What Matters

I finally worked a full week (well, not Tuesday) in the hospital. It was so good. This is the first time that I have genuinely thought that I could make this my life, my career. Unlike all of the specialty medicine I have previously worked in, this involves everything. This week, we worked on the orthopedics floor, which often meant that every patient was old or sick enough to have had a bad fall and break something. So the broken parts are managed surgically and with physical therapy, but you are also checking on their comorbidities. Some with internal bleeding, others with pneumonia, or leukemia, or something else. So there is always the challenge of bringing to mind everything you know about this wide variety of diseases, and it is just so fulfilling. You get to establish a short-term relationship with a given patient, knowing that you will likely only have a few days with them at most. And with this rotation, the best part is that when I take a patient's history, the doctor is not going to repeat my actions. What I do genuinely matters to an extent.

We also went to happy hour yesterday with some hospital staff and other medical people. I do not know who was covering the bill, but I left with the knowledge that it (and my meal) was free. I also learned through that that there are occasions for which I should most certainly wear my white coat outside of the hospital (up until now, it has mostly attracted beggars asking for money when I have worn it elsewhere).

On Monday, we had a patient die. We saw him for the first time in the late morning, breathing fast, not conscious, with his wife telling us about how wonderful of a person he was. Then, after lunch and more rounds, we went back to pronounce this patient as deceased. I have only seen a few dead bodies in my life. This is the first I have seen that was a patient. Granted, it was not my patient and I did not know them, but there was something there. The doctor told us about checking the pulse, listening to the heart for a full minute, then checking the pupils for nonreactivity (I rechecked the pupils after she did so). The wife claimed that he had been dead for something like 40 minutes, and the fingers on one of his hands was beginning to turn blue. She commented that the other hand must be maintaining its usual color because she had not stopped holding and kissing it for the past hour.

I hope that I remember to take the time to stop in the future, to preserve the memories of these things. My mind is not naturally designed for medicine, so perhaps my perspective could lend something to all of this.