New Beginnings

It’s time for most new medical school graduate to begin work! While I won’t be starting in the hospital for another month, I can’t wait to hear what everyone else has to say about finally working! It’s been 4 years since most of us had some sort of income, so it’ll be nice to finally see a paycheck. The adventures of medical school are now officially behind us, and the journey of residency is just beginning! Best of luck! Fake it until you make it!

Why I Love Pediatrics

I have been surprised! Caught off guard! Taken aback! Me – the girl who always assumed that I didn’t like kids – actually ended up loving pediatrics! It started in my third year rotations. I thought, “Hey, kids are OK, I guess.” And it turned out that I really enjoyed my time at the children’s hospital. To be more specific, it was my fourth year pediatric surgery elective that did me in. And here are a few of the reasons why:

  • Kids often have diseases/illnesses/defects that are 100% treatable. The scars left on their bodies after surgery often (but not always) are able to heal really well, to the point where you won’t be able to notice them as they age.
  • They’re innocent. You can’t often blame the little ones for something they were born with or caught, unlike the obese patient with debilitating chronic diabetes, or the 40-pack-year smoker coming in with an exacerbation of his COPD.
  • Kids are fighters! They’re very resilient. And I guess the same could be said for adolescents and adults.
  • The staff is amazing! Everyone from the doctors and nurses to the parents are all so supportive. I was in an environment where I thrived on knowledge and education; where there were staff and colleagues around that were willing to provide help. It was an atmosphere of awesome teamwork.
  • Surgery on the little ones is so intricate and delicate. Everything is so small – their healthy little organs, the instruments we use, the sutures we put in. You need really caring and delicate hands to work on such small patients.

So maybe pediatrics, especially pediatric surgery is something I should consider in my future. I really enjoyed my time, enjoyed the atmosphere, and I felt like I was really making a difference. I felt like I fit in. It might have something to do with still being a kid at heart =)

House of God

The “House of God” was written by Samuel Shem. It was about a doctor, freshly graduated from medical school, and starting his internal medicine residency. I had to re-start reading the book about three times, because each time I’d get about half-way through and then something would come up. When I’d try to pick up from where I left off, I’d be so lost that I just thought it better to start at the beginning. I wasn’t a big fan of the work. I mean, the story was interesting to read as a medical student, but the writing style was ugh for me to follow. And I thought the protagonist was far too pessimistic and cynical.

When I started my fourth year internal medicine elective in the general internal department, I felt like I was at the BMS Hospital myself. Gomers and gomeres abound. One gomere yelling, “Ma’am! Ma’am! Ma’am!” over and over again somewhere down the hall. Another patient urinating in his bed pan in the hall. The smell of C. diff diarrhea floating abound. I lost count of how many palliative patients there were on the ward. Many were frequent fliers. I don’t think I saw a single patient under the age of 40 during my stay there.

Maybe it was the book, but my view of internal medicine has forever been tainted. And having shifts in the ER was the worst. Awesome trauma cases would roll in. All the doctors would jump to their feet to see what had come in. As a student, I was excited, watching all the action. I even got to perform CPR on a patient one time. But that was about as exiting as it got. Because these cases would be handled by the surgical side of ER. As an internist, I got stuck with the headaches, the pneumonias, the diarrheas, and the drunks. And there was no treatment. There was partial diagnosis. There was the BUFF and TURF, as Shem would put it. Every single patient, every single ER shift. The resident I worked with prided herself with clearing all the beds – either through discharge, or by shipping the patient off to another department.

When I started medical school, I always considered internal medicine as one of my top choices in case I went the medicine versus the surgical route. During the third year rotation, I hated internal medicine. But I hated it because of the way the course had been structured, and not necessarily because of the patients and practice. In fourth year, however, internal medicine has completely fallen off my choices for residency. Maybe it was Shem that did me in? Maybe my experience? Maybe a bit of both? Who knows. But what I do know is that I can’t go down that route. It’s just not for me unfortunately. But I do realize what an important field of medicine it is – if I do go into general surgery, there are many things that I’ve learned in rotations like Gastroenterology and Hepatology that come in very useful. In fact, if I go down the UK-route, I do hope to rotate through an Internal Medicine elective at some point in my Foundation year. I just can’t do it for the rest of my life.

Risk Factor for Urologic Cancers – Smoking

As I was starting my Urology elective, I was hanging out in the doctor’s on call room, waiting for him to show up. He came and was a cheerful fellow. He said we’d start by taking a tour of the department. We left the on call room and as we’re about to round the corner the doctor, with a smile on his face, say “And smoking is absolutely forbidden inside the hospital.” And there was a group of 5 or 6 doctors standing by the window having their post-round morning cigarette. *faceplant*