Oh, hi. Remember me? Time has completely slipped away from me these past few months. Case in point, my desktop calendar still reads March.
I spent 2 months on the medicine wards (I believe this term refers back to the olden days when all the patients resided on the same floor, but nowadays our patients are spread throughout several buildings) at MCV and the VA hospital. It was, how shall I say, enlightening. Six days a week, 11-15 hour days, many of those hours spent in a drab team room typing notes and calling consults with less than enthusiastic residents. There was complaining, a few tears, anger and resentment on my part. I did not like myself in this environ. And more importantly, there was no one inspiring me enough to turn my frown around. The attendings were great physicians, don't get me wrong. I learned so much these past few months. But I always love coming to work knowing there will be someone invigorating and excited to teach me something. That rarely happened these past few months.
The patients were never a problem. I got quite close to a few. I helped one gentleman work through end of life decisions. He literally begged for us to let him die as he had developed a colitis that left him sitting in a pool of his own bloody diarrhea for weeks. Another young man I related to all too well, was fighting a brainstem tumor. That kid was mentally and physically tough and easily became one of my favorites. I even got to see him a week out from his discharge and all the progress he had made. Then there were the GI patients, a meek lady with Crohn's disease and a motherly figure with cirrhosis. And the devastatingly sad nursing home patients, many suffering from neglect and malnourishment. What. the. heck. The flirtatious old men at the VA hospital. So, so many of them. They all taught me something.
Towards the middle of the two months, I started to think about an internal medicine residency: nearly 3 years of wards and ICUs and scattered clinics that none of the residents seem to enjoy, even those that claim they are pursuing primary care careers. It got me down. I don't like the hospital much or the confines of the team room or the depressed attitudes. Residency seemed like such a forlorn experience and I lost hope for myself and my happiness over the next few years. But then I started to talk to friends and mentors about it and began to realize I may have been so mentally committed to internal medicine that I was suppressing my inner family physician! And since making that realization I have been so much happier. I admitted to myself that I don't hate pediatrics as much as I have said (I definitely enjoyed my peds rotation). And I love outpatient medicine, that much I knew already. I love that family docs to be get to train in a variety of settings, including a little bit of surgery and ob/gyn. And as my mentor put it, when he goes on a medical mission trip they press the internal medicine and pediatrics folks to see what ages of patients they are willing/capable of seeing, whereas with him they simply show him to his chair. He can see anyone and be of great service in many settings. Since I am pretty sure I want to work in a rural or underserved area, this just makes the most sense to me.
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