an operation on a man to remove part of his colon that was full of cancer. He had abdominal pain on Thursday, came to the hospital that night, and by friday at noon, he was told he had stage 4 colon cancer, needed part of his colon removed and was told he probably wouldn't live another year.  During the surgery the doc had me literally feel the inside of his abdominal wall and his intestines and all I could feel were little bumps...all tumor seeds. This 56 yr old man went from working full time, living a happy life with wife and 4 kids to knowing his entire abdominal wall was being overtaken by cancer and he would die soon.  His life changed in the time it took us to say the words.

 Another example, the end of a relationship. Generally speaking, when you're genuinely happy with someone, time seems to go by fast. Everything looks a little different and you sort of feel like your heart is smiling all the time. But it's crazy to me how all of that can go away overnight and you're right back to where you left off.  Something sets the ball rolling in the wrong direction (sometimes without you even knowing) and without warning, here you are, back in a familiar place, feeling just like you never left. I guess all you can do is pick up where you left off and keep going.

I guess my point is that you just never know. I'm constantly amazed at how drastically and quickly our lives can change. One minute you're blissfully happy and your life/health has a great outlook, and before you realize it, it's all different, maybe for better, maybe for worse. Either way, nothing really seems to ever stay the same and it's just a matter of how and how soon things are going to change.  Makes me want to just enjoy the right now, all the time, because tomorrow it can all be different, and the only thing you can do is react.

One of my favorite songs my one of my top 5 bands...
The Temper Trap- Soldier On