Oct 24, 2009

IM starts to near to a close

Oh yeah, I did the whole start ICU thing... er... let's just say I long for the unbridled excitement of the floor.
My day:
Ishie: "So, what brought you into the hospital?"
Intubated patient: "..."
Ishie: "No problem! I'll read your chart!"
Chart: (Unintelligible scribbling)
Ishie: "No wonder everyone whines about my handwriting."

ICU is also revitalizing my desire to fill out a "DNR/DNI/DNfreaking touch me under the following conditions: ___________, ___________ etc etc" notification with detailed, fact-checked data points that have been looked over by a team of doctors and lawyers, notorized, and then forwarded to every hospital in the country plus a bonus copy in my wallet, and heck, possibly tattooed across my back. This is not to discourage or dehumanize anyone, but the amount of unending human tragedy that has come about with the misinterpretation of phrases like "Do everything" is staggering. And trying to interpret pre-condition patient wishes from a host of subjective third party accounts and opinions is about as useful as consulting a magic 8 ball. Just saying.

It's also annoying when the lack of communication leads to very well intentioned family members trying to do everything to respect the wishes of hospitalized party, but the original intentions get lost in the medical mumbo jumbo so you end up with incomplete documentation that allows you to do sort of half a revival.

Bah, but anyway. I've been learning a lot, and with oral and written exams pending as well as my first Halloween in NYC, I'm trying to cram in a whole lot of study and 11th hour case write ups in a very short period of time. Because once a procrastinator, always a.. well, I'll get back to you tomorrow. Except that I won't.

In the meantime, I'm trying to get some semblance of a direction to go career wise. My current struggle is with my unending love affair with pathology and pathology-like subject matter, but then I find myself caught up in the general arguments against pathology (and radiology, but I suck at reading X-rays, and that's apparently important) which is its general stigma of individuals within the profession as maladjusted sociopaths that aren't real doctors. Not that I believe these arguments, but the potential future of having to qualify my job to everyone I come across is annoying. Of course, if I went into Emergency Medicine, Internal Medicine, or Surgery, I would just have to continue my same explanation which is "I am not a nurse. I am not training to become a nurse. No, I'm not planning on going into OB/Gyn. No, not pediatrics either. Because I'm not overtly fond of children. Why not? Because I'm a maladjusted sociopath that's not a real... aw man!"

Also there is the patient contact issue. I like some patients, and I like to help people (at least that's what my personal statement said), but as I've also said, I don't like mean people, and I don't like hurting nice people. My job description as a "seeing patients" doctor would generally involve either sticking needles, catheters, or scalpels in nice people and getting yelled at by mean people (while also sticking needles, catheters, or scalpels in them).

I also like to either see something and diagnose it or have something diagnosed that I can then remove manually. This pretty much limits me to pathology or surgery.

But we'll see. You never know, and I'm still keeping my options open.

In the meantime, since I'm busy writing up three case reports and bleaching the nastiness out of my white coat (I wish I could be hardcore and claim it's blood, sweat and tears, but I think the majority of it is curry sauce and balsamic vinegar), here's a video that's not related to anything, but I thought it was hilarious. Enjoy!

No comments: