What more can go wrong?
First week of medicine rotation: DONE.
Things I have learned:
- renal failure is bad
- heart failure is bad
- pneumonia is bad
- hyponatremia is bad
- heart attacks are bad
- arrhythmias are bad
- these things invariably happen to every single patient who is admitted to a medicine ward.
Well, perhaps that is a slight exaggeration, but man, these people are s-i-c-k. Its funny the terms that you aquire after being in a medical field for a long time. The best word that I can use to describe the patients that I have been seeing is: complicated. One of the patients my team recently admitted was introduced to us by the ICU team as a "trainwreck." They are far different from the patients I have worked with on my surgery rotation, or on my family rotation, who mostly have like one thing wrong with them. Two tops. But it seems like everyday that goes by something goes wrong with a major organ system of every patient.
Like I admit you for pneumonia, and then you into a-fib, and then you go into renal failure, and then your electrolytes get all out of wack, and then your bowels stop working. And I'm like "Why??" Why are theses things happening? And its such a scramble for me to understand whats even going on, much less formulate a diagnostic and treatment plan. And every day I feel like I have the most tenuous grasp on what's going on. And I feel so inefficient.
Maybe some day that feeling will go away.
In the mean time, just give me someone who needs some stitches or something. I might be able to handle that.
On the up-side: everyone on my team is a vegetarian!
I'm not vegetarian, but as a longtime hypochondriac, this stuff scared the hell out of me!
Why?? I am currently doing my internal rotations. That seems to be a question we all ask but then never really get the answer to. The only thing I have come to realize is that we, as doctors, can only "do our job" - warn the patients of side-effects of certain lifestyles. At the end of the day the patient will live the life he chooses. Upon completion of 4 weeks of my internal rotation I remember being annoyed by two major things - 1) the familial abandonment of the sick and 2) the patient's lack of follow thru with medical advice after discharge. Both things I seem to have learnt to cope with. I still get highly annoyed when I have a patient who came in with ketoacidosis - who we work on to get back to equilibrium - and once released they come back with GMRs of 500-700 and say "Doc, I don't know what happened." But you cannot live their life for them. You can just do your "job". Pondering why only depresses you and keeps you from doing your job to the best possible.
You might call it "Death Management". A few loose bolts and vibrations send you on your way to a much worse condition. I am learning how important prevention is. Mortality, a concept that I didn't take seriously until later.
If they want to sew your lip up in ED wait for plastics :)