I have 2 weeks 3 days and 18 hours until I'm officially done with my 3rd year of medical school. For those of you who don't know what exactly takes place third year here's a brief explanation. You do a series of rotations in the major areas of medicine (Internal Medicine, Family Medicine, Psychiatry, General Surgery, Pediatrics, and OB/GYN) with the idea that you will use this time to learn a lot about medicine and ultimately choose what you want to do for the rest of your life. I have picked Family Medicine for my career and I am very happy with it. It has been interesting, however, to note other peoples' responses to me when I tell them this decision. "Oh, that's...nice" or "Really?!? Why?" or my personal favorite, "Don't do that!!"
Some of the reasons people disparage the General Practicioner are
1) It is a very non-competetive field to get into which unfortunately means that some people go into it because they can't get into anything else.
2) As with most primary care fields (fields where most families have this type of doctor - family doctor, pediatrician, etc.) get paid much less than other fields
3) Some people view Family Medicine doctors as knowing a little bit of everything, but not master of any.
There may be some validity to these arguments, but here are some of the reasons that I want to go into it.
1) As a family medicine doctor you can go almost anywhere in the world and be of use to people. I would love to test this theory and travel to some of these places and/or live in a small town.
2) You can have a fantastic affect on people's health over the course of their lives. I know many people won't change their ways, but I believe that there are many out there who will given the right opportunity
3) There is a lot of face-to-face time with patients and I really like spending time with people.
There are others, of course, but they are harder to define. The best way I can describe it is that it fits my personality and lifestyle.
(Though I curse my luck that I'm not interested in radiology. Man, great lifestyle)
Friday, June 5, 2009
Tuesday, February 24, 2009
"Spoon People"
Now I am not a "crafty" person, meaning I have never been good at or particularly enjoyed making crafts. At Girls' Camp I hated the craft we always had to do, mine always turned out ugly. I never attend Super Saturdays, and I rarely enter stores like Michael's or JoAnn's Fabrics. Just not my kind of stores, you know? However, for the last couple of days my two girls have been sick, so we have been prevented from spending time with friends, or from going to the YMCA, because we don't want to make everyone else sick. The weather has been cold so we haven't been able to get out by ourselves either and just go for walks or head to the zoo. The result is that my two year-old is going stir crazy. So, in an attempt to add some variety to her life, I pulled out The Preschooler's Busy Book, which was a gift we received from Brock's sister and her husband for Christmas. I looked up a couple of things I thought we could do and headed to Walmart for a few supplies. One "craft" I tried was called "Spoon People." Here is a picture of my attempt at a "Spoon Person."
I was fairly satisfied with the result, and I thought my two year-old daughter, who was helping me glue on the hair, eyes, clothes, etc., would be thrilled with it. When we finished and I handed it to her to play with, she gave me this look that expressed some hesitancy, like she was embarrassed. I guess the toy her mother had made for her was not really up to par. "Come on," I said, "look how fun this is." She finally accepted the toy with a resigned air, as if she was humoring her mother. If this is how she is going to act at two, I wonder what she is going to be like at thirteen.
I was fairly satisfied with the result, and I thought my two year-old daughter, who was helping me glue on the hair, eyes, clothes, etc., would be thrilled with it. When we finished and I handed it to her to play with, she gave me this look that expressed some hesitancy, like she was embarrassed. I guess the toy her mother had made for her was not really up to par. "Come on," I said, "look how fun this is." She finally accepted the toy with a resigned air, as if she was humoring her mother. If this is how she is going to act at two, I wonder what she is going to be like at thirteen.
Maybe we will just stick to gluing macaroni to construction paper next time and letting her paint it. At least that doesn't embarass her.
Tuesday, February 10, 2009
Cookbook suggestions
I've always been a fan of eating healthy. Unfortunately I'm also a fan of delicious food and it can sometimes feel like those are mutually exclusive. We also feel a lot better when we eat more fruits and vegetables but have found it difficult to incorporate those into our daily fare. Enter Moosewood. My older sister gave us The New Moosewood Cookbook for Christmas and it's been really fun so far. Before you read too far I should give you my review of the books and then see if you want to read further. These two books are for people who want to incorporate more vegetables into their diet and aren't afraid of a little work in the kitchen. They don't take that long to make relative to other made from scratch dishes (usually anywhere from 40-60 minutes) to prepare. Some of the soups take special ingredients, but most are fairly simple. Another feature that I particulary like about one of the books (Daily Special) is at the bottom of each page are suggestions of what to pair it with. With that out of the way, back to Moosewood.
The Moosewood Restaurant (http://en.wikipedia.org/wiki/Moosewood_Restaurant) is a restaurant in Ithica New York that started in 1973. They found that their vegetarian dishes were selling best so they became a vegetarian restaurant. They have about 10 cookbooks our right now and the two we have are winners. Enjoy
The Moosewood Restaurant (http://en.wikipedia.org/wiki/Moosewood_Restaurant) is a restaurant in Ithica New York that started in 1973. They found that their vegetarian dishes were selling best so they became a vegetarian restaurant. They have about 10 cookbooks our right now and the two we have are winners. Enjoy
Friday, January 30, 2009
Orthopedics
Orthopedics is back on my short list. For the first two years of medical school I was all about the orthopedics surgery option for residency. However, I really came to enjoy family medicine. I continued to like it the more I did and it became the top thing I was interested in. Part of this reason was because of the horror stories I heard about surgery from my classmates.
This attitude was only encouraged when I started my Surgery rotation. The surgical residents and some of the full-fledged physicians are demeaning to the medical students, they can be verbally abusive, and seem like very bitter people. The hours are also really long (you get up at 4:20 or earlier, get to the hospital by 5AM, and don’t leave until 7PM, you also have to be on call at the hospital every 3rd night and you don’t get much sleep) and the residency is 5 years long of this. Unfortunately, most of the general surgeons I have talked to LOVED their surgery rotation. I really hate my general surgery rotation and I thought this was a death knell for any plans for surgery that were still floating around in my head.
Thankfully my father was persistent in encouraging me to not dismiss surgery too quickly. He sat next to his cousin who is an orthopedic surgeon on a recent trip and when he got back he told me give him a call and chat with him. One of the most encouraging conversations I’ve had recently. He HATED his general surgery rotation. When he went into orthopedic residency he had to do a year of general surgery before he got going on his orthopedics training and he said that that year was probably the worst year of his life.
Although that may sound less than stellar, it’s actually the best news I’ve heard in a long time. I have hated my surgical rotation and the thought of doing it for 5 years is intolerable, but if I only have to put up with it for 1 year before getting into a cool residency with cool surgeries and nicer people…well it’s back on the list. The hours are still going to be very very long as an orthopod resident, but I think it’s something that I can like as much as my family medicine dreams.
This attitude was only encouraged when I started my Surgery rotation. The surgical residents and some of the full-fledged physicians are demeaning to the medical students, they can be verbally abusive, and seem like very bitter people. The hours are also really long (you get up at 4:20 or earlier, get to the hospital by 5AM, and don’t leave until 7PM, you also have to be on call at the hospital every 3rd night and you don’t get much sleep) and the residency is 5 years long of this. Unfortunately, most of the general surgeons I have talked to LOVED their surgery rotation. I really hate my general surgery rotation and I thought this was a death knell for any plans for surgery that were still floating around in my head.
Thankfully my father was persistent in encouraging me to not dismiss surgery too quickly. He sat next to his cousin who is an orthopedic surgeon on a recent trip and when he got back he told me give him a call and chat with him. One of the most encouraging conversations I’ve had recently. He HATED his general surgery rotation. When he went into orthopedic residency he had to do a year of general surgery before he got going on his orthopedics training and he said that that year was probably the worst year of his life.
Although that may sound less than stellar, it’s actually the best news I’ve heard in a long time. I have hated my surgical rotation and the thought of doing it for 5 years is intolerable, but if I only have to put up with it for 1 year before getting into a cool residency with cool surgeries and nicer people…well it’s back on the list. The hours are still going to be very very long as an orthopod resident, but I think it’s something that I can like as much as my family medicine dreams.
Tuesday, January 13, 2009
Why surgeons are the way they are
I’m finding out on my surgery rotation that surgeons and family medicine (FM) doctors are worlds apart (as are many different types of doctors, but let’s compare these two). Surgeons don’t really spend a lot of time talking with their patients. They don’t really connect with them as readily as FM doctors. With this in mind, here are some thoughts on surgery and surgeons.
Surgery is a very interesting process. One minute I’m introducing myself to a 30-something year old lady who is worried about her upcoming surgery, answering her questions, and reassuring her I will have absolutely no part in the actual surgery, and the next she’s under anesthesia. We take off her flimsy hospital gown, put a Foley catheter in her so she doesn’t pee on herself during the surgery, start marking on her body where we’re going to cut, cover everything that we’re not operating on and suddenly…viola…she’s just a torso of meat that we’re going to cut on.
For the next 8 hours I’m fascinated with what the surgeons are doing, identifying which parts of her insides I can from anatomy, managing the laparoscopic camera and things like that. I totally forgot who she was as a person.
In a similar story, there was a lady who needed a really big catheter inserted into her femoral vein (big vein in the thigh). She was very nervous, jumpy, and the process took over an hour for what should have taken 15 minutes because she kept yelling that it was painful and jumping making the needle come out. She quickly became an annoying leg that needed a catheter inserted.
Overall, I think it’s good that surgeons view patients as warm living pieces of meat. They are going to do very uncomfortable and frankly extremely painful things to them. They are doing this to help the patient but things are going to get a lot worse before they get better.
Some surgeons are better than others at connecting with their patients, but surgeons don’t have a lot of time to talk because they are in surgery all day in addition to following up with patients after and before the surgery. If I were to break this article down, I would say that I respect surgeons for what they do and I don’t know where we would be without them, but I really like talking with people too much to be a surgeon.
Surgery is a very interesting process. One minute I’m introducing myself to a 30-something year old lady who is worried about her upcoming surgery, answering her questions, and reassuring her I will have absolutely no part in the actual surgery, and the next she’s under anesthesia. We take off her flimsy hospital gown, put a Foley catheter in her so she doesn’t pee on herself during the surgery, start marking on her body where we’re going to cut, cover everything that we’re not operating on and suddenly…viola…she’s just a torso of meat that we’re going to cut on.
For the next 8 hours I’m fascinated with what the surgeons are doing, identifying which parts of her insides I can from anatomy, managing the laparoscopic camera and things like that. I totally forgot who she was as a person.
In a similar story, there was a lady who needed a really big catheter inserted into her femoral vein (big vein in the thigh). She was very nervous, jumpy, and the process took over an hour for what should have taken 15 minutes because she kept yelling that it was painful and jumping making the needle come out. She quickly became an annoying leg that needed a catheter inserted.
Overall, I think it’s good that surgeons view patients as warm living pieces of meat. They are going to do very uncomfortable and frankly extremely painful things to them. They are doing this to help the patient but things are going to get a lot worse before they get better.
Some surgeons are better than others at connecting with their patients, but surgeons don’t have a lot of time to talk because they are in surgery all day in addition to following up with patients after and before the surgery. If I were to break this article down, I would say that I respect surgeons for what they do and I don’t know where we would be without them, but I really like talking with people too much to be a surgeon.
Wednesday, December 17, 2008
Some of my favorite things
I just finished my Psych rotation and while I don't have any interest in doing it as a profession it was definitely one of my favorite rotations so far. Part of it was because of the awesome hours (show up at 8am-ish, write up our notes and see patients until about 12 or 1pm and head home), the really relaxed attending physician I worked with and the interesting cases we saw. But by far the best part has been overhearing bizarre conversations I overheard that caused almost no reaction from the doctors.
Pt: "I see dead people coming out of my chest telling me to kill myself."
Doctor: "we don't really deal with dead people..."
Pt: "the black government implanted a chip in my head to monitor my thoughts and prove that God exists"
31 year old black Pt: "I'm 98 years old and used to be white, but the handicapped kids I taught kidnapped me and beat me up so badly that I turned black"
"I used to be a pink alien with pink hair down to my feet"
And many more that I just can't remember. I think this would keep things interesting and would be something that I could enjoy, but ultimately I still don't think it's for me. The reason being that I like talking with patients about their health, coming up with a plan together, and teaching them things they need to live a long and healthy life. This doesn't really work too well when the patients' brains are the problem and they can't really understand that what they are thinking is totally askew.
Pt: "I see dead people coming out of my chest telling me to kill myself."
Doctor: "we don't really deal with dead people..."
Pt: "the black government implanted a chip in my head to monitor my thoughts and prove that God exists"
31 year old black Pt: "I'm 98 years old and used to be white, but the handicapped kids I taught kidnapped me and beat me up so badly that I turned black"
"I used to be a pink alien with pink hair down to my feet"
And many more that I just can't remember. I think this would keep things interesting and would be something that I could enjoy, but ultimately I still don't think it's for me. The reason being that I like talking with patients about their health, coming up with a plan together, and teaching them things they need to live a long and healthy life. This doesn't really work too well when the patients' brains are the problem and they can't really understand that what they are thinking is totally askew.
Monday, December 1, 2008
Once in a blue moon
If any of you have ever watched the TV series House M.D. you will know that he believes all patients lie. If you haven't seen the show then here's the low down...he thinks patients lie.
We had a guy that we took care of this week because he came in with a self-inflicted gunshot wound to his lung. Yeah, he shot himself but not with the intent to kill himself, just to get attention; a "cry for help" as he put it. There have got to be better ways for getting help, but nevertheless he was admitted to the hospital for depression, got some pain medications, and got his hydrocele surgically repaired so I guess it worked (A Hydrocele is a very uncomfortable disease of certain man parts). As with all patients that a doctor sees, we have to ask them a whole bunch of questions, and especially in the Psych Ward we see a lot of drug abuse so we ask a lot of questions about drugs. When we asked this guy if he did drugs he told us that he only did marijuana "once in a blue moon". When pressed further on that he admitted that he smoked a bowl of marijuana (not a joint, but a bowl) once a week and it helped with his vision (which it doesn't).
So in case you're wondering, "once in a blue moon" for this guy means once a week. (In case you're still wondering, a blue moon means either having 13 full moons in a given calendar year or having 2 full moons in the same calendar month. The 13 full moons one is much rarer than the 2 ful moons one).
We had a guy that we took care of this week because he came in with a self-inflicted gunshot wound to his lung. Yeah, he shot himself but not with the intent to kill himself, just to get attention; a "cry for help" as he put it. There have got to be better ways for getting help, but nevertheless he was admitted to the hospital for depression, got some pain medications, and got his hydrocele surgically repaired so I guess it worked (A Hydrocele is a very uncomfortable disease of certain man parts). As with all patients that a doctor sees, we have to ask them a whole bunch of questions, and especially in the Psych Ward we see a lot of drug abuse so we ask a lot of questions about drugs. When we asked this guy if he did drugs he told us that he only did marijuana "once in a blue moon". When pressed further on that he admitted that he smoked a bowl of marijuana (not a joint, but a bowl) once a week and it helped with his vision (which it doesn't).
So in case you're wondering, "once in a blue moon" for this guy means once a week. (In case you're still wondering, a blue moon means either having 13 full moons in a given calendar year or having 2 full moons in the same calendar month. The 13 full moons one is much rarer than the 2 ful moons one).
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