It’s done

Can’t believe its over.¬†

6 years of school. Thats 4 of an undergraduate degree, and 2 in a professional program. Working through each and every summer. Blood, sweat and tears into exams, assignments, labs. Then my last and final year doing clinical placements throughout different areas of the hospital.

Some memorable moments

  • The Australian medical resident who looked like Dr. House
  • Icecream everyday at 4 pm for 2 weeks with a certain preceptor in internal medicine
  • Being called “Anna” or Dr Anna, on every rotation despite introducing myself as “Anne, the PA Student”
  • Being able to be first assist in every orthopedic surgery I attended
  • Being mistaken for a medical student, or resident
  • Overnight call at a hospital while I was doing my surgery rotation, and SM stayed with me at the hospital all night, even brought pho to the hospital, when I was hungry!
  • Free sushi at a big city academic hospital for rounds!
  • Being told I had the qualities and potential to become a physician by many of my preceptors
  • Getting to know the patients and their families
  • Being able to take the time to provide quality care, and receiving appreciation from patients
  • Discovering things I never realized about myself:
    • Emotionally and physically, I am a lot stronger than I thought I would be
    • That I probably can’t do shift work
    • I love team work (I’m usually shy)
    • When receiving didactic-type lecturesthat the rotation I dreaded the most (internal medicine) ended up being the rotation I loved most!
    • I’ve finally grown up.
After everything, I made it. Sorry if I sound cheesy, I’m simply overwhelmed. Glad to be done ūüôā

Lost and found

So I purchased a roots “flat” handbag for my internal medicine rotation. Opting in to sport a bag rather than a white coat with all of its pockets. I am able to fit a few pocket handbooks, as well as having something to hook my pager onto.

Well, I realized since the start of this morning that I had no idea where my handbag was. I knew it had to be somewhere in my house. I searched every conceivable place, even calling up SM to see if it was there with him.

As I became frantic, I realized my bag has my pager. So I called the hospital’s paging system, and explained that I lost my pager and required just a few “pings”.

I heard it, and to my relief I heard it somewhere in the house (that pager is LOUD). I ran upstairs to my mom’s room, called the hospital again to ping my pager and they did. I discovered it hidden behind a towel hanging behind the door. How embarassing T_T My mom started lecturing me and my dad came in laughing, since he witnessed my relentless search and then my victorious find almost an hour later.

My aunt then said to me, “Some things never change…” in reference to all the things I used to lose when I was little (my sweater, my lunch bag, my gloves, my socks, my toys, the list goes on). I guess I’m just more clever at finding it (versus the lost and found at daycare for the things I lost when I was little) – really is just a matter of time.

Weekend to rejuvenate

We were short one staff this week, and only 3 people to cover 45 patients, some more active than others, we had to take on twice as many. At about around Wednesday I started getting a sore throat, fatigue and weakness.

I’m on week 5 of 6 of my internal medicine rotation. We usually take on a max of 2 or 3 “active patients”, and¬†however¬†many patients who don’t have as many critical issues. Being as enthusiastic a learner as I wanted to be, I never said “no” to my attending. I took on as much as I could, worked as hard as I could, because I knew that I had to take advantage of every learning opportunity I could. As much as I impressed my attending, it seemed to come at a price. I showed up Thursday morning, sharp stabbing pains down my throat, dizziness, fatigue despite a full night’s sleep – and I just did not feel right. I spent 3 hours trying really hard to work through the day, but I had been assigned 11 patients, 8 were active and 3 were not – and I had only 4 hours to get through them all as opposed to 8 due to a half academic day. I kept telling myself “5 hours left, 5 hours left”. But when the NP I worked with came and asked how I was doing, my first response, “I don’t feel so hot“. My attending checked my throat, and temperature (so my supervisor apparently was a GP before becoming an internist) and told me to go home.

To be honest, a sore throat would be something I would have stayed at work at anyway. I was going the entire week 2-3 times harder than my usual norm, maybe it was burn out too. I felt so emotionally depleted, and I felt guilty about going home. As SM told me, “If you’re sick and continue working, this will impact your health, and the health of your patients!”. I was finally convinced.

I had hot teas, soups, plenty of rest. Unfortunately I had to cancel on a friend’s birthday on Saturday. I spent Friday completely away from work and with SM. Today, I slept, a LOT, I read leisurely, and I also spent some quality time with SM. The throat is still sore, but I am feeling much better emotionally, and feel as if I have the strength to take on as many responsibilities as I need to. I’m lucky to have someone as nice as SM to look out for me.

Forgiveness

“To forgive is to set a prisoner free and discover that the prisoner was you.”
– Lewis B. Smedes

I’m week 4 into my internal medicine rotation, and was speaking with one of my patients. He’d told me a lot about his life, and his experiences. A retired corporate lawyer, now working on his deteriorating health. Since he was just waiting in hospital for placement in the community, he doesn’t have any acute issues, so he was one of the last patients I saw for the day. I usually sit with him for an hour or so because we have pretty unique conversations.

We were discussing some of his experiences in law school, and practise. He told me some of the reasons why he was averse to family-practice and divorce-law, and he replied “I never want to be in the middle of two people that hate each other immensely.” So I told him how I couldn’t believe that two people that vowed for undying love would turn to hatred. I asked him whether it had to do with communication or trust. “No, its about forgiveness. People hold on to the smallest things of lttle¬†significance, and its like a spur under a saddle. It builds resentment over time. If you can’t let go of the little things, the resentment builds and turns to hate, and when something big happens – everything falls apart. It happens because people can’t forgive. Some are just incapable of it, and hold on to things simply because they don’t know how to let go.

Forgiveness is a lot harder for me than trust. It means not bringing up someone’s past and using it against them. It means taking a step back and appreciating why someone may have betrayed your trust. To me, that is hard to fathom. But I realize that forgiving someone is¬†acknowledging¬†the fact that friends and loved ones are human, and make mistakes. ¬†I think more importantly, without being able to forgive, we shut out people in our lives that could have made a world of difference, and we limit our ability to grow and expand.

However, if someone truly hurt us, in the most deepest, intimate and unimaginable of ways – is forgiveness appropriate in that situation? Because even if forgiveness takes place, betrayal changes a relationship (of any kind whether with family, friends, a partner – it changes trust. So how does true forgiveness occur in that circumstance?

A Good Teacher

Today I am week 3 into my internal medicine rotation. Our clinical teaching team just switched attending physicians. The internal medicine physician I worked with today called me over, and told me he had a good Emergency Consultation. My case:

78 year old male with history of hypertension, diabetes, renal transplant after 15 years of dialysis, severe peripheral vascular disease and gangrene of the toes, past coronary artery disease presented with 3 second periods of light-headedness which started this morning at 8:30 AM when he sat down to read the paper. This occurred six times. The paramedics found atrial fibrillation on ECG at 10:30 AM while on route to hospital. Pt has had no other symptoms other than the lightheadedness. Patient denies chest pain, shortness of breath, altered level of consciousness or mental state. Physical findings were unremarkable, however cardio exam revealed a 4th heart sound. All investigations came back normal (bloodwork, Troponin T, CK, glucose, etc.).

He told me, “this would be a good case for you, I have lots of clinical pearls to teach.”. I saw the patient on my own, wrote up my consultation note, and reviewed the case once I was ready. He listened to me as I listed what I gathered from the history and physical, investigations, as well as my assessment of the situation and plan.

“Talk me through the common causes of Atrial Fibrillation”

“What do we worry about for management of New-Onset Atrial Fibrillation?”

“What drugs would we use?”

After each point, he gave me feedback. ¬†He wasn’t condescending towards me as I expressed that I didn’t know the answer to some of his questions. He even sat down and walked me through how to read this gentleman’s ECG. Afterwards, he thanked me and acknowledged my contributions for this patient’s care at the hospital under the Internal Medicine unit.

I walked away, feeling like I had learned so much. I appreciated his patience, his time, and acknowledged the fact that medicine is not something I can learn entirely on my own.

What an end to a great day.

Sleep

Ehh… I’ve been working on this project on wordpress (shhh… Its still secret and unfinished! But you can check out how its doing by clicking here). I stayed up a little late last night to work on it, then woke up extremely early. Seems like I am the kind of person that requires AMPLE sleep in order to function. So guess what? Bad day.

I felt I had very little to run off on today, and a pretty hefty workload, so I got overwhelmed pretty early in the day. Instead of powering through and being on top of all of my patient’s issues, I felt I was chasing my tail. It made me realize if you aren’t on top of your game, Internal Medicine can become overwhelming. If I have a lot of gusto and good sleep, I’m good and enjoy it so much. If I don’t, even staying awake is really difficult, and the job is less fun.

Gonna take tonight to re-energize and ensure I can tackle work so is fun again.