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Tag Archive for 'patients'

i took the plunge!

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mylifemypace
1 month, 3 weeks ago
in medical school
. 0 Comments

So part of our third year curriculum includes the much-loved warm-and-fuzzy doctoring class that kicks my ass because I’m so not warm and fuzzy.

I’ve been trying to not be super quiet, but it’s been hard because my group consists of people I don’t know who all seem to know each other so well and because there are a couple of extraverted people who tend to dominate the discussion. But I am thankful that there are only about 2 extraverts instead of 6 when I got screwed during my second year.

Well, the other day, our session was about dealing with family members of someone in the ICU who isn’t going to make it. The discussion centered on how difficult it is to handle such a tough, emotional situation in a way that makes the family feel better. And, of course, just to make things hard on us, there was going to be a standardized patient interview. We decided to fly by the seat of our pants early in the course, with the interviewer volunteering on the day of the interview instead of pre-assigning days to people. Of course, I did not volunteer. Not because I was afraid of it being too emotionally draining or heartbreaking or whatever. But because this case required loads of empathy, which I severely lack and I didn’t want to be evaluated doing the thing that I am weakest at (these stupid mock interview evaluations go into our Dean’s Letter to residency programs!). Someone else volunteered, so it was okay.

But after learning the heartbreaking details of this particular case, the volunteer interviewer chickened out, saying that she knew she would break down during the interview (which I thought was lame because we all know that this is fake!). She did break down right after making that statement and left the room in tears. Somebody apparently has too much empathy. So with her out of the picture, we had to procure another volunteer. And no one else volunteered. Like I said earlier, I wasn’t about to volunteer either. But after two prolonged awkward silences, I knew that I was ripe for being picked on because I hadn’t talked much in any of the prior sessions. So before I could be forced to “volunteer,” I volunteered.

And the interview was hard. Our standardized patients were an irate father and a hysterical mother. The mother I could deal with. The father…not so much. But I eventually muddled my way through and it wasn’t an utter disaster (as has happened to me before in my second year warm-and-fuzzy doctoring class). I actually got pretty good marks, which I’m happy about.

What I’m proudest of though is the fact that I volunteered and that I wasn’t as self-conscious and nervous as I usually am about these things. Maybe it’s because I don’t know these people and don’t care what they think of me. Who knows. But it was a really big step for me. This case was hard for me, but not in the same way as it was for other people. Everyone else’s heart breaks over the case itself and they fear that they cannot stay unemotional while talking to the patient’s family. I have the opposite problem: I don’t really care and I’m not very good at pretending that I care. Which one is harder to deal with? Well, I think that less people would fault an overly emotional doctor than they would fault one who just didn’t seem to care. There is such value placed on empathy that it makes me feel that I fail at being a doctor just because I lack in that area. Forget my smarts. I’m screwed because I don’t have empathy.

Well, at least I was able to fake it until I made it this time.

in response to my dear reader post…

Published
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mylifemypace
3 months, 1 week ago
in medical school
. 6 Comments

Ages ago, I noticed an onslaught of new user registrations without much in the way of comment-posting, so I wrote a post requesting that readers give me some input about what they want to see on this blog. I am now finally getting around to responding to loyal (I hope so still…) reader 314’s questions listed below.

1. Did you ever have any dream careers as a child?

When I was in elementary school, I wanted to be a scientist. I even went so far as to draw a picture of myself in a labcoat working with chemicals at a lab bench when I was in second grade or so. So I’ve always been interested in the sciences. In high school, I wanted to be an astronomer until my mom told me that I’d never find a job (she was probably right). Not very interesting, huh?

2. What did you think being a doctor meant when you first decided to go to med school?

I lived a pretty sheltered life until my mom passed away when I was in high school. Even afterwards, I remained pretty sheltered (thanks to a psycho possessive ex-boyfriend). I had never really been exposed to what it is that doctors actually do except for what I saw whenever I went to my own doctor, who was invariably either a family practician or a pediatrician. So I thought that being a doctor meant having my own general practice and that was what I wanted to do. I thought that being a doctor meant seeing sick people and making them better, even after watching doctors fail to cure my mom. To put it simply, I was pretty naive and idealistic about the whole thing.

3. How/why has that changed as time passed?

Well, the first thing I learned when I started med school was that there were all these different specialties that I could choose from that I had absolutely no idea existed before. Then I learned that I do not, under any circumstance, want to go into a general field of medicine (e.g., family practice, internal medicine, pediatrics). Then along the way, I learned that being a doctor isn’t all that it’s cracked up to be. I don’t like seeing sick people. I don’t want to see people die under my watch. I don’t like the long hours and being treated like crap. I’ve been lucky to have pretty pleasant patients so far, but I’m sure the day will come when I get abused by a patient who thinks that I’m not good enough for them (and they would probably be right). I haven’t yet been yelled at either, but I hate living each day in fear of the time when I will finally get yelled at. I’ve also learned that a large part of medicine is about how well you get along with people, which I utterly fail at. I make do and plenty of patients like me, but when you put me next to Mr./Ms. Extrovert, I look like an utter failure. So what’s changed from my idealistic vision of everything is that med school is full of abuse and that the long, hard road is seldom worth it. And that contrary to what I had hoped, I cannot change who I am and be good with people. Which means that I have to hide in the shadows in Radiology instead of becoming a brilliant diagnostician (because, unlike TV, I’m pretty sure I can’t be an ass like House and still have a job).

Wow. How utterly demoralizing. But you introverts might as well know that med school and being a doctor is 100x harder if you’re an introvert before you jump in.

i am so going into radiology

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mylifemypace
6 months, 1 week ago
in medical school
. 0 Comments

After 1 week of psych consult, I learned that I do not, under any circumstance, want to go into Internal Medicine. How anyone can stand the smell of someone else’s diarrhea is completely beyond me. And I’m from psych consult! I probably had to smell it for, what, five minutes? Yeah, well, five minutes is far too long. I cannot imagine being on Medicine and actually having to do a physical on someone who stinks of poo. Let’s just say that I was actually glad I hadn’t eaten before seeing this patient because I would have surely vomited otherwise.

We get a lot of consult requests from the various Medicine teams in the hospital. So I’ve had the distinct pleasure of visiting many Medicine areas in the hospital. And they all have that distinct hospital smell that I have now grown quite sick of. Sometimes, this smell is intermingled with the distinct smell of poo. The people in these areas tend to be pretty sick with multiple problems. And MRSA. I guess I should be glad I’ve learned how to gown up for such situations. But, really, I just don’t like it.

At the end of my second week, I learned that I don’t like talking to patients. Or their family. Or anyone else, really. Sure, I already knew that, but I thought it would change when I started wards. That something inside of me would magically change and I all of a sudden wouldn’t be socially awkward anymore or hate talking with people. No such luck. There’s nothing like knowing nothing to really make you not want to open your mouth when speaking to patients. Patients who expect you to know everything.

By the end of my third week, I decided that I’m going into Radiology. Over the weekend, I debated whether it was really what I wanted because I never really liked what little Radiology I had been exposed to in my first two years of med school. And it’s also 4 years on top of an internship year. Plus I’d want to either do a Neuro or Interventional fellowship, which would add another 1-2 years, making it 6-7 years total, far too long a time for someone who has already wasted 4 years on a PhD that she’ll likely never use. So I had my doubts.

Then, yesterday, my attending insisted on watching me interview a patient. These kinds of situations are particularly painful for me because of my social awkwardness and nervousness when being watched by other people. Of course, I get a psychotic patient. Which I’ve never seen before. So I really concentrated on making sure I asked the right questions on the timecourse of his symptoms as well as things to rule out depression and mania and the like. And because I was being watched and didn’t want to waste the attending’s precious time, I directed the interview more than I usually do, sometimes cutting off the patient’s rambling answers to interject my own questions, but never too brazenly. I also took this approach because I’ve gotten quite a few delirious/talkative patients who would talk and talk and talk without making much sense, making for really long pointless interviews and I was kind of tired of it. Also, I was modeling the interview style of the other attending, who I’ve worked with more than this particular one, who keeps things nice and short. Well, at the end of it all, this attending called me an unempathetic information gatherer. Now that might sound painful to those who aren’t used to hearing themselves being described that way. But it didn’t surprise me at all. I actually wanted to respond by saying, “Tell me something I don’t already know” because I didn’t find that assessment particularly useful. I know that I suck at empathy. That’s because I suck at social interactions, period. Sometimes, I think I have Asperger’s. And the sad thing is that I was actually trying during this interview. Though not as much as with unwatched interviews because I always feel so fake doing such things and didn’t want the attending to call me out on it. Yeah, that plan worked out well.

So, that’s how I’ve come to decide that Radiology is for me after just 3.5 weeks on rotations. The only thing that might change my mind is Surgery. But I doubt it. And I’m sure my attendings will be glad to know that I won’t be spreading my unempatheticness wide and far.

contrary to what you may think…

Published
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mylifemypace
8 months ago
in medical school
. 1 Comment

I’m not an uptight know-it-all.

Yes, I preach a lot about making sure you know what you’re getting into when you decide you want to become a doctor. But that’s because I didn’t quite know myself (*gasp*) and because I see far too many people naively thinking that the junk on TV actually even comes close to portraying what it’s really like to be a doctor. Yes, it’s obvious that doctors treat illnesses, injury, and other health conditions. But what may not be obvious is that it’s not quite that simple. Every patient is different–some may listen to you, some may think they know more than you, and some just want to look for any excuse to sue you. You may want to become a doctor to help people, but many times, your hands are tied by bureaucracy and you can’t do anything about it but feel bad. Oh yeah, and the income to amount-of-work-you-have-to-put-in ratio kind of sucks when it comes to doctors (unless, of course, you go into derm or some other lifestyle specialty).

Also, despite my ragging on and on about how it’s not fair that people get ahead by kissing ass instead of working hard, I’m the biggest slacker you’ll ever meet. I never studied in high school and made it a habit to never study in college until 1-2 days (at most 2.5) before any midterm or final and graduated summa cum laude with more honors and awards than you care to read about here. I also only studied for a week before the MCAT and yet my numbers were awesome and I had no problem at all getting into medical school. I have my semi-photographic memory to thank for allowing me to be such a slacker. Even in med school, I slacked more than most and still made it through the first two years just fine. Yes, I worked harder than I’ve ever worked in my life, but not as hard as most of my classmates. Let’s not even mention grad school because it’s a complete joke compared to med school and I’m sure you get the point. I have no problem with slackers as long as they eventually get “serious” enough to know when to work when it matters. What I do take issue with are those who purposely skirt the rules and expect everything to be handed to them on a silver platter simply because they know someone…those who slack and have crappy numbers who just want a free ride while other slackers actually earned their way…those who have no sense of how much trust will be placed in them when they become doctors and do not take it seriously. I was taught by my favorite high school math teacher that the cream always floats to the top and maybe I was naive to believe it, but it is because of this belief that I can’t stand ass-kissers who actually get ahead not because they’re awesome in every way and deserve it, but merely because they kissed the right ass. I believe in people being rewarded for how awesome they are and not because of sneaky underhanded tactics.

So there it is. I hope we’re all on the same page now.

inspirational music for the medical student 2.8

Published
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mylifemypace
8 months, 2 weeks ago
in for the med student, inspirational music and medical school
. 2 Comments

Starting med school is like starting a new life…you have to learn to study extremely efficiently, deal with slightly crazy classmates, and fumble your way through your first physical exams and patient interviews. Along the way, you’re going to make mistakes, many embarrassing ones. You’re going to be scared that you’re never going to be good enough. And you’re going to be happy that you’re pursuing your dream. So in honor of new beginnings, my song for this week is Yael Naim - New Soul.

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Send song suggestions here.