Last couple days have been a med student’s dream. Tuesday morning we had 6 patients and then there was only 1 person scheduled for the afternoon and it was the last visit of the day so my doctor, being the awesome person she is, asked me at lunch “so, how do you feel about taking the rest of the day off. i mean, this is your elective and your new to portland so i think you should go do something fun.” Naturally, my first reaction was to think ‘is this a trick?’
i responded with “well, i dont want to look like a slacker... are you sure?” She was sure.
i left at 12:30 and spent the afternoon hiking. I also had Wednesday off per her usual schedule so really the last couple days have been pretty great.
When i got home, i spoke with a non-medical student friend [who is friends with a lot of med students] about this situation and his response was “it seems like every time one of you is asked to go home, your worried about going even though the doctor is practically pushing you out the door.” this is very true.
So, just to clarify, if you ask any third year medical student what their reaction is when asked if they want to go home early the answer is always going to be no until you directly hear “yes its fine,go home” several times. You may think this question would cause a wave of excitment but really, it just provokes panic and confusion.You always have to balance how this newfound freedom will affect the rest of your rotation and of course, your evaluation. 9 times out of 10 the doctor really is just being nice and wants you to go home and relax because they know that med school sucks, but for some reason our thoughts are always geared toward several thoughts: 1) how is this going to make me look 2)how is this going to screw me over 3) will i look better than other students if i DONT go home. sad but true, we are a predictable bunch and we are scared shitless of admitting to a preceptor that we would rather be at home watching netflix than doing scutwork at the hospital/clinic. The cool part about this is that there are a few rotations that when asked if you want to go home, you actually don’t. and this my friends, is how we decide what kind of medicine to go into.
Thursday, October 27, 2011
Monday, October 24, 2011
had an amazing weekend in seattle and went into work for 8am this morning. i was moving and thinking very slowly...so exhausted.
a drug rep brought in donuts. seriously, doctor's offices have the most unhealthy food of anywhere else i have worked. irony?
a married man came in to get an HIV test after having cheated on his wife with a woman who he hired to give him a massage. you cant make this stuff up.
a drug rep brought in donuts. seriously, doctor's offices have the most unhealthy food of anywhere else i have worked. irony?
a married man came in to get an HIV test after having cheated on his wife with a woman who he hired to give him a massage. you cant make this stuff up.
Friday, October 21, 2011
family medicine, a form of psychiatry?
Today started out at 8am with me giving a pap smear to an OB/GYN... It was a crazy experience that I am not sure I will soon forget. The patient was a doctor [a DO] that was in for her yearly well woman's exam. We chatted with her for a while about OB and how she had her own practice and then after about 20 minutes Dr. X started to get into her medical concerns and did a breast exam. When that was over and we were about to do the pap smear she looked at me and said, "do you want to do it? i mean, would that be weird for you?" i laughed and said "no, would that be weird for you? if your ok with it im ok with it." So there i was, doing a pap on a women who was talking me through it/teaching me about it while another doctor stood behind me and gave me pointers. talk about being nervous. i def messed up a bit but what medical student wouldn't under that kind of pressure!
Another interesting part of my day was when a lesbian couple came in. one being pregnant and the other being our patient with back pain. the notable part about this patient was not the lesbian part [im not that politically incorrect] it was the fact that she is a chiropractor and we did OMM on her.... trying to adjust a chiropractor, thats pretty much what they do all day! we walked out and dr. X said "talk about intimidating, trying to adjust a chiropractor is pretty hard on the ego." we both laughed since both of us tried and neither of us were able to get any results in our attempt at lumbar HVLA.
in the afternoon we had a mom and daughter come in, each having their own separate appointment. First, we talked to the 18 year old daughter who had a history of severe cramps and the birth control we started her on were making her nauseous so we switched her to something else. I sat and listened to dr. X explain to our patient that she may have endometriosis and what that diagnosis meant. I worked in OB/GYN for 6 weels and never did i hear such a well formulated and easy to understand explanation of the disease. the more i listen to this doctor the more i admire her. she is SOOOO good at explaining things to patients but yet she doesn't make them feel stupid. she is great and i really hope i can be just as good at it as she is. she really is helping shape me into the doctor i want to be.
Then, we roomed the mom in the next room and had the daughter wait in the waiting room. The mom patient was in for a well women's exam and man was it an educational patient visit for me.
we started out the visit like we always do, chatting with them about how their lives are going and just getting a feel for their lifestyle. as conversation progressed, we slowly started to get into this woman's relationship with her daughter. it sounded like they had a healthy teenage daughter/mom relationship and that right now they were struggling with starting the conversation about the daughter's sexual activity. when we started to explore this area, we learned that this patient [the mom] had a lot of trouble talking to her daughter about self-respect and setting boundaries with men because when she was an adolescent her step-father sexually abused her along with his friends. because of this experience, she became very open sexually and for the rest of her adolescence whenever she liked a boy she would just have sex with him because that is the only way she she knew to be. so now with her daughter, she knows this is not the way to teach her how to be but she doesnt know how to express appropriate advice because it is so foreign to her.
being a doctor at this point in a visit is not about medical advice, it is about being a counselor/listener/advocate for your patient. we are the official 'secret keepers' and really, that alone is enough for some people. i think we helped this mother out extremely by giving her an open ear and also some advice on how to go about speaking with her son and daughter about their relationships and self- worth while also making the mother realize that she is a good person, a good mother, and more importantly, that she is doing a good job despite her insecurities and doubt.
Another interesting part of my day was when a lesbian couple came in. one being pregnant and the other being our patient with back pain. the notable part about this patient was not the lesbian part [im not that politically incorrect] it was the fact that she is a chiropractor and we did OMM on her.... trying to adjust a chiropractor, thats pretty much what they do all day! we walked out and dr. X said "talk about intimidating, trying to adjust a chiropractor is pretty hard on the ego." we both laughed since both of us tried and neither of us were able to get any results in our attempt at lumbar HVLA.
in the afternoon we had a mom and daughter come in, each having their own separate appointment. First, we talked to the 18 year old daughter who had a history of severe cramps and the birth control we started her on were making her nauseous so we switched her to something else. I sat and listened to dr. X explain to our patient that she may have endometriosis and what that diagnosis meant. I worked in OB/GYN for 6 weels and never did i hear such a well formulated and easy to understand explanation of the disease. the more i listen to this doctor the more i admire her. she is SOOOO good at explaining things to patients but yet she doesn't make them feel stupid. she is great and i really hope i can be just as good at it as she is. she really is helping shape me into the doctor i want to be.
Then, we roomed the mom in the next room and had the daughter wait in the waiting room. The mom patient was in for a well women's exam and man was it an educational patient visit for me.
we started out the visit like we always do, chatting with them about how their lives are going and just getting a feel for their lifestyle. as conversation progressed, we slowly started to get into this woman's relationship with her daughter. it sounded like they had a healthy teenage daughter/mom relationship and that right now they were struggling with starting the conversation about the daughter's sexual activity. when we started to explore this area, we learned that this patient [the mom] had a lot of trouble talking to her daughter about self-respect and setting boundaries with men because when she was an adolescent her step-father sexually abused her along with his friends. because of this experience, she became very open sexually and for the rest of her adolescence whenever she liked a boy she would just have sex with him because that is the only way she she knew to be. so now with her daughter, she knows this is not the way to teach her how to be but she doesnt know how to express appropriate advice because it is so foreign to her.
being a doctor at this point in a visit is not about medical advice, it is about being a counselor/listener/advocate for your patient. we are the official 'secret keepers' and really, that alone is enough for some people. i think we helped this mother out extremely by giving her an open ear and also some advice on how to go about speaking with her son and daughter about their relationships and self- worth while also making the mother realize that she is a good person, a good mother, and more importantly, that she is doing a good job despite her insecurities and doubt.
Thursday, October 20, 2011
Vampire Success!
Today i drew blood out of a patient for the first time! it went really smoothly and i got a 'flash' [flash of blood showing you are in the vein] on my first try. She didnt scream in pain at all so im gonna take this as a huge success! I found the vein initially and then when i actually went to put the needle in i couldnt find it again so i just kinda went in blindly and it worked :)
the rest of the day went just as well. morning started out with a representative from a diagnostic lab brining everyone a pumpkin spiced latte from starbucks [again, i have mixed feelings about this but they are just so good and i am just so poor/loaned out!]. After this i took a look at my own throat and my tonsils and pharynx didnt look too hot so i asked the MA [medical assistant] to do a rapid strep antigen test on my throat. we took a swab of the white stuff sittin in the back of my throat to make sure it wasnt strep. it came back negative so i now know i just have a lil virus that will go away with time. a very convenient thing to be able to do :)
We saw about 10 patients today. One patient i remember in particular because when i was reviewing her medical history i clicked on the 'medication' tab and saw a huuuuuge freakin list pop up. this lady had 30 prescriptions and was probably on around 20 of them everyday [the other 10 were PRN which means on an as needed basis]. This lady was on 4 different anti-depressants alone.... talk about medication management.
last patient of the day had scheduled her appointment in the early afternoon because she was sick for over a month and was starting to have chest pain. I went in and did a history and her physical exam was completely unremarkable. her lungs sounded fine. i went back and talked to the doctor and we both started to get worried about her heart. The pain might be from the previous virus she had because certain viruses can also attack your heart after you have been sick [pericarditis, myocarditis, cardiac tamponade can all be a problem]. we sent her upstairs to get a STAT CXR [chest x ray] which came back negative and then we did an EKG on her in the office which came back normal [though it was really badly done because the ekg machine wasnt working well so it wasnt very reassuring]. we sent her to get an echo [echocardiogram] at a cardiologist office tomorrow to make sure nothing serious was going on.
the more i work at this practice the more i love it. the doctor is great and the staff is so sweet. i am having a good time and learning a lot. im struggling with the fact that i really am starting to like family medicine because i just dont know how long i will be able to do it if i go into it...its great to know the patients well but i have to admit, i think i would get really bored, fast! good thing i have a couple more weeks to ponder over all of this!
the rest of the day went just as well. morning started out with a representative from a diagnostic lab brining everyone a pumpkin spiced latte from starbucks [again, i have mixed feelings about this but they are just so good and i am just so poor/loaned out!]. After this i took a look at my own throat and my tonsils and pharynx didnt look too hot so i asked the MA [medical assistant] to do a rapid strep antigen test on my throat. we took a swab of the white stuff sittin in the back of my throat to make sure it wasnt strep. it came back negative so i now know i just have a lil virus that will go away with time. a very convenient thing to be able to do :)
We saw about 10 patients today. One patient i remember in particular because when i was reviewing her medical history i clicked on the 'medication' tab and saw a huuuuuge freakin list pop up. this lady had 30 prescriptions and was probably on around 20 of them everyday [the other 10 were PRN which means on an as needed basis]. This lady was on 4 different anti-depressants alone.... talk about medication management.
last patient of the day had scheduled her appointment in the early afternoon because she was sick for over a month and was starting to have chest pain. I went in and did a history and her physical exam was completely unremarkable. her lungs sounded fine. i went back and talked to the doctor and we both started to get worried about her heart. The pain might be from the previous virus she had because certain viruses can also attack your heart after you have been sick [pericarditis, myocarditis, cardiac tamponade can all be a problem]. we sent her upstairs to get a STAT CXR [chest x ray] which came back negative and then we did an EKG on her in the office which came back normal [though it was really badly done because the ekg machine wasnt working well so it wasnt very reassuring]. we sent her to get an echo [echocardiogram] at a cardiologist office tomorrow to make sure nothing serious was going on.
the more i work at this practice the more i love it. the doctor is great and the staff is so sweet. i am having a good time and learning a lot. im struggling with the fact that i really am starting to like family medicine because i just dont know how long i will be able to do it if i go into it...its great to know the patients well but i have to admit, i think i would get really bored, fast! good thing i have a couple more weeks to ponder over all of this!
Wednesday, October 19, 2011
family med- week 1 continued
My doctor has every wednesday off so consequently, i dont have to work on wednesdays. bummer. i spent the day a lil sick but still tried to see a little bit of portland. from what i have seen so far, i can definitely see myself living here in the future.
yesterday, day 2 of family practice, was a good day. We didnt see a ton of patients so again we had some down time [i had a 2 hour lunch] but i still enjoyed it. We started out the morning with another pap smear and spent a good amount of time talking with a very pleasant lady.
my doctor spends upwards of 40 minutes with some patients. She sits and talks with them for a long time and really gets to know them. Some people just need someone to talk to and she is there to listen. i really like this aspect of family medicine. i am curious if all practices are like this or if she is taking a hit on her paycheck by spending so much time with each patient? maybe its just because she doesnt have that many patients anyways so she can spend so much time with each one? i am still trying to decide this.... either way, i am finding a lot of patients are on anti-depressants or have anxiety and really just need someone to talk to and vent for a bit.
The next patient we saw was a patient i had just met the previous day. she had come in monday because of neuropathy in her legs. she is the sweetest lady and is an ovarian cancer survivor. she was just diagnosed and had chemotherapy last year and is in remission now. unfortunately, the chemo drugs are still creating side effects. she is mildly overweight and has apparently been pre-diabetic for a long time and when her blood results came back we had to call her to come back in on tuesday. her blood tests showed she was not pre-diabetic anymore, she now had diabetes. it was pretty rough having to tell her this and explain what this meant and how her lifestyle needs to drastically changed. she was very surprised and cried. i felt pretty bad for her. she kept repeating "i just feel like a failure" and im glad Dr. X was in the room because i really didnt know how to respond to this. i didnt want to give her false assurance [because she really did need to change her diet] but i also didnt want her to continue thinking she is a failure. we had to increase her medication and will continue to monitor her blood sugars and HbA1C.
the next patient was a 37yo women who had fallen on her elbow and wanted it looked at. dr X thought this would be a good patient for me to start off solo with so i went in first and did a history and physical and then went back, presented to dr x, and we then went in together. we did some OMM on the patient and also talked about medications because she wanted to go back on her anti-depressants. i wonder if she used her elbow as an excuse to come in as i think her depression was her primary concern.
after a couple other patients we had a 2 hour lunch and i did some reading. when i walked over to the area where the computers and nurses are i saw them just hanging out reading so i jokingly said, "oh do you guys have some down time? which one of you can i practice blood draws on?" and to my complete surprise, one of them got up and said oh i will, lets get in room 5. i was shocked and nervously laughed and said i was joking but Molly [the nurse] said nope, you got yourself into this lets do it. she apparently lets students practice on her all the time. so, we went into a patient room and she showed me how to use their needles and she was a pretty easy stick. got blood on the first try. their needles are called 'butterflies' and once you put it in the vein you can let it go [which is very different from what i learned on at school] so it really was a lot easier than i expected. hopefully i can do some more during my rotation there. i asked her how i did and she said, great. i told her she was probably lying and that she had a good poker face. either way, she completely increased my confidence on drawing blood so im very appreciative.
in the afternoon i started charting my elbow pain patient and dr. x helped give me some corrections/advice. we then saw some more patients, one of them was a couple and the husband reeked of cigarettes. it was awful. i was doing OMM on him and had to breathe out of my mouth a couple times to keep from gagging. not cool.
after a good day, i chatted a bit with dr.x and the nurses and the topic of having children came up. i laughed and said i didnt want any and she kinda smiled telling me she used to feel the same way and that once i am done with school and married, things will most likely change. i reluctantly agreed. I told her it was nice to see a female doctor working for herself but still being able to enjoy her family and home life. dr. x really does had a good balance. she does not do any charting at home and from what she told me, she basically leaves her 'doctor self' at the door and when she gets home all she is is 'mom.' again, it is very nice to see that this is possible. she gets most of her charting and paperwork done at lunch and before she goes home so that no work is brought back with her.
i asked her when she thought the best time to have children was and she told me after residency. she followed this with, "but make sure you work somewhere with benefits and save money, be a saver. dont be one of those doctors who graduates with a sense of self entitlement and buys a BMW" i laughed hysterically to myself trying to not crack a smile and just nodded. OOPS.....
yesterday, day 2 of family practice, was a good day. We didnt see a ton of patients so again we had some down time [i had a 2 hour lunch] but i still enjoyed it. We started out the morning with another pap smear and spent a good amount of time talking with a very pleasant lady.
my doctor spends upwards of 40 minutes with some patients. She sits and talks with them for a long time and really gets to know them. Some people just need someone to talk to and she is there to listen. i really like this aspect of family medicine. i am curious if all practices are like this or if she is taking a hit on her paycheck by spending so much time with each patient? maybe its just because she doesnt have that many patients anyways so she can spend so much time with each one? i am still trying to decide this.... either way, i am finding a lot of patients are on anti-depressants or have anxiety and really just need someone to talk to and vent for a bit.
The next patient we saw was a patient i had just met the previous day. she had come in monday because of neuropathy in her legs. she is the sweetest lady and is an ovarian cancer survivor. she was just diagnosed and had chemotherapy last year and is in remission now. unfortunately, the chemo drugs are still creating side effects. she is mildly overweight and has apparently been pre-diabetic for a long time and when her blood results came back we had to call her to come back in on tuesday. her blood tests showed she was not pre-diabetic anymore, she now had diabetes. it was pretty rough having to tell her this and explain what this meant and how her lifestyle needs to drastically changed. she was very surprised and cried. i felt pretty bad for her. she kept repeating "i just feel like a failure" and im glad Dr. X was in the room because i really didnt know how to respond to this. i didnt want to give her false assurance [because she really did need to change her diet] but i also didnt want her to continue thinking she is a failure. we had to increase her medication and will continue to monitor her blood sugars and HbA1C.
the next patient was a 37yo women who had fallen on her elbow and wanted it looked at. dr X thought this would be a good patient for me to start off solo with so i went in first and did a history and physical and then went back, presented to dr x, and we then went in together. we did some OMM on the patient and also talked about medications because she wanted to go back on her anti-depressants. i wonder if she used her elbow as an excuse to come in as i think her depression was her primary concern.
after a couple other patients we had a 2 hour lunch and i did some reading. when i walked over to the area where the computers and nurses are i saw them just hanging out reading so i jokingly said, "oh do you guys have some down time? which one of you can i practice blood draws on?" and to my complete surprise, one of them got up and said oh i will, lets get in room 5. i was shocked and nervously laughed and said i was joking but Molly [the nurse] said nope, you got yourself into this lets do it. she apparently lets students practice on her all the time. so, we went into a patient room and she showed me how to use their needles and she was a pretty easy stick. got blood on the first try. their needles are called 'butterflies' and once you put it in the vein you can let it go [which is very different from what i learned on at school] so it really was a lot easier than i expected. hopefully i can do some more during my rotation there. i asked her how i did and she said, great. i told her she was probably lying and that she had a good poker face. either way, she completely increased my confidence on drawing blood so im very appreciative.
in the afternoon i started charting my elbow pain patient and dr. x helped give me some corrections/advice. we then saw some more patients, one of them was a couple and the husband reeked of cigarettes. it was awful. i was doing OMM on him and had to breathe out of my mouth a couple times to keep from gagging. not cool.
after a good day, i chatted a bit with dr.x and the nurses and the topic of having children came up. i laughed and said i didnt want any and she kinda smiled telling me she used to feel the same way and that once i am done with school and married, things will most likely change. i reluctantly agreed. I told her it was nice to see a female doctor working for herself but still being able to enjoy her family and home life. dr. x really does had a good balance. she does not do any charting at home and from what she told me, she basically leaves her 'doctor self' at the door and when she gets home all she is is 'mom.' again, it is very nice to see that this is possible. she gets most of her charting and paperwork done at lunch and before she goes home so that no work is brought back with her.
i asked her when she thought the best time to have children was and she told me after residency. she followed this with, "but make sure you work somewhere with benefits and save money, be a saver. dont be one of those doctors who graduates with a sense of self entitlement and buys a BMW" i laughed hysterically to myself trying to not crack a smile and just nodded. OOPS.....
Monday, October 17, 2011
Vacation is over, technically...
Well 4 weeks of vacation (and a US tour later) I am back to rotations but not back home. After going to Nebraska, Chicago, making a road trip from LA to Portland and going to Little rock arkansas, I am back in Portland for 4 weeks doing my elective in family practice and today was my first day....
I flew in last night at 11:45pm then by the time i picked up my car and got settled into my new place I got to bed around 1:15am. Then i woke up at 5:45am so i could be at the clinic for 7am only to find that the receptionist told me wrong and i didn't have to be there until 8. I sat and got familiar with the office and then had some coffee. The doctor came in at about 8, we chatted for a bit and then I shadowed her for the day to see how the clinic runs [and mostly learn how to fill out the electric medical recorded computer system...paperwork, charting, insurance, etc etc]. Dr. X [not real name...obviously] is an awesome doctor and a great lady. She went to Western and was an OMM fellow and is now working in a group practice. She did a residency in family practice and she also incorporates OMM into her practice.
We started off the day with a women wellness exam [a pap smear....like i haven't seen enough of those] and then had a couple older ladies come in to check on their blood work. they both had diabetes and high blood pressure...i think this might be a trend for this rotation.
Then the most important part of my day came... I saw my first adult male patient. Since I have only done OB/GYN, peds and then vacation...after 17 weeks of my 3rd year i finally was a student doctor to an older male. And when we asked what we could do for him today, the first thing that comes out of his mouth...he needs a refill on his viagra. and that was my introduction to males. haha
I was told for lunch a drug rep was coming and got excited cause that means free food...and its usually damn good food. Then, i was even more excited when the drug rep came and i discovered it was a very good looking, talk, dark haired, very handsome man in a suit. He was around my age and wasn't wearing a wedding ring....he taught us about a new diabetes drug and we ate panera. i can see why drug companies only hire good looking people and i dont think its a coincidence that this GUY came into be the rep for this clinic that has all female employees [except for one doctor]. they know how to play their cards right...
by the end of the day i was becoming more comfortable with the doctor and i think she was starting to relax a little more around me because we started to joke around with the staff. a couple patients cancelled so we had a lot of down time in the afternoon and got to chat a lot more. Overall we saw 7 patients from 8:30 to 1pm and then only 3 in the afternoon.
What i noticed today was most of the patients smoked, heavily smoked. It was interesting to see them truly struggling with their addiction. One lady was 14 days into quitting while another 68yo lady who was well aware that she needed to quit and sounded very logically about wanting to, just couldnt. it has such a grasp on people and even though they smoke over a pack a day and their health is drastically deteriorating over it, they just cant find the motivation or drive to quit. i am struggling with how i can counsel these patients in the future knowing it is such a powerful mental obstacle to have to overcome.
overall i really liked my first day and have yet to completely rule out family medicine. im wondering if as time goes by i start to really enjoy it. dr. x really knew each of her patients and couldnt stop telling me reasons why she loved her job.
i dont have to be there until 8:30 tomorrow but i think i will go to bed now so i can get a solid 10 hours of sleep :)
good quote from the day:
"Mr. X, Have you been short of breath at all?" -doctor
"no. Well... I was the other day, but that was after climbing a mountain" -patient
I flew in last night at 11:45pm then by the time i picked up my car and got settled into my new place I got to bed around 1:15am. Then i woke up at 5:45am so i could be at the clinic for 7am only to find that the receptionist told me wrong and i didn't have to be there until 8. I sat and got familiar with the office and then had some coffee. The doctor came in at about 8, we chatted for a bit and then I shadowed her for the day to see how the clinic runs [and mostly learn how to fill out the electric medical recorded computer system...paperwork, charting, insurance, etc etc]. Dr. X [not real name...obviously] is an awesome doctor and a great lady. She went to Western and was an OMM fellow and is now working in a group practice. She did a residency in family practice and she also incorporates OMM into her practice.
We started off the day with a women wellness exam [a pap smear....like i haven't seen enough of those] and then had a couple older ladies come in to check on their blood work. they both had diabetes and high blood pressure...i think this might be a trend for this rotation.
Then the most important part of my day came... I saw my first adult male patient. Since I have only done OB/GYN, peds and then vacation...after 17 weeks of my 3rd year i finally was a student doctor to an older male. And when we asked what we could do for him today, the first thing that comes out of his mouth...he needs a refill on his viagra. and that was my introduction to males. haha
I was told for lunch a drug rep was coming and got excited cause that means free food...and its usually damn good food. Then, i was even more excited when the drug rep came and i discovered it was a very good looking, talk, dark haired, very handsome man in a suit. He was around my age and wasn't wearing a wedding ring....he taught us about a new diabetes drug and we ate panera. i can see why drug companies only hire good looking people and i dont think its a coincidence that this GUY came into be the rep for this clinic that has all female employees [except for one doctor]. they know how to play their cards right...
by the end of the day i was becoming more comfortable with the doctor and i think she was starting to relax a little more around me because we started to joke around with the staff. a couple patients cancelled so we had a lot of down time in the afternoon and got to chat a lot more. Overall we saw 7 patients from 8:30 to 1pm and then only 3 in the afternoon.
What i noticed today was most of the patients smoked, heavily smoked. It was interesting to see them truly struggling with their addiction. One lady was 14 days into quitting while another 68yo lady who was well aware that she needed to quit and sounded very logically about wanting to, just couldnt. it has such a grasp on people and even though they smoke over a pack a day and their health is drastically deteriorating over it, they just cant find the motivation or drive to quit. i am struggling with how i can counsel these patients in the future knowing it is such a powerful mental obstacle to have to overcome.
overall i really liked my first day and have yet to completely rule out family medicine. im wondering if as time goes by i start to really enjoy it. dr. x really knew each of her patients and couldnt stop telling me reasons why she loved her job.
i dont have to be there until 8:30 tomorrow but i think i will go to bed now so i can get a solid 10 hours of sleep :)
good quote from the day:
"Mr. X, Have you been short of breath at all?" -doctor
"no. Well... I was the other day, but that was after climbing a mountain" -patient
Sunday, October 9, 2011
quotes
"finished call shift with a delivery. when it was over, i stood there thinking, "no way did that baby just come out of that small vagina. that was weird."
-Vince
"Jaw saw my first vaginal delivery! Holy shit!!!!"
-Sarah
"12 hour shifts Mon-Fri, 6 hour shift on Saturday, plus a couple 30 hour call-shifts = My Internal Medicine clerkship just started. (not to mention that I still need to study outside of work) — at Downey Regional Medical Center."
-Ryan
-Vince
"Jaw saw my first vaginal delivery! Holy shit!!!!"
-Sarah
"12 hour shifts Mon-Fri, 6 hour shift on Saturday, plus a couple 30 hour call-shifts = My Internal Medicine clerkship just started. (not to mention that I still need to study outside of work) — at Downey Regional Medical Center."
-Ryan
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