Wednesday, September 28, 2005
Sunday, September 18, 2005
Day off, or just another day
I get few days off these days. I was off yesterday and today--two in a row--which is a rarity, but often actually a consequence.
Two days off...after working eleven straight.
All I wanted to do this morning was go and hit golf balls on my day off.
It's raining.
Back to work tomorrow for another week, sunrise to sunset...weather is supposed to be great.
Get to work a 6:30...copy down morning labs in the hospital. Thumb through the chart trying to make heads or tails of illegible notes from other doctors. Write a note about the patient, not totally knowing what my supervising doc really wants to do today with the patient. Repeat this for each of the 8 patients i am responsible for in the hospital. Be interrupted in this process by questions from nurses ranging from the banal to the insurmountable, usually covering any and every patient care topic not expressly covered in medical school. Talking to patients who talk amazingly slow, who smell bad, who are tragically unaware/ignorant of taking care of their own health.
It has becomed terribly difficult to connect to the "I just want to help people" aspect of medicine that we all had going into medical school. Whatever I personally had to offer with my charm is far outweighed and imbalanced by the difficulty of the science and procedure of health care. While I may be an intelligent and talented person, I often feel I am a burden to my supervisors, getting a few to many glances with smirks or furrrowed brows asking me, "Now where did you go to medical school?" These intellectual blows along with the frustrating patients who all too often reside in the margins of tolerability are making it a tired and sad era in my life right now.
Patients far too often hold a tragic flaw. Or perhaps a half dozen of them. Personal disregard (ie, smoking, fat), denial (fat, smoking), poor education, distrust of doctors, complete reliance upon doctors, addiction (fat, smoking, pain killers)...just to name a few. I would venture to say that maybe 1 of 8 patients is a reasonable, socially and hygenically aware, of moderate habits, negotiable, trusting...all at the same time. Even so, there is the idea of "What are you gonna do to fix up what I have screwed up?...And if you can't...or if you're wrong.........."
Of course not everyone is like that. But you would be surprised. And it has been very difficult for me to have much sympathy with these folks.
For the Christians out there, these are the beggars on the streets we see in the New Testament. These are the helpless and the exhausting people who were passed by. And now I can see why. Though some were certainly calloused and perhaps far from merciful, I imagine many of Jesus' entourage were incapable of helping the beggars and the sick.
They had no idea where to start with them, thinking, here we go again with the father bringing his kid to us again with the demon spells. Every day, begging for help, and what are we supposed to do.
And there's the local floozy, sleeps with any man who provides any semblance of a relationship even if the man's married, then comes to us when her heart has been broken or she's dumped on the street or she's sick and out of money or shelter.
Or...great, now we've got about a few hundred people following us around, somehow knowing exactly where we're going to be, knowing exactly where to sit outside the city to beg, expecting us to feed them. And they're only going to get pissed of when I tell them I can't help the way that I really want to help.
(Aside: Does anyone else see how amazing Jesus' feeding of the 5000 was in light of what's happening in New Orleans?)
All of this to say that, with the "all work, no play", the paralyzing weight of medical knowledge and expectation, the difficult patients...it's just been quite difficult lately.
And it's raining on my day off.
And I just found out that my vacation in two weeks has been denied...no vacation until February.
Two days off...after working eleven straight.
All I wanted to do this morning was go and hit golf balls on my day off.
It's raining.
Back to work tomorrow for another week, sunrise to sunset...weather is supposed to be great.
Get to work a 6:30...copy down morning labs in the hospital. Thumb through the chart trying to make heads or tails of illegible notes from other doctors. Write a note about the patient, not totally knowing what my supervising doc really wants to do today with the patient. Repeat this for each of the 8 patients i am responsible for in the hospital. Be interrupted in this process by questions from nurses ranging from the banal to the insurmountable, usually covering any and every patient care topic not expressly covered in medical school. Talking to patients who talk amazingly slow, who smell bad, who are tragically unaware/ignorant of taking care of their own health.
It has becomed terribly difficult to connect to the "I just want to help people" aspect of medicine that we all had going into medical school. Whatever I personally had to offer with my charm is far outweighed and imbalanced by the difficulty of the science and procedure of health care. While I may be an intelligent and talented person, I often feel I am a burden to my supervisors, getting a few to many glances with smirks or furrrowed brows asking me, "Now where did you go to medical school?" These intellectual blows along with the frustrating patients who all too often reside in the margins of tolerability are making it a tired and sad era in my life right now.
Patients far too often hold a tragic flaw. Or perhaps a half dozen of them. Personal disregard (ie, smoking, fat), denial (fat, smoking), poor education, distrust of doctors, complete reliance upon doctors, addiction (fat, smoking, pain killers)...just to name a few. I would venture to say that maybe 1 of 8 patients is a reasonable, socially and hygenically aware, of moderate habits, negotiable, trusting...all at the same time. Even so, there is the idea of "What are you gonna do to fix up what I have screwed up?...And if you can't...or if you're wrong.........."
Of course not everyone is like that. But you would be surprised. And it has been very difficult for me to have much sympathy with these folks.
For the Christians out there, these are the beggars on the streets we see in the New Testament. These are the helpless and the exhausting people who were passed by. And now I can see why. Though some were certainly calloused and perhaps far from merciful, I imagine many of Jesus' entourage were incapable of helping the beggars and the sick.
They had no idea where to start with them, thinking, here we go again with the father bringing his kid to us again with the demon spells. Every day, begging for help, and what are we supposed to do.
And there's the local floozy, sleeps with any man who provides any semblance of a relationship even if the man's married, then comes to us when her heart has been broken or she's dumped on the street or she's sick and out of money or shelter.
Or...great, now we've got about a few hundred people following us around, somehow knowing exactly where we're going to be, knowing exactly where to sit outside the city to beg, expecting us to feed them. And they're only going to get pissed of when I tell them I can't help the way that I really want to help.
(Aside: Does anyone else see how amazing Jesus' feeding of the 5000 was in light of what's happening in New Orleans?)
All of this to say that, with the "all work, no play", the paralyzing weight of medical knowledge and expectation, the difficult patients...it's just been quite difficult lately.
And it's raining on my day off.
And I just found out that my vacation in two weeks has been denied...no vacation until February.
Saturday, September 03, 2005
It knows...
...the pager knows, Dave.
...the pager knows when you've just caught up...when you've just put your face on the flat, industrial grade pillow...
...it knows when the nurses are bored and paranoid...
...it knows when to start a run of V-tach...
...it knows when to make patients start pulling at IV lines...when to make them breathe "funny"...
...it knows when you've capped on your admissions and you are wanting to sleep the night away
...the pager knows when you've just caught up...when you've just put your face on the flat, industrial grade pillow...
...it knows when the nurses are bored and paranoid...
...it knows when to start a run of V-tach...
...it knows when to make patients start pulling at IV lines...when to make them breathe "funny"...
...it knows when you've capped on your admissions and you are wanting to sleep the night away
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