pressure is rising

Picking a specialty has become so incredibly difficult. My decision has morphed into the question: why did i want to be a doctor?


 I try to reflect on what i want to do and what i want my life to be like but then i just start day-dreaming about nothing. Im not sure if my attention span is just that short or i really just cant picture what and where i want my life to be. I juggle between wanting EM and then not wanting it. what i have realized is that the main reason i cant decide is because i keep asking myself, "what if im not good at it?" once i start residency there is no turning back. Thats it. How can i know if im good at quick decision making and procedures if i havent really been challenged to do so?

Do i go for it and handle the consequences? Or do i settle for family medicine or specialize in IM and possibly regret my decision later.

Reflecting on why i went into medicine, i find i love science and being a doctor because its interesting. its hands on working with needles, suture, etc. Its not a lot off bullshit. You learn something, you remember it, you use it later. Did i really go into medicine to listen to my patients talk about their feelings and adjust their medications and make their lives better? Or did i go into it because i knew it would keep me entertained, i get to cut people open, and make changes in a patients life that i can see the outcome on the spot. Ex: in OB: do c-section = see baby. in EM: see laceration, suture it= stop the bleeding. Whatever i do, i need to see this change. Because if i dont, im not sure how long i can go on pretending to care about certain things when realistically, i dont. Is that selfish or just self-sustaining? TBD...

schizophrenia

listening to schizophrenic's is like being on drugs yourself. they talk about absolutely nothing or just talk about nothing and you try so hard to understand what they are trying to say but you just cant. its very sad and you really do try to stay in the conversation with them. its like you are high and trying to figure out what is going on but can't. these people have some intricate minds and they are not necessarily dumb, they just cant keep track of their thoughts....or their thoughts are completely delusional. for example, the lady that was completely confident that Jesus was communicating through her and that she is divine and invincible.

"on that's all i have to say about that"- psych patient after everytime she speaks

psych patients are the most outgoing patients i have had yet

First day being at the Psych hospital and seeing patients. Today and tomorrow i am in the 'outpatient' facility which is patients that come to process groups during the day but go home for the night. interestingly, medical then medicare patients [which are most of them...as their mental illness counts as a disability] covers every single day at these outpatient groups which they stay at from 10am-3pm and the amount they can take are unlimited. they do so because it is cheaper to do this then to have them overdose, relapse, attempt suicide, etc. and need to be placed in an inpatient facility. but, all the other insurance companies cover only 12-15 sessions a year. sad.

first group i sat in was an adult process group that were medium-high functioning adults, in the afternoon i sat in on a substance abuse group. each had young [18yo] to old [60s]. the dynamics were interesting and everyone definitely had issues they were trying to get over. im sure i will have some interesting stories to remember once this rotation is over...

IM Overnight...while on Psych. lame.

night shift went well, admitted 4 patients. one of them was jaundice...like legit had yellow eyes and body from pancreatitis 2/2 gallstones. also admitted a patient that really had no reason to be admitted...but i have found that that happens a lot [gotta pay hospital bills somehow...]

the night would have been EPIC because the overnight intern had to do 2 central lines and she said i could do them! around 1am she told me to go to bed and get some rest and she would call me around 3am and we co do them. unfortunately, she called me at 5:30am instead for another admit and when i asked about the lines she said BOTH patients refused the procedure. i have been here for over 1 month and i have not heard of any patient refusing a central line. just my luck. grrrrr

morning rounds ended around 8:30am, i grabbed some breakfast and went home. Wednesday is a freeeeee day :)

Psych day 1

welp, first day of Psych rotation but at the same hospital i just did IM at. still have to show up for 7am morning report and listen to the PD scold the interns as he goes over the patient census and then we drive over to the psych hospital which is nearby. thank god nicole tan and justin are with me, the old crew is reunited once again. we help each other survive for sure, IM would have been a lot easier if i had them around....

so in the psych hospital i will do a week in the 'outpatient' groups, a week in the adolescent unit and then two weeks in the adult units seeing the high and low functioning adults. my day will be mostly sitting in on group sessions listening to the counselor and the patients. today we spent the morning doing an orientation of the hospital [again for me] and then an orientation and watching videos at the psych hospital. we were dismissed at 2:45pm... i am going to love these hours.

im on call tomorrow night [valentine's day...] and am kinda sick so im gonna skip out on morning report and then show up for my shift at 7pm, then ill get home wednesday after morning report. its kinda ridiculous that this hospital makes me do IM calls when i am on a psych rotation but hopefully i will do and see something cool.