Tuesday, August 31, 2010

August Rush

RANT ALERT!(Don't say I didn't warn you)

Another month down.

At this point in any residency training, 2 months before I hopefully enter my third year in Internal Medicine, you come to the dog days -- days when you're dead tired, getting snide remarks about your work from people who do their best work from a distance, and you sometimes, do not feel the need to go on.

These are times when you feel that quitting is an option.

Believe me, these days come.


But I have come to realize that quitting isn't an option. It is a mirage. It looks like it's there but it really isn't. It's tempting, but it won't do you any good. Sometimes you get lucky and you find a casbah and a big pool of fresh water, but if only we can all be so lucky.

I wish an 80 hour work-week was in effect in our country but it isn't. We tally a total 100+ hours by my count (my brain isn't processing numbers at this time, so I could be wrong).

I've been working with people who say that I've been extra sensitive and touchy about how I work with my patients. And these are people who aren't even doctors and do not, in the first place, have any idea what is going through the mind of one.

So to them I say, BLESS YOU!

It's the only way I know how to work. I was raised by a mother who wakes up at 5 am to go to the market and sell meat, rush home, gets into her uniform to go to the bank and comes back at night to talk to us and help us with homework; a father who goes to the bank every morning and is dedicated to his organizations.

I take pride in my work and I will rant and rave in anger at any attempt to discredit it. You can break me down, tell me I'm ugly (I hope at least I'm average-looking), fat (I do need to lose weight), dumb (now wouldn't you want me as a doctor?) and other really bad adjectives you can think of, you don't get a free pass when you talk about my work.

I give you everything I have, everyday.

He who matters (pointing up) knows I do.

And His opinion is the one that matters.

The rush of August has come and gone.

Tuesday, August 17, 2010

Happy August

There have been several things that have brought a smile or two to my stress-laden face these past few days. I’m not talking about the crappy one-liners that crack you up, but rather it’s all about those times that come up and surprise you – that box of chocolates, those life-affirming purpose-filling experiences and those moments that bring joyful memories and images that you just can’t help but radiate happiness.


I’ve made it no secret that I fell in love with this line of work during my post-graduate internship. The endless diagnostic puzzles and the countless thanks we get when we see a patient walk out the hospital doors floor me now as much as it did then. And for every intern that has come through our hospital (two batches) I’ve always tried to impart that sense of awe, respect, and interest in the diagnosis and treatment of patients. One way of doing that is having them man the triage and outpatient consults (as we did then). After they see the patients and take their histories, they come to us, residents, with a plan for diagnosis and treatment. I have always given them a little free hand to do and get what they want as long as it is in line with the diagnostic possibilities.

A week ago, we were saddled with a patient with abdominal pain, mainly in the epigastric area with radiation into the back, noted after eating a meal of squid. There was epigastric tenderness and vomiting. My intern mentioned all the differential diagnoses and was hedging on Gastroesophageal Reflux Disease and Pancreatitis, ruling out of course an acute coronary syndrome with a negative ECG. I was already happy with the way she handled the patient. In the background of a previous history of GERD, it was highly likely just GERD, but she wanted to rule out Acute Pancreatitis.

I said, “Convince me to allow you to take a serum amylase.” She went into the doctors call room and brought out our text books and began to read from the symptomatology of Acute Pancreatitis. I laughed and conceded. Who couldn’t say no to that?

Serum amylase was negative. Endoscopy eventually still showed GERD.

She came up to me after the results came out and said, “Doc, I’m kind of disappointed and happy at the same time. Happy that my patient doesn’t have pancreatitis, but disappointed that I didn’t get it right.”

For someone to try that hard, to figure out a patient, and bounce back after getting it wrong is a lesson learned in itself.

That became a life-affirming moment for me. I love teaching whatever I can to those who listen and when you see it come together like that, it’s a wonderful thing.
I told her, “You can’t get all your patients right, you can hope to try, but you just can’t. It’s the thinking process that counts. And you are well on your way.”
She stood up, flashed a smile and went on to the next patient.

Small victories.


I don't have any fangled camera DSLR's and whatnot, but I have my hearing and I've rediscovered my love for music -- thus, thanks to my mother (ever-supportive, she was the one who had us take lessons way back in kindergarten), I've been reconnecting with my love for music through a new keyboard. (thank you ma.)

As Gaya says, it's chasing giants that make this life worth living. Hahaha, if I didn't know better, I would have sworn those were lyrics. But that's just me.