IM: a week summary

So I'm surprised to say this-- but I definitely like internal medicine. I was walking around the floor with the interns and still unable to answer questions and still not the favorite and-- i felt relaxed anyway. I felt like the team I was with was good and I liked what I was doing. It wasn't thrilling, but it definitely made me think internal med could be an option.

IM gives you time to think about your patient and research it. There is something to be said about time to think. There is something to be said about constantly thinking about your patient, seeing them several days and googling things. The residents had time to cancel their stat orders or reorder wrong tests. It takes a bit of the stress off.

Anyhow, I don't know if i'm learning as much I should be. I have two patients everyday and I follow the interns around. I probably ask too many questions, but I do it anyway. I think they got used to it because several of them asked me to hang out outside of work.  One I even went to dinner with at this amazing jazz club bar.   But I wish I was getting pimped more questions and going through more ways to diagnose. I should be reading more instead of doing these stupid presentations for lazy doctors who don't want to read the new studies they use the medical students to do it and then present the important stuff. Genius really. I should be reading more though.

I've noticed that the doctors linger more at the nice people's room. The little old lady with the fecal impaction gets tons of attention while the guy with pancreatitis who screams in pain we only go in for about 5 minutes. And what's worse.... I think i'm starting to do it too.  I spent over 3 hours reviewing her chart and about 20 minutes researching pancreatitis.  I have to be careful of falling into the trap like so many doctors do.

This week I also witnessed my first death note. The patient died on the floor and we had to come in and declare them dead. Had to do all the reflexes and listen to heart and lungs and all the legal stuff. The lady was 40 and starting to go into rigor mortis already. She was very waxy and just staring at the wall with her eyes open.  Even though I knew she was dead before going into the room, seeing her like that made me instinctually back out of the room and my veins fill with adrenaline.  I have no idea why, i've seen plenty of dead people-- but this lady just freaked me out.  Turns out death notes are really important if a legal case gets brought up. There is a particular way to do them and its so unlike SOAP format.  You have to state not just time of death and reflexes but also discuss organ donation, funeral arrangements, things for the mortician, you have to list every device or line on the body (including IVs and foleys which you can't remove).  It was educational.

I have to go to bed now.... but more cases to come.