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.