A few days ago, Kyle surprised me with this vintage locket with an anatomical heart design to congratulate me on beginning residency (He's the best). I love the anatomical heart. It begins at first as a simple tube that spontaneously starts beating 21 days after conception. It then folds on itself and eventually develops into four chambers of muscle, pumping blood to a beat determined by a little bundle of nerve cells. I plan to put pictures in it- maybe of mom and champ- or maybe a mantra-- something to remind me to work from my own heart, to be patient, to be kind.
When I explained the locket to my upper-level, she said "Wow it's only been a week and you already feel that way?" No, I don't, at least not yet. It's only been 10 days and I'm still enjoying work, still feeling very excited to be a doctor every day. My last post-call morning was a bit tough, though. After a 30 hour shift with only 1-2 hours of sleep, I noticed that I had less patience and was pretty eager to leave the hospital, a really difficult feeling when trying to transfer important patient information. Hence, I think the locket reminder may come in handy in the future.
I've started on the ICU and though our patients are very sick, there's actually not too many of them, so it's been a nice smooth start. There's a lot to learn and I've been reminding myself not to be too self-critical. I've been making plenty of rookie mistakes: writing the orders wrong or forgetting to follow-up on some lab results. Luckily, I get called by the pharmacy or my resident catches my errors. There's always back-up. It's just frustrating to be inefficient when there's so much to do. So again, I keep reminding myself to be patient, that the learning will come with time.
My biggest worry about residency is trying to balance the work load while still being human. I've seen plenty of doctors who are smart as hell but have no bedside manner. I've seen them explain a diagnosis in front of a clearly dumbfounded family and then leave without answering questions. Worse yet, I've seen them talk about the patient to the team- right in front of the alert and awake patient- without addressing the patient himself. I've seen doctors be rude to nurses and to each other. I don't ever want to be like that, but I can also see how lack of sleep and a busy schedule make one just a little more irritable, a little more rude and then it's a slippery slope...
Mindful of this potential issue, I'm trying to start out on the right foot. I've been introducing myself to all the nurses and getting to know their names. Luckily, they are all super friendly with me right now since I'm pregnant (they all want to know how far along I am and what I'm having, etc). I've been touching base with the patient's families almost daily, either in the hospital or over the phone. And I've been trying to treat each patient with respect and caring (even the homeless guy in alcohol withdrawal who peed all over himself and smelled like butt and the guy with AIDS/pneumonia/ with respiratory distress who yelled at me and threatened to leave the hospital if I didn't give him "a shot to put him to sleep." I'm sorry sir, there just is no such thing. I know you want to sleep and I want you to stop yelling at me, but if I give you something for sleep, you might stop breathing on me... so how about some morphine?) (And he did lose the ability to breathe on his own some hours later so we intubated him. I felt sorry for him and relieved that he wouldn't be yelling at me for awhile :)
What I am trying to describe has been summed up by "the mama's rule," That is, treat each patient "like they yo mama" (this must be said with my program director's black southern accent or else it doesn't sound as good). I carry Mom in my heart everywhere I go. Even when I had a routine blood draw recently and felt a ping of anxiety, I remembered how many IVs and blood draws she had and I felt more brave. I think about Mom a lot. And I think about how families feel about their loved one being in the hospital and how effective communication and good decision making can effect their perception of their loved one's life forever. I feel very grateful that my last memories of mom were at home, that she was afforded a graceful death from an otherwise terrible disease. It is this memory that inspires me. In death, we should be able to simply grieve the passing of a person and not harbor resentment over their medical care.
Love you Ra!
ReplyDelete