Sunday, September 27, 2009

Use somebody

Remember how I had that patient and we lost her blood work and there was threats of suing and heads rolling and lots and lots of yelling?

Well, miraculously, she likes me.

She doesn't like my resident so much.

But she likes me.

So when it came time for her to be discharged, she pulled out her business card and told me to keep in touch.

I went through her discharge instructions with her, helped tidy up her things, pulled out her PIC line, and wished her the best of luck.

I went back to my team room and was finishing up my note, when my resident turned to me and asked how it went. "Oh, it was fine - there were no more threats of lawsuits at least! Haha, and oh, she wants me to keep in touch with her," I replied. My resident's eyes opened wide, and thinking that she thought I was going to breach some patient-physician boundaries, I quickly added, "Oh, but don't worry, I wasn't actually going to email her....because that would be strange and bizarre....and out of line, of course." But my resident shook her head and said, "No, you definitely should email her in a week or so to see how she's doing. The best way to not get sued is to show that our team cares about her health, and apparently you're our lifeline!" I laughed nervously, and promised I would.

So one week later, I wrote my patient an email asking how she was doing.

She wrote back within five minutes.

Perfect timing. I've been thinking of you and since I'm on my way to [Other Hospital] tomorrow for a second opinion and had to pick up my records yesterday, when I read them, I kept seeing your name. I'm torn between wanting them to find the unknown and being afraid the unknown may be something bad that was missed. Anyway, I'm in for a penny and in for a pound. I'll stay until they give us some answers.

I wrote back with something reassuring, and told her to let me know how things went during her hospital stay.

A couple days later, she wrote to tell me what the various care teams were saying about her condition. And at the end of the email was this:

But here's what I want to tell you; I have all the reports, etc. from your hospital; about 75 pages and the ones they keep referring to are your med student notes from the day I was discharged. You had all the final blood tests plus a good recap of my condition that day. Your name will be well known here at [Other Hospital] when this is all over.

I was shocked. Don't worry, I didn't let the last sentence go to my head; I know no one will remember my name at the end of the day. But on that day, at that moment, I had finally gotten the "good job" I'd been waiting to hear. True, it was via a second party and from completely different doctors than the ones I had been working with, but it was something.

And that little bit of something meant quite a whole lot to me.

I mean seriously, someone actually read my notes! And they were useful! I was useful. And really, that's all a third year med student can hope to be. I just want to be helpful. I just want to be part of the team, feeling as though I'm doing something that actually means something.

Friday, September 11, 2009

America the beautiful

Tribute in Light from 2002 (top) and 2009 (bottom)

I remember when this memorial was first unveiled in March 2002. It was such a simple concept and truly beautiful - light reaching all the way to the heavens to those we lost on 9/11. And perhaps it was a way to show that they were reaching down to us too. It was an image that reflected our loss but also conveyed comfort.

Every year I see the 9/11 tribute pictures, I'm always awed by how such a simple design works so well at eliciting such different emotions in the same heartbeat. Loss. Pain. Hope. Love.

This year, with the low-lying cloud cover over New York, the lights didn't go on to eternity as they have in the last seven years. Indeed, if you looked quickly, it was almost as if the Manhattan skyline had never changed. A fleeting glimpse of what could have been. And a terrible reminder of unnecessary loss.

It's haunting, but beautiful just the same. Achingly beautiful.

People say, "never forget." I don't see how we possibly could.

Light on

[ A rendering of the National September 11th Memorial and Museum at night]

Take a minute today and just reflect.

Thursday, September 10, 2009

My kind of town



I LOVE CHICAGO! <3

And I loved this! From the giant 21,000+ modified wave to the disgusted, what-the-hell look on the girl's face when that first chick is dancing all crazy in the beginning. Oprah's reactions to the ever-expanding dancing crowd. The #1 proclamation at the end. And of course, the gorgeous Chicago backdrop.

Yes indeed, Oprah - this is the coolest thing ever.

Hey Olympics, think of what kind of spectacle we would put on for YOU. Chicago 2016! Back the bid!

Thursday, September 03, 2009

In an effort to be more efficient and studious, I will not be blogging until the end of this month. You see, my roommate has changed my password to facebook, twitter, and yes, this blog. But I'll be back in a couple of weeks, with lots and lots of stories already brewing!

See you then!

Thursday, August 20, 2009

My funny valentine


ME
Ugh. I had a bad day today...and I'm feeling really terrible right now. And unloved. And crappy. Ugh, I hate this. Can you cheer me up?

MARTIN
Sure! [sing-song] Michelle - do you know how much I love you? Let me tell you... my love for you is like dots in a line, and according to the rules of geometry, lines are infinite. And you know how my watch has to be wound up because it's an automatic? If it ran on my love, it'd never stop. And you know how stars die, but we still see the light? I love you as much as that, because the light keeps going. [pause] How about that?

ME
[dying with laughter throughout his speech]
Hahahahahaha!! What is up with all these abstract metaphors? Star light? Lines? I don't know if they even make sense! Shouldn't it be like a circle? A line?!

MARTIN
Yeah, I don't know why all my metaphors are all math and astronomy and physics and stuff.

ME
Hahahahahahahaha!

MARTIN
Fine. Fine! I love you as much as flowers, okay? No, I love you as much as rainbows. There.

ME
Soooooo, you only love me on rainy days. And your love dissipates after half an hour.

MARTIN
See? This is why the abstract ones are better.

ME
Okay fine. You love me as much as a dead star. Wonderful.

---


We the dreamers


There are some days when I feel like Charlie Brown. And on those days, I wonder why I don't just walk away.

There are some days when I'm absolutely great at what I do. I can take a history like nobody's business. Got a heart murmur? I'll hear it. Took some ilicit drugs last night? I'll know. Can't speak English? I'll translate. (Or find someone who can.) I'll gain a patient's trust with just a ten minute interview. I can churn out those H&Ps and get pharmacists and social workers to help my patients with a simple phone call, my charm on full blast.

Those are the good days. The football-kicking days.

And then there are the other days when I feel as though there must have been some kind of fluke in the admissions system, because there's no way someone like me - someone as dumb as dirt - could possibly have been admitted to this school.

I feel it when I get asked stupid "pimp" questions, where it's one of those either you know it or you don't situations, and you swear you knew the answer three months ago, but right now, on the spot, it's eluding you - the name of that syndrome that presents with watery diarrhea, hypokalemia, hypochlorhydria, and metabolic acidosis. (It's Verner-Morrison Syndrome, by the way. Also known as VIPoma, but apparently that answer isn't detailed enough for some attendings.)

I feel it when I present my oral presentations, and I'm asked pointed questions that ultimately make me realize that my diagnosis was all wrong. Or that it's fairly obvious to everyone else that I should have known to check for a folate and B12 level.

I feel it when I miss stupid study questions, and I internally yell at myself. "UGH! I KNEW THAT. WHY DID I PICK THE OTHER ANSWER? STUPID STUPID STUPID!"

Medicine. I hate it, but I love it. Even though it brings me down more often than not. Much more often than not.

And so, on those bad days, I yell and cry and rage against the machine, and the next day, I pick myself up to start all over again. Because I have to believe that I'm going to be able to kick that football. Maybe not today, but maybe tomorrow. Or the day after that. Or even the day after that. Gotta just keep running after that football.

AAUGH indeed, Charlie Brown.