Mary's Song
by Luci Shaw
Blue homespun and the bend of my breast
keep warm this small hot naked star
fallen to my arms. (Rest …
you who have had so far to come.)
Now nearness satisfies
the body of God sweetly. Quiet he lies
whose vigor hurled a universe. He sleeps
whose eyelids have not closed before.
His breath (so slight it seems
no breath at all) once ruffled the dark deeps
to sprout a world. Charmed by doves’ voices,
the whisper of straw, he dreams,
hearing no music from his other spheres.
Breath, mouth, ears, eyes
he is curtailed who overflowed all skies,
all years. Older than eternity, now he
is new. Now native to earth as I am, nailed
to my poor planet, caught
that I might be free, blind in my womb
to know my darkness ended,
brought to this birth for me to be new-born,
and for him to see me mended
I must see him torn.
Wednesday, December 26
Wednesday, December 12
Failure. Pleasing others.
So I started this audition month by looking at a joint x-ray. After about 30 seconds of confused contemplation, I finally gathered my courage and asked the resident, "Hey, where's the patella on that x-ray?" As soon as the words left my mouth, my eyes made sense of the radial head. Crap. That's an elbow! Before she could start to say anything, I was shaking my head and saying, "Ooh. I mean. Never mind because that's not a knee that's an elbow and elbows don't have kneecaps. Let's forget I said anything. In fact, I was merely remarking on what a normal looking elbow that xray is showing." She laughed at me.
Apparently I began as I meant to go on. I've missed IVs, messed up Foley catheters, placed endotracheal tubes in the esophagus, placed orogastric tubes in the lungs, had to rip out a few sutures, fumbled immobilisations... I'm such a klutz and it is beyond frustrating! I am not super neurotic, but I'm certainly type A enough that I HATE doing stuff that I'm bad at - and at this stage of my training I'm bad at everything. Still. I've been trying my best to keep a good attitude about my failures, work hard, and ask thoughtful questions. I may not be good at anything, but I swear I'm teachable!
I have been struggling very much lately with wanting to please other humans. This, I think, is the quintessential struggle of any Christian who is currently aspiring to some new position. This morning I was reading the letter written by Jesus' brother, James; these passages in particular became my prayer today:
"For jealousy and selfishness are not God’s kind of wisdom. Such things are earthly, unspiritual, and demonic. For wherever there is jealousy and selfish ambition, there you will find disorder and evil of every kind. But the wisdom from above is first of all pure. It is also peace loving, gentle at all times, and willing to yield to others. It is full of mercy and good deeds. It shows no favoritism and is always sincere. And those who are peacemakers will plant seeds of peace and reap a harvest of righteousness."
"Don’t you realize that friendship with the world makes you an enemy of God? I say it again: If you want to be a friend of the world, you make yourself an enemy of God... But he gives us even more grace to stand against such evil desires."
That last sentence is perhaps the most important. Through the Holy Spirit, I am empowered to fix my eyes on my King, and to allow Him to set my goals and priorities. I am glad to let Him.
Apparently I began as I meant to go on. I've missed IVs, messed up Foley catheters, placed endotracheal tubes in the esophagus, placed orogastric tubes in the lungs, had to rip out a few sutures, fumbled immobilisations... I'm such a klutz and it is beyond frustrating! I am not super neurotic, but I'm certainly type A enough that I HATE doing stuff that I'm bad at - and at this stage of my training I'm bad at everything. Still. I've been trying my best to keep a good attitude about my failures, work hard, and ask thoughtful questions. I may not be good at anything, but I swear I'm teachable!
I have been struggling very much lately with wanting to please other humans. This, I think, is the quintessential struggle of any Christian who is currently aspiring to some new position. This morning I was reading the letter written by Jesus' brother, James; these passages in particular became my prayer today:
"For jealousy and selfishness are not God’s kind of wisdom. Such things are earthly, unspiritual, and demonic. For wherever there is jealousy and selfish ambition, there you will find disorder and evil of every kind. But the wisdom from above is first of all pure. It is also peace loving, gentle at all times, and willing to yield to others. It is full of mercy and good deeds. It shows no favoritism and is always sincere. And those who are peacemakers will plant seeds of peace and reap a harvest of righteousness."
"Don’t you realize that friendship with the world makes you an enemy of God? I say it again: If you want to be a friend of the world, you make yourself an enemy of God... But he gives us even more grace to stand against such evil desires."
That last sentence is perhaps the most important. Through the Holy Spirit, I am empowered to fix my eyes on my King, and to allow Him to set my goals and priorities. I am glad to let Him.
Tuesday, December 4
On Catastrophes.
From my personal journal, edited slightly for anonymity.
This is actually my second time in the town where I'm currently rotating. I guess it will always hold a little place in my heart because even if I successfully go on to do disaster work as my career, this town was the first place where I grabbed my work gloves and dug in to help other people whose lives had just been wrecked. I showed up with a group a few days after the disaster to do general cleanup and hand out supplies. I know now that I really should have found out where the medical tents run by the hospitals were and gone there to help, but I was uncertain enough of my skills that I didn't have the courage. They could have used me.
Someone recently told me the area had been "totally cleaned up," so I was deeply surprised to see how destroyed it still looks. There are a lot of new little houses, but nothing like the density of homes that was there before. All the dead trees are still there. There are still blue tarps around, for goodness' sake. The two things that moved me most were seeing all the power/ telephone poles, which were all downed the last time I was here, and seeing how the foundation for one of the destroyed hospitals has been removed. When I was here, everything was a flat, even layer of shredded insulation and fragments of levelled houses... It was nightmarish.
Remembering back to how awful that whole scene was, for a moment today I couldn't help but wonder why I even want to go into disaster relief. But part of the answer settled into me as I looked out over the scarred hillside this morning. This, this brutality and overwhelming power, is how the world truly is. And the way we deal with these crises - how we crumble, how we push back - is how we truly are.
This is actually my second time in the town where I'm currently rotating. I guess it will always hold a little place in my heart because even if I successfully go on to do disaster work as my career, this town was the first place where I grabbed my work gloves and dug in to help other people whose lives had just been wrecked. I showed up with a group a few days after the disaster to do general cleanup and hand out supplies. I know now that I really should have found out where the medical tents run by the hospitals were and gone there to help, but I was uncertain enough of my skills that I didn't have the courage. They could have used me.
Someone recently told me the area had been "totally cleaned up," so I was deeply surprised to see how destroyed it still looks. There are a lot of new little houses, but nothing like the density of homes that was there before. All the dead trees are still there. There are still blue tarps around, for goodness' sake. The two things that moved me most were seeing all the power/ telephone poles, which were all downed the last time I was here, and seeing how the foundation for one of the destroyed hospitals has been removed. When I was here, everything was a flat, even layer of shredded insulation and fragments of levelled houses... It was nightmarish.
Remembering back to how awful that whole scene was, for a moment today I couldn't help but wonder why I even want to go into disaster relief. But part of the answer settled into me as I looked out over the scarred hillside this morning. This, this brutality and overwhelming power, is how the world truly is. And the way we deal with these crises - how we crumble, how we push back - is how we truly are.
Sunday, December 2
Carving your own way is not always fun
So here I am, at 5:30 on a Sunday morning, awake. I have learned that one of the harder things about working in the ER is the shifting from days to nights and back again, generally with only 24 or 48 hours to do so. I find myself frequently staying up for 24- 36 hours because I have things to do, or simply because my body has no idea what it needs. I stare at the ceiling and rehearse interview questions a lot.
As a fourth year student, I'm in the phase of trying to get into residency, my required postgraduate training. Generally, that takes this form:
- take Step/ Level 2 board exam during the summer
- apply to residency programs during the fall through a standardised system, the Electronic Residency Application Service, aka ERAS
- during autumn, spend time at various residency program locations for 2-4weeks at a time, trying to impress and hopefully scoring...
- interviews, which are how a program shows interest in an applicant after their ERAS application has been submitted
- during December/ January, students and residency programs create ranked lists of the programs/ students they would like, respectively. So I might make a list that said my #1 choice was Program A, #2 is Program B, and so on. At the same time, those programs are making lists that might say their #1 student pick is Jane, #2 is Zoe, #3 is Steven, etc. All of these lists are fed into a computer that works through a matching algorithm, pairing students with residency programs according to their preferences.
- Match Day, the day when all successful matches are revealed, occurs in February for D.O.s and March for M.D.s. Everyone hopes they received a match to a program, but as some fields are more competitive than others, there are invariably not enough spots in each area for all the people who want to do that work. Hence the Scramble.
- the Scramble is something no one wants to do. The day after Match Day, a list of unfilled residency spots is published, and it's a barely restrained free-for-all. Think of tossing a pile of gold pieces into a crowd and saying, "Go!" Yeah.
I just finished my third audition rotation: one family medicine, two emergency medicine. I have one more ER audition and then I'm finished with this part and can get back to working/ learning without also feeling like I should be jockeying for a job.
The thing about this season is that it is insecurity-inducing and it impels you to contort yourself to please people. You see how high-stakes this is, right? Because you want to get a job, but you know you aren't that great as you are, so you start to compromise yourself in order to look more attractive to whichever program you are with at the time. Which of course, is a futile goal, and one not pleasing to Christ. My job isn't to please other humans. My job is to do my best to please Him, every day. Walking through this time has taught me a few very important things:
- not everyone at every site will like me, and there may be nothing I can do about it
- I most certainly will not like everyone I will have to work with
- pursuing Christ will make me enemies - the more openly I do it, the more enemies I make
- being a patient advocate will make me enemies - the more openly I do it, the more enemies I make
- a few doctors still think of women as not good physician material
- some programs will expect you to abandon your dignity and become a supplicant rather than an applicant who seeks to become an equal. These programs will provide ample opportunities for you to play their stupid game
- we who seek to glorify the Lord are truly a remnant, a small band of rebels trying not to get shot down as we slip through and around the rigid expectations of others
- calling missions "international aid" or "providing care to those who are less fortunate" is a good way to keep from getting doors slammed in my face for now
- many people will want to compare notes with you endlessly - where you've been, how many programs you applied to, what your boards scores are, how many interviews you have. It's easy to get obsessed with statistics and probabilities
- these people will not be inspired by you telling them you trust God to place you where you're meant to be. They will look at you with pity. They think stress is how you know you're doing it right
I can't even tell you what a weird process this has been. The whole point of it is to prove how awesome you are and to get what you think you want for yourself, even if getting what you want means doing a bunch of stuff you hate and lying to people. The pressure to conform is high and constant, and I've dealt with a lot of anxiety as I grapple with this system that I must survive in but still want to reject. It is very hard to see an opportunity to impress or agree with someone who you know has power over you, and to count the cost and deem it too high, and to consciously allow the opportunity to pass. There's no earthly reward for that kind of behaviour.
I work to avoid straying from pleasing God to pleasing men because God has impressed something deeply on my soul. It is not about getting into residency. It is not about emergency medicine or family medicine. It isn't even about being a doctor. My purpose is to serve the King - to trust that He will let me know what my tasks are for that day, and to work at them diligently. The tasks themselves are pretty much incidental.
Now how is that supposed to translate in an interview, hm?
As a fourth year student, I'm in the phase of trying to get into residency, my required postgraduate training. Generally, that takes this form:
- take Step/ Level 2 board exam during the summer
- apply to residency programs during the fall through a standardised system, the Electronic Residency Application Service, aka ERAS
- during autumn, spend time at various residency program locations for 2-4weeks at a time, trying to impress and hopefully scoring...
- interviews, which are how a program shows interest in an applicant after their ERAS application has been submitted
- during December/ January, students and residency programs create ranked lists of the programs/ students they would like, respectively. So I might make a list that said my #1 choice was Program A, #2 is Program B, and so on. At the same time, those programs are making lists that might say their #1 student pick is Jane, #2 is Zoe, #3 is Steven, etc. All of these lists are fed into a computer that works through a matching algorithm, pairing students with residency programs according to their preferences.
- Match Day, the day when all successful matches are revealed, occurs in February for D.O.s and March for M.D.s. Everyone hopes they received a match to a program, but as some fields are more competitive than others, there are invariably not enough spots in each area for all the people who want to do that work. Hence the Scramble.
- the Scramble is something no one wants to do. The day after Match Day, a list of unfilled residency spots is published, and it's a barely restrained free-for-all. Think of tossing a pile of gold pieces into a crowd and saying, "Go!" Yeah.
I just finished my third audition rotation: one family medicine, two emergency medicine. I have one more ER audition and then I'm finished with this part and can get back to working/ learning without also feeling like I should be jockeying for a job.
The thing about this season is that it is insecurity-inducing and it impels you to contort yourself to please people. You see how high-stakes this is, right? Because you want to get a job, but you know you aren't that great as you are, so you start to compromise yourself in order to look more attractive to whichever program you are with at the time. Which of course, is a futile goal, and one not pleasing to Christ. My job isn't to please other humans. My job is to do my best to please Him, every day. Walking through this time has taught me a few very important things:
- not everyone at every site will like me, and there may be nothing I can do about it
- I most certainly will not like everyone I will have to work with
- pursuing Christ will make me enemies - the more openly I do it, the more enemies I make
- being a patient advocate will make me enemies - the more openly I do it, the more enemies I make
- a few doctors still think of women as not good physician material
- some programs will expect you to abandon your dignity and become a supplicant rather than an applicant who seeks to become an equal. These programs will provide ample opportunities for you to play their stupid game
- we who seek to glorify the Lord are truly a remnant, a small band of rebels trying not to get shot down as we slip through and around the rigid expectations of others
- calling missions "international aid" or "providing care to those who are less fortunate" is a good way to keep from getting doors slammed in my face for now
- many people will want to compare notes with you endlessly - where you've been, how many programs you applied to, what your boards scores are, how many interviews you have. It's easy to get obsessed with statistics and probabilities
- these people will not be inspired by you telling them you trust God to place you where you're meant to be. They will look at you with pity. They think stress is how you know you're doing it right
I can't even tell you what a weird process this has been. The whole point of it is to prove how awesome you are and to get what you think you want for yourself, even if getting what you want means doing a bunch of stuff you hate and lying to people. The pressure to conform is high and constant, and I've dealt with a lot of anxiety as I grapple with this system that I must survive in but still want to reject. It is very hard to see an opportunity to impress or agree with someone who you know has power over you, and to count the cost and deem it too high, and to consciously allow the opportunity to pass. There's no earthly reward for that kind of behaviour.
I work to avoid straying from pleasing God to pleasing men because God has impressed something deeply on my soul. It is not about getting into residency. It is not about emergency medicine or family medicine. It isn't even about being a doctor. My purpose is to serve the King - to trust that He will let me know what my tasks are for that day, and to work at them diligently. The tasks themselves are pretty much incidental.
Now how is that supposed to translate in an interview, hm?
Wednesday, October 31
The Good, The Bad, And The Facepalm, or, June/July: ER
Sorry! I wrote this on time ages ago and then just never posted it. I'll be catching up to the present over the next couple of weeks so expect drama, epiphany, and laffs! And now, June and July:
For June and July, I was in a rural ER, working as a fourth-year student. It was pretty flipping awesome. Here are some highlights:
The Good:
- I did so much suturing. I sewed every day. Hands, arms, legs, faces; old people, tiny kids; everything from tacking gunshot wounds closed for the trip to the big city for surgery, to closing up messy lacerations from biking accidents.
- I learned an enormous amount about management. Third year the focus is slightly more on honing your history-taking and diagnosis skills, so it was pretty invigorating to start really focusing on when to get a CT vs. an x-ray, when to admit vs. discharge, and some of the specifics of prescribing.
- I saw some decent trauma and a lot of drugs. Interestingly enough, I was never on shift when any of the really serious stuff (stabbings and such) came through, but what I did see was plenty for a beginner like me. I'll spare you the gory details, but man, people find a lot ofawesome gruesome ways to mess up their hands.
The Bad:
- Every doctor at this hospital worked 24 hour shifts. I was allowed to choose my own hours, so I started out doing 12-hour shifts, then had to cut them down to 10-hours so I could study more for boards. By the end of the month, though, I was routinely working 13-14 hour shifts as well as commuting 3 hours back home a couple of times a week. It wears on you.
- I got run off the road in the middle of the night by a cow. It was terrifying. I'm so thankful I was able to avoid actually hitting that enormous thing, and thankful that when I ran off into the adjacent field I didn't hit something or flip or whatever and damage myself or my car. Stupid cow. When I told my coworkers the next day, they were horrified. I guess people die from that. Cows are HUGE.
The Facepalm:
- Sometime during the first month, a patient came in with a dislocated little finger. I stood outside the room as my attending demonstrated on my hand the grip I would take and the vector of my force to put the joint back in place. Sounds normal, right?
I almost passed out.
Joints are a definite weakness of mine. Fluids, fractures, ears, feet - no problem. But joints. Joints fill me with a visceral dread so deep that apparently my body can't handle it, and I start to vasovagal. I didn't even put the finger back in place. I watched, nauseated and weak, as my attending did it for me. I practically had vapors, for goodness' sake. I still can't think too hard about it.
- You know how when you pick up a baby out of a carrier/ carseat, it's normal human impulse to lift the child way up above your head so they laugh and squeal? It's fun and harmless and everyone enjoys it. Unless you don't realise there's a metal lamp hanging above the childseat. I was mortified. Mortified. M-O-R-T-I-F-I-E-D. I can't even tell you. The mother was really nice about it, all, "Oh, babies are tough! He's done way worse to himself so he'll be fine in three minutes!" but it took me a while to stop hyperventilating. What if I knocked his brain about and he lost his ability to enjoy dense poetry before he can even appreciate what he had? What if I slightly malformed his skull so he can't ever have a buzz cut because he'll look funny? What if he grows up with a lamp phobia and never knows why?! Horror!
I mean, I'm sure he's fine.
Conclusion: Man, ER medicine is cool stuff. I'm liking the blood and adrenaline, you guys. And I actually like the small ER I was in, where I could personally keep track of all the patients in the department and know what was going on at all times. It felt more like running things and less like being a little doctor cog in a big hospital machine, and part of the reason I wanted to be a doctor in the first place was to be in charge. And once you get a certain distance outside the big cities, rural ERs see all of the trauma and sickness and craziness that the urban ones do.
For June and July, I was in a rural ER, working as a fourth-year student. It was pretty flipping awesome. Here are some highlights:
The Good:
- I did so much suturing. I sewed every day. Hands, arms, legs, faces; old people, tiny kids; everything from tacking gunshot wounds closed for the trip to the big city for surgery, to closing up messy lacerations from biking accidents.
- I learned an enormous amount about management. Third year the focus is slightly more on honing your history-taking and diagnosis skills, so it was pretty invigorating to start really focusing on when to get a CT vs. an x-ray, when to admit vs. discharge, and some of the specifics of prescribing.
- I saw some decent trauma and a lot of drugs. Interestingly enough, I was never on shift when any of the really serious stuff (stabbings and such) came through, but what I did see was plenty for a beginner like me. I'll spare you the gory details, but man, people find a lot of
The Bad:
- Every doctor at this hospital worked 24 hour shifts. I was allowed to choose my own hours, so I started out doing 12-hour shifts, then had to cut them down to 10-hours so I could study more for boards. By the end of the month, though, I was routinely working 13-14 hour shifts as well as commuting 3 hours back home a couple of times a week. It wears on you.
- I got run off the road in the middle of the night by a cow. It was terrifying. I'm so thankful I was able to avoid actually hitting that enormous thing, and thankful that when I ran off into the adjacent field I didn't hit something or flip or whatever and damage myself or my car. Stupid cow. When I told my coworkers the next day, they were horrified. I guess people die from that. Cows are HUGE.
The Facepalm:
- Sometime during the first month, a patient came in with a dislocated little finger. I stood outside the room as my attending demonstrated on my hand the grip I would take and the vector of my force to put the joint back in place. Sounds normal, right?
I almost passed out.
Joints are a definite weakness of mine. Fluids, fractures, ears, feet - no problem. But joints. Joints fill me with a visceral dread so deep that apparently my body can't handle it, and I start to vasovagal. I didn't even put the finger back in place. I watched, nauseated and weak, as my attending did it for me. I practically had vapors, for goodness' sake. I still can't think too hard about it.
- You know how when you pick up a baby out of a carrier/ carseat, it's normal human impulse to lift the child way up above your head so they laugh and squeal? It's fun and harmless and everyone enjoys it. Unless you don't realise there's a metal lamp hanging above the childseat. I was mortified. Mortified. M-O-R-T-I-F-I-E-D. I can't even tell you. The mother was really nice about it, all, "Oh, babies are tough! He's done way worse to himself so he'll be fine in three minutes!" but it took me a while to stop hyperventilating. What if I knocked his brain about and he lost his ability to enjoy dense poetry before he can even appreciate what he had? What if I slightly malformed his skull so he can't ever have a buzz cut because he'll look funny? What if he grows up with a lamp phobia and never knows why?! Horror!
I mean, I'm sure he's fine.
Conclusion: Man, ER medicine is cool stuff. I'm liking the blood and adrenaline, you guys. And I actually like the small ER I was in, where I could personally keep track of all the patients in the department and know what was going on at all times. It felt more like running things and less like being a little doctor cog in a big hospital machine, and part of the reason I wanted to be a doctor in the first place was to be in charge. And once you get a certain distance outside the big cities, rural ERs see all of the trauma and sickness and craziness that the urban ones do.
Thursday, August 16
Levelling Up - COMLEX
I am still alive.
I am studying for my board exam, which is in -checks desktop countdown- 11 days.
I am buried in lectures and notes and COMBANK questions.
I am still having my career crisis on a weekly basis.
I finished two months of ER a couple of weeks ago and have a half-written post about that, as well as a percolating one about my current month, OMM. And if you don't know what OMM is, I will explain it to you.
In a minimum of 12 days.
Please understand that everything in my life is and has been on hold for about two months now. This is the home stretch. This fall is going to be a very exciting time and I can't wait to share it with you. I just have to get there. And that means going off the grid whilst preparing for this exam, and then lickety-split getting my residency application all put together and shined-up for those Judgy Judgersons, the residency directors and admissions people.
(I'm not serious, residency directors. I'm sure you are all very nice. Please let me into one of your programs.)
Anyway, I will leave you with this teasing snippet that I have only told my closest friends about so far but will expand upon in amusing fashion in my ER post: in July, I almost fainted from something really, really lame.
See you in two weeks.
I am studying for my board exam, which is in -checks desktop countdown- 11 days.
I am buried in lectures and notes and COMBANK questions.
I am still having my career crisis on a weekly basis.
I finished two months of ER a couple of weeks ago and have a half-written post about that, as well as a percolating one about my current month, OMM. And if you don't know what OMM is, I will explain it to you.
In a minimum of 12 days.
Please understand that everything in my life is and has been on hold for about two months now. This is the home stretch. This fall is going to be a very exciting time and I can't wait to share it with you. I just have to get there. And that means going off the grid whilst preparing for this exam, and then lickety-split getting my residency application all put together and shined-up for those Judgy Judgersons, the residency directors and admissions people.
(I'm not serious, residency directors. I'm sure you are all very nice. Please let me into one of your programs.)
Anyway, I will leave you with this teasing snippet that I have only told my closest friends about so far but will expand upon in amusing fashion in my ER post: in July, I almost fainted from something really, really lame.
See you in two weeks.
Wednesday, July 4
So sweet, this surrender
If I could just get a little room to breathe... My exhaustion is at that point where it's a constant ache in my chest. I
can't seem to get a grip on my application for residency, or sorting
out my elective rotations, or studying for boards. It just feels like
there is too much going on and all the deadlines are piled on top of
another and I can't fix any of it because I'm working every day. I have
no idea what I'm doing. Is there a most efficient way to do this? Can
I even get it all done?
I feel most worried about boards because I have to do well, and yet I can feel mediocrity creeping up on me again. I don't remember pressing snooze for that extra half hour this morning but apparently I did, and I really needed that time for studying. Or did I need sleep since my head feels stuffed with cotton?
I don't know.
Save me, God,
for the water has risen to my neck.
I have sunk in deep mud, and there is no footing;
I have come into deep waters,
and a flood sweeps over me.
I am weary from my crying;
my throat is parched.
My eyes fail, looking for my God.
But as for me, Lord,
my prayer to You is for a time of favor.
In Your abundant, faithful love, God,
answer me with Your sure salvation.
Rescue me from the miry mud; don’t let me sink.
Let me be rescued from those who hate me
and from the deep waters.
Don’t let the floodwaters sweep over me
or the deep swallow me up;
don’t let the Pit close its mouth over me.
Answer me, Lord,
for Your faithful love is good;
in keeping with Your great compassion,
turn to me.
O God, you are my God;
I earnestly search for you.
My soul thirsts for you;
my whole body longs for you
in this parched and weary land
where there is no water.
I have seen you in your sanctuary
and gazed upon your power and glory.
Your unfailing love is better than life itself;
how I praise you!
I will praise you as long as I live,
lifting up my hands to you in prayer.
You satisfy me more than the richest feast.
I will praise you with songs of joy.
I lie awake thinking of you,
meditating on you through the night.
I am at rest in God alone;
my salvation comes from Him.
He alone is my rock and my salvation,
my stronghold; I will never be shaken.
I feel most worried about boards because I have to do well, and yet I can feel mediocrity creeping up on me again. I don't remember pressing snooze for that extra half hour this morning but apparently I did, and I really needed that time for studying. Or did I need sleep since my head feels stuffed with cotton?
I don't know.
Save me, God,
for the water has risen to my neck.
I have sunk in deep mud, and there is no footing;
I have come into deep waters,
and a flood sweeps over me.
I am weary from my crying;
my throat is parched.
My eyes fail, looking for my God.
But as for me, Lord,
my prayer to You is for a time of favor.
In Your abundant, faithful love, God,
answer me with Your sure salvation.
Rescue me from the miry mud; don’t let me sink.
Let me be rescued from those who hate me
and from the deep waters.
Don’t let the floodwaters sweep over me
or the deep swallow me up;
don’t let the Pit close its mouth over me.
Answer me, Lord,
for Your faithful love is good;
in keeping with Your great compassion,
turn to me.
O God, you are my God;
I earnestly search for you.
My soul thirsts for you;
my whole body longs for you
in this parched and weary land
where there is no water.
I have seen you in your sanctuary
and gazed upon your power and glory.
Your unfailing love is better than life itself;
how I praise you!
I will praise you as long as I live,
lifting up my hands to you in prayer.
You satisfy me more than the richest feast.
I will praise you with songs of joy.
I lie awake thinking of you,
meditating on you through the night.
I am at rest in God alone;
my salvation comes from Him.
He alone is my rock and my salvation,
my stronghold; I will never be shaken.
Monday, June 18
Lord, please keep me righteous.
A few days ago, as I was leaving work, one of the paramedics shouted out, "And where do you think you're going?" I responded, "To bed! My shift is over! You don't pay me enough to keep me here!" She laughed and I went on my way.
As I walked into my room, though, I was feeling so unsettled I stopped dead in the doorway to ask myself what was wrong. It took a bit of searching but I finally figured out it was that parting remark that so aggravated my conscience. It's not that it was a particularly mean or rude response. It fit the conversation. The problem is that I didn't mean it.
I would say that if left to myself, it's fairly hard to get me mad or move me to cynicism when it comes to patients. I don't get stressed out by high patient loads; I just start chugging away at the list. I'm not likely to get dramatic about bad smells or low IQs or nasty feet. I would say my professional demeanor is fairly warm and unruffled. But if I have one flaw that I have struggled with consistently throughout medical school, it is that I am easily influenced by negativity specifically. It's quite a weakness when you think about it. It means that when people around me are stressed, irritated, bitter, burnt out, or just being big bloody divas, I often get caught up in it even if that's not how I would feel if left to myself. It's actually terrible. I'm ashamed of it to the point that I almost didn't write this post.
The night this happened, everyone else had spent the shift irritated with how busy the ER had been. I'd been enjoying myself for the most part, but conversation centered around, "AGH why won't people stop coming in" and "Someone shoot me now" and "I can't wait to get out of here. CAN'T WAIT." I think I soaked that up and gave it right back, which is so dumb. And it's even more dumb because I believe all of that was just crap. Just talk. The people I'm working with like their jobs, so why the pissed off chit-chat?
God is keeping me on this planet to be a light to others - to be a living example of the transformative power, the freedom and joy, of walking with Christ. And yet, I struggle daily against what is essentially the pack mentality, emotional peer pressure, assimilation by the Borg. And among medical people, the collective mindset is quite frankly poisonous. It's critical, irritable, jaded, sarcastic almost to the point of viciousness, hardhearted, and unhappy. It has dehumanizing them-vs.-us undertones, where patients are the opposing team. Logically I get it; this is the underbelly of the mental pickiness necessary to be good at medicine and the distance we have to maintain so we can see sad/ traumatic things every day. But that does not make it okay.
Another giant problem that arises in medicine concerns gossip. I know everyone everywhere struggles with it. But medicine is one of the few places I can think of besides police work where your work is directly concerned with people's dirty secrets (and also just their general dirtiness). That means the line between sharing information and gossip is even thinner, and most medical personnel I've met don't even try to walk it because the information is so juicy. Conversations segue straight from, "So her exam was pretty normal despite her insistence that she was in pain," to, "She was such a jerk to me! And she smelled! And did you see her teeth? Ew!" The issue is that pain, combativeness, malodorousness, and poor dentition can all be appropriate parts of a discussion regarding medical care, but they can all also be poisonous gossip that hurts not only the patient, but the gossiper.
I don't know exactly how to handle that yet. In college I got pretty good at asking people to stop gossiping around me, but that was when I worked in retail, where it was blatantly obvious that we had no business discussing such things. In medicine it can be difficult to pin people down, and as humans we will always get defensive when our sins are pointed out to us. I wonder if it will be easier for me when I am a doctor and thus have some official and some unofficial authority; I've seen how often the doctor unconsciously sets the working atmosphere. At the same time, though, I know that the Lord does not rely on earthly authority when it comes to people keeping each other righteous. I technically have all the authority I need right now.
I just need to let Christ make me bold about what is true.
As I walked into my room, though, I was feeling so unsettled I stopped dead in the doorway to ask myself what was wrong. It took a bit of searching but I finally figured out it was that parting remark that so aggravated my conscience. It's not that it was a particularly mean or rude response. It fit the conversation. The problem is that I didn't mean it.
I would say that if left to myself, it's fairly hard to get me mad or move me to cynicism when it comes to patients. I don't get stressed out by high patient loads; I just start chugging away at the list. I'm not likely to get dramatic about bad smells or low IQs or nasty feet. I would say my professional demeanor is fairly warm and unruffled. But if I have one flaw that I have struggled with consistently throughout medical school, it is that I am easily influenced by negativity specifically. It's quite a weakness when you think about it. It means that when people around me are stressed, irritated, bitter, burnt out, or just being big bloody divas, I often get caught up in it even if that's not how I would feel if left to myself. It's actually terrible. I'm ashamed of it to the point that I almost didn't write this post.
The night this happened, everyone else had spent the shift irritated with how busy the ER had been. I'd been enjoying myself for the most part, but conversation centered around, "AGH why won't people stop coming in" and "Someone shoot me now" and "I can't wait to get out of here. CAN'T WAIT." I think I soaked that up and gave it right back, which is so dumb. And it's even more dumb because I believe all of that was just crap. Just talk. The people I'm working with like their jobs, so why the pissed off chit-chat?
God is keeping me on this planet to be a light to others - to be a living example of the transformative power, the freedom and joy, of walking with Christ. And yet, I struggle daily against what is essentially the pack mentality, emotional peer pressure, assimilation by the Borg. And among medical people, the collective mindset is quite frankly poisonous. It's critical, irritable, jaded, sarcastic almost to the point of viciousness, hardhearted, and unhappy. It has dehumanizing them-vs.-us undertones, where patients are the opposing team. Logically I get it; this is the underbelly of the mental pickiness necessary to be good at medicine and the distance we have to maintain so we can see sad/ traumatic things every day. But that does not make it okay.
Another giant problem that arises in medicine concerns gossip. I know everyone everywhere struggles with it. But medicine is one of the few places I can think of besides police work where your work is directly concerned with people's dirty secrets (and also just their general dirtiness). That means the line between sharing information and gossip is even thinner, and most medical personnel I've met don't even try to walk it because the information is so juicy. Conversations segue straight from, "So her exam was pretty normal despite her insistence that she was in pain," to, "She was such a jerk to me! And she smelled! And did you see her teeth? Ew!" The issue is that pain, combativeness, malodorousness, and poor dentition can all be appropriate parts of a discussion regarding medical care, but they can all also be poisonous gossip that hurts not only the patient, but the gossiper.
I don't know exactly how to handle that yet. In college I got pretty good at asking people to stop gossiping around me, but that was when I worked in retail, where it was blatantly obvious that we had no business discussing such things. In medicine it can be difficult to pin people down, and as humans we will always get defensive when our sins are pointed out to us. I wonder if it will be easier for me when I am a doctor and thus have some official and some unofficial authority; I've seen how often the doctor unconsciously sets the working atmosphere. At the same time, though, I know that the Lord does not rely on earthly authority when it comes to people keeping each other righteous. I technically have all the authority I need right now.
I just need to let Christ make me bold about what is true.
Friday, May 25
Putting A Bow on Third Year
I'm on vacation this month. It's pretty sweet. I can tell it's been a proper vacation because I'm starting to miss work. Seeing patients, having structure, using my brain... it will be nice to get back to it. That said, I have almost two weeks left of time off, and I intend to enjoy them.
I was looking back over the posts I've made this last year and I realised, with a quick flash of guilt, that there are some key months I didn't write about. In fact, there are some months I specifically said I'd write about that I then never wrote about. Clearly, I am untrustworthy. But to show you that I am capable of trying to make amends well after it matters, here is a quick rundown of The Months I Missed!
THE MONTHS I MISSED
September, family practice clinic: My attending worked like a dog. And he had cancer. Which meant I worked like a dog while he tried to work and often failed and sat in a chair with his head down, breathing deeply. I was constantly worried about what would happen when he collapsed. He gave a lot of steroid shots. Pros: I got comfortable with autonomy and learned how to give knee injections. Cons: none. JUST KIDDING MY ATTENDING HAD CANCER. You try watching a cancer patient work three jobs with a chemo pump on while he's almost too weak to stand and see what happens to your blood pressure.
(He's fine now.)
December, surgery: I know, I know. How could I haven forgotten to write about surgery? I don't really know, because it was a very post-worthy month, seeing as how I hate surgery and surgery hates me. Not the people; they're just fine. But the actual job. Do you know how many times I almost collapsed during laparoscopic surgeries because I was falling asleep? How many times people had to send me back to rescrub because I left my wedding ring on/ my hands were too high/ my hands were too low/ my elbows were touching my sides? (Side note: my elbows were touching my sides. Well, I promise not to rest my elbows on the surgical field, then - I mean, I was planning on it, but now that they're tainted and all.)
And then there's the wound care. (Look up "chronic wound debridement" on an image search if you are brave and would like a visual.) Keep in mind that I love abscesses and acute injuries. I could lance infected wounds all day, go home smiling, and eat a casserole for dinner. So. When I tell you that cleaning/ debriding a chronic wound gives me uncontrollable full body shudders, it should give you an idea of how very much I should not do that job. I could go on, but hopefully I've already accomplished my mission and put you off your food and we can all stop thinking about this now.
Pros: I know without a doubt how to scrub in now, and they managed to beat the basics of sterile procedure into my brain. Apparently that's important. Cons: CHRONIC WOUNDS. NEVER AGAIN. Except probably again. They're a difficult thing to avoid. Also, I learned I am physically incapable of getting up before 0530. I was late to work every day that month. Every. Day.
February, pulmonology: I got to see why people in internal medicine like to specialise. It's because as a specialist you get time to stop and think while making boatloads of money, and you get to do procedures. If I didn't think -oscopies were boring (from bronchi to bladders, if you have a tube or a space, we can stick a camera up/down/into it), and I didn't think 3 years of internal medicine residency would break me, I would consider specialising in something. Seems like a nice life. Pros: learning the basics of ventilator settings and a little ICU medicine. Actually, learning period. My attending this month wasn't the sweetest man, but he was a bloody good teacher, and that's more important. He didn't load us down with scut work, so we could actually use our brains instead of tearing through paperwork as fast as possible to get it finished in time. Cons: I'm really not built for a subspecialty. If pulmonology is any indication, you learn about one small field in extremely thorough and technical detail, you use a lot of gadgets, and you avoid getting anywhere near chest compressions. I'm a jack-of-all-trades, big-picture kind of lady. Also a chest compressions kind of lady. I probably won't become an -ologist.
March, family practice: Family practice is nice. We're all aware that I struggle with family medicine vs. emergency medicine, so the fact that I liked this month is no surprise. I do know that clinic is a place where I struggle spiritually, because it's so easy to get lulled into the rhythm of paperwork, timed visits, and mild complaints. I have trouble staying sensitive to what the Lord might ask His servant to do day-to-day. I don't know. It was a good month and a good way to cap off the year.
~~~
Overall, I loved third year. I finally feel like I am being trained to be a doctor and it's thrilling. That's probably a really naive-sounding thing to say, but guess what? I'm not ashamed that my third year was awesome! And I am deeply hopeful that fourth year will be similarly challenging and exasperating and bizarre and intense and fun. Especially because my husband's back now. Everything's better when he's home.
I was looking back over the posts I've made this last year and I realised, with a quick flash of guilt, that there are some key months I didn't write about. In fact, there are some months I specifically said I'd write about that I then never wrote about. Clearly, I am untrustworthy. But to show you that I am capable of trying to make amends well after it matters, here is a quick rundown of The Months I Missed!
THE MONTHS I MISSED
September, family practice clinic: My attending worked like a dog. And he had cancer. Which meant I worked like a dog while he tried to work and often failed and sat in a chair with his head down, breathing deeply. I was constantly worried about what would happen when he collapsed. He gave a lot of steroid shots. Pros: I got comfortable with autonomy and learned how to give knee injections. Cons: none. JUST KIDDING MY ATTENDING HAD CANCER. You try watching a cancer patient work three jobs with a chemo pump on while he's almost too weak to stand and see what happens to your blood pressure.
(He's fine now.)
December, surgery: I know, I know. How could I haven forgotten to write about surgery? I don't really know, because it was a very post-worthy month, seeing as how I hate surgery and surgery hates me. Not the people; they're just fine. But the actual job. Do you know how many times I almost collapsed during laparoscopic surgeries because I was falling asleep? How many times people had to send me back to rescrub because I left my wedding ring on/ my hands were too high/ my hands were too low/ my elbows were touching my sides? (Side note: my elbows were touching my sides. Well, I promise not to rest my elbows on the surgical field, then - I mean, I was planning on it, but now that they're tainted and all.)
And then there's the wound care. (Look up "chronic wound debridement" on an image search if you are brave and would like a visual.) Keep in mind that I love abscesses and acute injuries. I could lance infected wounds all day, go home smiling, and eat a casserole for dinner. So. When I tell you that cleaning/ debriding a chronic wound gives me uncontrollable full body shudders, it should give you an idea of how very much I should not do that job. I could go on, but hopefully I've already accomplished my mission and put you off your food and we can all stop thinking about this now.
Pros: I know without a doubt how to scrub in now, and they managed to beat the basics of sterile procedure into my brain. Apparently that's important. Cons: CHRONIC WOUNDS. NEVER AGAIN. Except probably again. They're a difficult thing to avoid. Also, I learned I am physically incapable of getting up before 0530. I was late to work every day that month. Every. Day.
February, pulmonology: I got to see why people in internal medicine like to specialise. It's because as a specialist you get time to stop and think while making boatloads of money, and you get to do procedures. If I didn't think -oscopies were boring (from bronchi to bladders, if you have a tube or a space, we can stick a camera up/down/into it), and I didn't think 3 years of internal medicine residency would break me, I would consider specialising in something. Seems like a nice life. Pros: learning the basics of ventilator settings and a little ICU medicine. Actually, learning period. My attending this month wasn't the sweetest man, but he was a bloody good teacher, and that's more important. He didn't load us down with scut work, so we could actually use our brains instead of tearing through paperwork as fast as possible to get it finished in time. Cons: I'm really not built for a subspecialty. If pulmonology is any indication, you learn about one small field in extremely thorough and technical detail, you use a lot of gadgets, and you avoid getting anywhere near chest compressions. I'm a jack-of-all-trades, big-picture kind of lady. Also a chest compressions kind of lady. I probably won't become an -ologist.
March, family practice: Family practice is nice. We're all aware that I struggle with family medicine vs. emergency medicine, so the fact that I liked this month is no surprise. I do know that clinic is a place where I struggle spiritually, because it's so easy to get lulled into the rhythm of paperwork, timed visits, and mild complaints. I have trouble staying sensitive to what the Lord might ask His servant to do day-to-day. I don't know. It was a good month and a good way to cap off the year.
~~~
Overall, I loved third year. I finally feel like I am being trained to be a doctor and it's thrilling. That's probably a really naive-sounding thing to say, but guess what? I'm not ashamed that my third year was awesome! And I am deeply hopeful that fourth year will be similarly challenging and exasperating and bizarre and intense and fun. Especially because my husband's back now. Everything's better when he's home.
Saturday, May 5
How I Learned To Stop Worrying And Love Kids For Short Periods Of Time, or, April: Pediatrics
I have a long and storied history of detesting children. They are loud, messy, stubborn creatures whose apparent sole intent is to overwhelm you with snot, poop, and really loud screams. For most of my life to date I have studiously avoided them and certainly have never understood why anyone would choose to spend time around them. This year, the Lord decided to change that.
The first step was when my really good friends started having kids. To be around my friends, I had to be around their (surely) loud, messy, poopy, screaming children. And despite myself I realised... babies maybe are not always terrible to be around. And they can be sort of cute. At times. And maybe they are cuddly when they're not crying. And sometimes when you look into their big, trusting eyes, you see the future and blah blah blah they're nice, okay?
You can imagine how horrified I was to find out that I like babies. But kids, I thought. Certainly kids are still irritating and stressful and zero units of fun. So it was with a certain amount of trepidation that I entered my last third year rotation.
My school gives students a mixture of outpatient and inpatient pediatrics, which is nice because it gives you greater exposure while still allowing you to get familiar with things like pediatric vital signs, lab values, most common diseases/ infections, etc. And of course you see all ages. So I had good opportunity to learn some things:
- Children get constipated a lot. Like, a lot. And they also get a lot of diarrhea. Yet another similarity between elderly people and the very young: it's all about the poop.
- There is way too much asthma and obesity in our country.
- Pediatricians are vastly undercompensated given how hard they work and how valuable their services are. And yet they're pretty cool people to be around. Pediatricians like their jobs and like their patients, and now that I've seen both ends of that spectrum I know how much of a difference liking one's life makes to the kind of care patients receive.
- Sometimes, a toddler on sildenafil for his lungs is going to stare at you, slowly undo his diaper, and grab his penis.
- FINE I ADMIT IT. Kids are funny and fun. And exhausting. And they do scream and poop a lot, and sometimes cough RSV into your face. Somehow this does not negate how fun they are.
The Lord showed me part of what all of this was for recently. I have been praying about where to serve in my church, trying a few different areas and just feeling like God was closing doors in my face. Youth? No. Bible study leader? Not yet, at least. Worship? Surprisingly, no. Finally I accepted what the Lord has been trying to tell me for a while but I didn't have the strength to acknowledge: for now at least, my way to help at church is with the little kids. So I signed up. And I love it, because kids are fun.
(And because their parents come and take them away at the end of the morning.)
The first step was when my really good friends started having kids. To be around my friends, I had to be around their (surely) loud, messy, poopy, screaming children. And despite myself I realised... babies maybe are not always terrible to be around. And they can be sort of cute. At times. And maybe they are cuddly when they're not crying. And sometimes when you look into their big, trusting eyes, you see the future and blah blah blah they're nice, okay?
You can imagine how horrified I was to find out that I like babies. But kids, I thought. Certainly kids are still irritating and stressful and zero units of fun. So it was with a certain amount of trepidation that I entered my last third year rotation.
My school gives students a mixture of outpatient and inpatient pediatrics, which is nice because it gives you greater exposure while still allowing you to get familiar with things like pediatric vital signs, lab values, most common diseases/ infections, etc. And of course you see all ages. So I had good opportunity to learn some things:
- Children get constipated a lot. Like, a lot. And they also get a lot of diarrhea. Yet another similarity between elderly people and the very young: it's all about the poop.
- There is way too much asthma and obesity in our country.
- Pediatricians are vastly undercompensated given how hard they work and how valuable their services are. And yet they're pretty cool people to be around. Pediatricians like their jobs and like their patients, and now that I've seen both ends of that spectrum I know how much of a difference liking one's life makes to the kind of care patients receive.
- Sometimes, a toddler on sildenafil for his lungs is going to stare at you, slowly undo his diaper, and grab his penis.
- FINE I ADMIT IT. Kids are funny and fun. And exhausting. And they do scream and poop a lot, and sometimes cough RSV into your face. Somehow this does not negate how fun they are.
The Lord showed me part of what all of this was for recently. I have been praying about where to serve in my church, trying a few different areas and just feeling like God was closing doors in my face. Youth? No. Bible study leader? Not yet, at least. Worship? Surprisingly, no. Finally I accepted what the Lord has been trying to tell me for a while but I didn't have the strength to acknowledge: for now at least, my way to help at church is with the little kids. So I signed up. And I love it, because kids are fun.
(And because their parents come and take them away at the end of the morning.)
Sunday, March 25
The New Old Normal, or, Sometimes I Am Very Foolish
Okay so Matt is home. And it's wonderful. It's wonderful to see him, to wake up beside him, to have good conversations with a sane person face to face. A deeper sense of peace has yet to settle in, though; I'm instead getting little fragments of the realisation that he doesn't have to leave again. Like: I am working in the hospital this week, yet he will be here. I associate the hospital with loneliness, but I don't have to anymore. Maybe never again. Or: I will have to continue to buy groceries for two people. Or: I don't have to buy groceries by myself anymore! Understanding that there is now a second person in my life is such a complex process that I can't even force it - it's all situational. I can't have the thoughts about groceries before actually going and getting groceries and thinking, "What would Matt like?" and then feeling shock.
But whatever. I dig it.
What I do not dig is giving up my space. Yeah, I said it. And I know that is totally selfish. I'm working on it - it's only been a week! - and I'm not suggesting I deserve any sympathy. But literally the only pleasure in living by myself the last year was having whatever schedule/ routine I wanted and always doing things my way. Now I have to, like, share the Xbox. And not turn on the closet light in the morning because that would throw light directly on Matt's face, and no one should wake up at 6 if they don't have to. Or if Matt opens something in the kitchen in a way I wouldn't, then a short while later leaves a light on, then doesn't answer a phone call because he doesn't feel like it - crap like that is undeniably petty, but nevertheless frequently builds up to the point where I need to take a moment and consciously untense my shoulders. I'm not used to noise. I'm not used to dishes I haven't dirtied or a towel being wet before I try to use it. I'm not used to asking someone else if they would like to do the thing I would like to do. Amazing how I didn't even realise I was getting used to all of this, yet clearly I was.
I mean, I'm an idiot. I'm being a total idiot when stuff like that gets to me. I know. And the majority of the time I look at him and am overwhelmed with gratitude to God that He brought Matt through the deployment and back home. I have this sense that despite all the changes that I went through in the last year, my life was nevertheless mostly in a holding pattern, and now Matt and I can Get Back To It. That's exhilarating.
I just have to relearn how to compromise. And hopefully stop being addicted to chocolate. But more on that later.
But whatever. I dig it.
What I do not dig is giving up my space. Yeah, I said it. And I know that is totally selfish. I'm working on it - it's only been a week! - and I'm not suggesting I deserve any sympathy. But literally the only pleasure in living by myself the last year was having whatever schedule/ routine I wanted and always doing things my way. Now I have to, like, share the Xbox. And not turn on the closet light in the morning because that would throw light directly on Matt's face, and no one should wake up at 6 if they don't have to. Or if Matt opens something in the kitchen in a way I wouldn't, then a short while later leaves a light on, then doesn't answer a phone call because he doesn't feel like it - crap like that is undeniably petty, but nevertheless frequently builds up to the point where I need to take a moment and consciously untense my shoulders. I'm not used to noise. I'm not used to dishes I haven't dirtied or a towel being wet before I try to use it. I'm not used to asking someone else if they would like to do the thing I would like to do. Amazing how I didn't even realise I was getting used to all of this, yet clearly I was.
I mean, I'm an idiot. I'm being a total idiot when stuff like that gets to me. I know. And the majority of the time I look at him and am overwhelmed with gratitude to God that He brought Matt through the deployment and back home. I have this sense that despite all the changes that I went through in the last year, my life was nevertheless mostly in a holding pattern, and now Matt and I can Get Back To It. That's exhilarating.
I just have to relearn how to compromise. And hopefully stop being addicted to chocolate. But more on that later.
Wednesday, February 1
Wrong Place, Wrong Time, or, January: Internal Medicine
I think my month in Internal Medicine will be forever coloured by this last week - incidentally the last gasps of the rotation - starting with Saturday.
It had been a hard week with a high patient load, so I launched into my last weekend working the general floors with perhaps an overabundance of enthusiasm. It was going to be a good day, I was going to see all my patients quickly and well, and things were going to present no problems. It was 7am on a beautiful morning.
Cut to lunch, where I was trying to sip at a cup of soup that was too hot while talking to my husband, except the call kept getting dropped somewhere in the Atlantic or in space. The morning, despite my resolve, had gone anything but smoothly. It involved: patients being jerks, patients taking out their frustrations on me, patients telling me they hoped Jesus forgave me for what I was doing to them, etc. Every visit had taken twice as much time as it should have. There's something about people you are helping being mean to you, one after the other, for hours, that wears out a very particular part of you, and I was worn out. But it was not my turn to stay late that day, and all I wanted to do was eat some calories and GO HOME.
So of course I was asked to stop eating and go and help one of the students from the other IM team do a history and physical down in the ER. I stared at the asker blankly. First of all, we have two internal medicine teams at my hospital, and they don't share work. Ever. I would go so far as to say that is the point. Second of all, no one needs help on an H&P - it's a one-person job. There's no way to speed it up or spread out the work.
There was a moment of silent communication. You know, the kind that isn't really socially appropriate. My eyes said, you're really doing this to me? And her eyes said, absolutely, and don't think you can finish eating, either, because I mean right now. And my eyes said, you know I've had a bad day, right? And her eyes said, I work in internal medicine so every day is a bad day and right now I need to spread the wealth; you'll do.*
Of course I said yes, dumped my soup, and went down to the ER. She'd only given me the patient's first name (I'd forgotten to ask for more) so I couldn't find the patient. Five minutes later my classmate walked up with the completed H&P and a text from his boss saying, Oh hey The Zoe doesn't have to help you anymore.
I went home posthaste. Horrible hospital. Horrible patients. I dragged myself into work the next morning with zero units of motivation and zero units of hope. Because I just knew it was going to be another bad day.
And I was totally right. Well, I was wrong, but I was right; the patients were somewhat better, but that afternoon I came down with a rip-roaring GI virus. I had vomiting and diarrhea every 10-15 minutes for eight hours, at which point I couldn't really walk very well and my friend rightly got scared and took me to the ER for IV fluids. (That friend took care of me for two days straight. I am so grateful.)
I think the virus is gone now. But I had no idea that your body is weak and miscalibrated for days after something like that. I don't remember Monday because I was sleeping the deep, wonderful sleep of phenergan. Tuesday I miserably worked half a day, got sneered at by more terrible patients, gave up, and went home early to have a coma. Today, the same (minus the terrible patients - I started a new rotation).
So whatever else I did or learned this month, all I can think of is the last five days. And the last five days sucked.
Lessons:
1. Living by yourself sucks! Especially when you get sick.
2. Despite IM getting to see all the really cool diseases, I can't deal with seeing the same mean people every day and being forced to care about their bowel movements. Thus, I am not an internal medicine doctor.
3. My prayer has changed over completely from, "Lord, help me love my patients" to "Lord, love my patients through me." Because my love runs out too quickly, and despite my best intentions, it comes with strings. Be nice to me. Accept my help graciously. Use deodorant sometimes because you live in a first world country and you are not that sick, you are just being lazy. People need far more than I can give. But the Lord's love is endless and perfect and patient. How much better for everyone around me than the imperfect crumbs that I have.
Next up: pulmonology. Whatever that is.
*This person is very nice, so probably it didn't go like this on her side. And since she is an IM doctor she probably likes IM. Probably she would tell you her eyes went, Please just help out for the common good. And my eyes went, No, you're not on my team and I don't like helping people and also I hate you. And her eyes went, I really don't want to have to force this on you but I have 3000 things to do so just do your job so I can do mine. And my eyes went, I'm on the phone and don't want to do any more work and DON'T YOU SEE I HAVE SOUP. And her eyes went, just do it and stop being a snotty medical student. And my eyes went, fine but I'm not cleaning my room and you can't make me.
It had been a hard week with a high patient load, so I launched into my last weekend working the general floors with perhaps an overabundance of enthusiasm. It was going to be a good day, I was going to see all my patients quickly and well, and things were going to present no problems. It was 7am on a beautiful morning.
Cut to lunch, where I was trying to sip at a cup of soup that was too hot while talking to my husband, except the call kept getting dropped somewhere in the Atlantic or in space. The morning, despite my resolve, had gone anything but smoothly. It involved: patients being jerks, patients taking out their frustrations on me, patients telling me they hoped Jesus forgave me for what I was doing to them, etc. Every visit had taken twice as much time as it should have. There's something about people you are helping being mean to you, one after the other, for hours, that wears out a very particular part of you, and I was worn out. But it was not my turn to stay late that day, and all I wanted to do was eat some calories and GO HOME.
So of course I was asked to stop eating and go and help one of the students from the other IM team do a history and physical down in the ER. I stared at the asker blankly. First of all, we have two internal medicine teams at my hospital, and they don't share work. Ever. I would go so far as to say that is the point. Second of all, no one needs help on an H&P - it's a one-person job. There's no way to speed it up or spread out the work.
There was a moment of silent communication. You know, the kind that isn't really socially appropriate. My eyes said, you're really doing this to me? And her eyes said, absolutely, and don't think you can finish eating, either, because I mean right now. And my eyes said, you know I've had a bad day, right? And her eyes said, I work in internal medicine so every day is a bad day and right now I need to spread the wealth; you'll do.*
Of course I said yes, dumped my soup, and went down to the ER. She'd only given me the patient's first name (I'd forgotten to ask for more) so I couldn't find the patient. Five minutes later my classmate walked up with the completed H&P and a text from his boss saying, Oh hey The Zoe doesn't have to help you anymore.
I went home posthaste. Horrible hospital. Horrible patients. I dragged myself into work the next morning with zero units of motivation and zero units of hope. Because I just knew it was going to be another bad day.
And I was totally right. Well, I was wrong, but I was right; the patients were somewhat better, but that afternoon I came down with a rip-roaring GI virus. I had vomiting and diarrhea every 10-15 minutes for eight hours, at which point I couldn't really walk very well and my friend rightly got scared and took me to the ER for IV fluids. (That friend took care of me for two days straight. I am so grateful.)
I think the virus is gone now. But I had no idea that your body is weak and miscalibrated for days after something like that. I don't remember Monday because I was sleeping the deep, wonderful sleep of phenergan. Tuesday I miserably worked half a day, got sneered at by more terrible patients, gave up, and went home early to have a coma. Today, the same (minus the terrible patients - I started a new rotation).
So whatever else I did or learned this month, all I can think of is the last five days. And the last five days sucked.
Lessons:
1. Living by yourself sucks! Especially when you get sick.
2. Despite IM getting to see all the really cool diseases, I can't deal with seeing the same mean people every day and being forced to care about their bowel movements. Thus, I am not an internal medicine doctor.
3. My prayer has changed over completely from, "Lord, help me love my patients" to "Lord, love my patients through me." Because my love runs out too quickly, and despite my best intentions, it comes with strings. Be nice to me. Accept my help graciously. Use deodorant sometimes because you live in a first world country and you are not that sick, you are just being lazy. People need far more than I can give. But the Lord's love is endless and perfect and patient. How much better for everyone around me than the imperfect crumbs that I have.
Next up: pulmonology. Whatever that is.
*This person is very nice, so probably it didn't go like this on her side. And since she is an IM doctor she probably likes IM. Probably she would tell you her eyes went, Please just help out for the common good. And my eyes went, No, you're not on my team and I don't like helping people and also I hate you. And her eyes went, I really don't want to have to force this on you but I have 3000 things to do so just do your job so I can do mine. And my eyes went, I'm on the phone and don't want to do any more work and DON'T YOU SEE I HAVE SOUP. And her eyes went, just do it and stop being a snotty medical student. And my eyes went, fine but I'm not cleaning my room and you can't make me.
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