Sunday, November 11, 2007

poets that we never find time to know

[I think I'll be titling posts with song lyrics from now on, because of all the things that drive me crazy, coming up with subject lines and titles are one of the things that get me there the fastest.]

So this week has consisted mostly of me falling into bed at 11 o'clock and hauling myself out of it at 5:30 am, with lots of internal medicine in between. Which I'm enjoying far more than I expected to, actually - I'm not the biggest fan of the inpatient setting, but I'm learning exponentially more on this service that I have on any other, my team is great, and I have a ton of autonomy. For example, I wrote my first prescriptions this week! Like, on a prescription pad and everything. I wrote scripts at Metro occasionally, but they had the electronic prescription system, which is vastly superior and less error-prone, etc, and I totally appreciate that. But the prescription pad thing is kind of fun. It's almost like I'm a real doctor. :)

So the actually interesting part of my week, though, was our society dinner at my dean's house on Friday. She invited Dr. Joseph Foley to come and speak, who, sadly, does not have a Wikipedia entry, but he's an internist and neurologist who first described asterixis in 1949. He's in his 90s now, but he's still pretty involved in teaching and community activism. He spoke about his early training in Boston in the 30s and 40s, and his time as a medic in WWII. It was a really interesting evening, and his talk sparked some great conversation afterwards.

A few of us were discussing the existence of the "physician-scholar" - you know, those people (often neurologists, it seems) who are incredible clinicians and also experts in Roman architecture or something totally esoteric, and we were wondering if those kind of physicians are perhaps a casualty to the modern face of medicine. Because none of us seem to have much time to even fully study what we're supposed to be learning, much less pursue an avocational interest in something non-medically-oriented. Or do we find the time for that sort of thing later, once we're attendings or have our own practices? (I'm not sure knitting counts, if only because I usually knit while I'm doing something else.)

Anyway. I think part of these musings stem from the shock to the system that is the transition from research to clinical medicine. I managed to forget how intensely time-consuming this whole thing is. What I do appreciate, though, and what I'm not sure I ever heard before I started clerkships, is that the hours really don't seem that bad when you're there. The wards are always (or usually) incredibly busy, and you've got enough coffee and epinephrine to get you through a 16 hour day without much difficulty. It's only once I'm home, I find, that I'll get hit with it - on my way to the shower or something, I'll find myself kind of looking around the apartment and thinking, Oh, yeah, I live here. That's right. It's this bizarre sensation, when you're conscious for less than an hour a day in your own home, how it starts to feel ... less real. I remember this from when I started on OB, and I think I'll be getting more accustomed to the schedule as time goes by, but this first week has been a bit of a readjustment.

But sleep deprivation and dissociation aside, it's actually been really great getting back to clinical medicine again. I was worried that I would have totally lost those skills after research block, but I can still do a decent physical exam and get an assessment and plan together, so that's reassuring. Hopefully I will have some interesting clinical stories to share soon, but so far it's just been heart failure and renal failure and ... heart failure and renal failure. I think internal medicine will be what it takes to get me back to the gym.


(P.S. - I totally turned on iTunes just now, solely because my widget was showing that the last song I listened to was John Denver's "Take Me Home, Country Roads" over and over. I'm not sure I fully appreciated the fact that I'd be publicly airing my guilty-pleasure music when I stuck that feature on the blog.)

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