Welcome to 7th floor....

The Psych Sorting Mug (yes, we picked out of a mug) was good to me. #12. This means I spend the first three weeks on 7 West (General Inpatient Psych) and the second half of the rotation on 7 East (Med/Psych). Overall, orientation went smoothly complete with a three hour lunch break.... M and I treated ourselves to Corner Bakery (complete with cookies that we saved for during the afternoon's lecture). Yes, you read that correctly... lecture. They suckered us into two hours of lecture while we were orienting. After all the sitting about and "learning", we went on a tour of Seventh Floor... and I can't lie, I've been in lock-down units before (South State Hospital), but it's always a little creepy, and a little sad.

Even though I have no interest in psychiatry as a profession, I'm looking forward to the next six weeks.... learning how to deal with people on the edge, and hopefully helping bring them back.

Did I mention our mornings start at 8 AM? I think this is gonna be a nice breakrotation.

A new era... and the Psych Sorting Hat

A new rotation ushers in a much-needed blog overhaul. Hope y'all like it!

In other news, I've officially requested my first LOR and unofficially set a date for Step II CS (thanks to my awesome best friend who is determined that we can go together). Time is going by so fast! I can't believe how quickly this year is flying... and how much there is left to learn/do before those two little letters are at the end of my name.

Still a little nervous about starting psych, simply due to the unknowns that go with it. This whole picking out of a hat for your rotations.... I'd rather let the hat pick for me.

PS, psych sorting hat, I'm Slytherin with a side of Gryffindor. I'm pretty sure it's Ravenclaw that would be designed for Consults.... ;)

Internal Medicine is OVER!

Goodbye, internal medicine. Goodbye, grownups (for now, sort of). You see, next up is psychology... and we'll be dealing with a lot of adults who are stuck in not-so-adult situations or wanting to be kids again... or acting like them.. or something. It should be interesting. I'm kind of just going to pretend like it isn't happening and start counting down... 30 work days of that, and I'm off to peds! For ten weeks... just long enough that I really, really REALLY won't want to go to surgery afterwards.

I LOVED Blue House Medicine. LOVED my attending. LOVED my residents. LOVED my M4, and working with my best friend.

I still would rather do the most unpalatable job you can think of than be an internist.
Yay for ruling out one specialty!

noncompliance: disagreement, disobedience, dissent, objection, protest, refusal , defiance, rebellion, sabotage

The list of synonyms could go on and on....

The rest of the week has definitely gone uphill from my last two posts. I finally had my first "kid" patient - a crossover who just got old enough to leave Peds and come to the adult side... and even though it was a not so interesting case, I was hyped on the fact that I had a kid at all. Before she went home, we had a long talk on noncompliance with medications... which is an issue we face every single day in IM.

Medical noncompliance frustrates me to no end. I find myself having to bite my tongue to keep from saying what I really mean when I tell a patient "you have to take your medicines... if not, you're going to end up right back here again". But then they do... over and over and over again.

When I get super frustrated, I get to thinking about non-compliance in general. And I realize that even I suffer from this human error in some form or fashion every day. Just because I take my medications when the doctor tells me to certainly doesn't mean I'm compliant with every aspect of my life. Reading my bible for example.... ashamedly, I find myself extremely non-compliant with that. And I wonder if God feels the same way, like he just wants to shake some sense into me..... probably.

I'll try harder this week to be less frustrated with you not taking your medicines, even if it's gonna kill you. Because not taking care of myself spiritually could also kill me... and I do that way too much. I'll work harder to be more compliant and to help you understand how important it is that you join me.

Some days, it's amazing the lessons you learn from your patients... in the strangest places

cartoons and codes

This morning, one of our patients just didn't look right. Any physician you talk to will tell you that through clinical experience you'll learn that no matter what the numbers say, your gut will tell you when something is wrong. My gut was screaming as we looked in. Within thirty minutes of the workup, we heard "Code Blue.... X unit" overhead. No matter what the rest of the announcement said - M and I looked at each other and our stomachs dropped as we headed off in that direction. About ten minutes into the code, I looked up through the chaos towards the television that was set on Cartoon Network. I fully realize that with the specialty I've most likely chosen, most - if not all - of the codes I attend as a physician have the likelihood of having cartoon network in the background. And that shook me to the core. It got me thinking about how often life isn't fair, and how sometimes things just don't seem right. For an hour or so, I wished I'd become hardened so these type of events would be easier on me. The rest of the day, I prayed I never will.

The Lord gives and the Lord takes away. His will be mine. Thank you, Lord, for allowing me the opportunity to take care of your sons and daughters during their time here. Help my heart never harden to their suffering, help me always see things through your eyes - but grow me into the doctor I know I can be even on the most challenging days.

saying goodbye

I went into this weekend with excitement. It was the first two days I've had off in a row this month, and I was looking forward to resting and rejuvenating my soul to prepare for the rest of internal med.

And then, as quickly as the excitement began, my stomach dropped when I found out that my first patient passed away yesterday. How do you deal with a loss you aren't prepared for? Funny thing is, I maybe should've been... but I'm too glass half full for that. I can see why some people become jaded, it might be easier that way.

But I'd rather spend a few moments crying and reflecting on how this moment - and this person - changed my life. Yesterday morning, we spent several moments talking about the future - how the patient wanted to get better, to figure out what was really going on, to watch their high schoolers grow into men. A perfectly normal conversation you might have with your neighbor over your own breakfast. Just another day. Feeling well, but watchfully waiting for the other shoe to drop.

Then it did. And she was gone.