Saturday, June 11, 2011

Looking Forward to Monday


I've thought about writing all week and while it's been a good week, my best in recent memory, it's also been a long one and I'm glad today is Saturday. Admittedly, my weariness can be traced, in part, to the distance I'm driving, nearly fifty miles from farm to hospital parking lot. In itself, that's really not a big deal. The landscape is pretty, the traffic minimal, and there are zero speed traps, but it's another couple of hours tacked onto an already busy schedule. There's student housing on site -- taking advantage of it, however, means not coming home in the evenings to find the dogs and cat waiting at the door. I'll take the drive.

The days themselves are fast and furious. My attending is known for the rate at which his long legs propel him down the hallways; I find that refreshing since mine do similarly.
We go from patient to unit, upstairs, down and back, crisscrossing St. Mary's as though Guinness is timing our attempt to set a land speed record. With luck, I'll arrive at mid-July having shed those five stubborn pounds I've been working on the past few months.

The very best part of this rotation is waking up every morning, even if it's been a short night, with the anticipation of being scarcely able to wait until I get to the hospital. Walking onto the psych unit on Monday was everything I'd hoped it would be. The staff was cheerful and friendly and the routine as comfortable as a well-worn and obviously well-loved pair of Sketcher Shape-Ups (the best all-round footwear for the hospital, in my humble opinion). By the time my cohort, another medical student whom I've known from school, and I finished our tour of the premises, I was so charged if they'd plugged me into a light socket I could have powered the unit for a week.

One thing I've discovered in previous rotations, was how much I actually enjoy physical medicine. I think I may have mentioned how concerned I was when beginning medical school, that things might not turn out that way. Based on experience I knew I loved psychiatry but had nothing comparable when it came to listening to hearts, lungs, or palpating prostate glands. In particular, my rotation in pediatrics had me wondering if I hadn't misread my calling. My first morning in psychiatry, the clouds parted, the sun was shining through, and I swear I heard a heavenly choir under the direction of John Denver singing, "Hey, it's good to be back home again..."

It wasn't just the familiarity, though, it was the atmosphere, the sense that this was the here where I'd always belonged. A dear friend of mine struggling with choosing between psychiatry and internal medicine for residency, got it right when she said, she wasn't ready to hang up her stethoscope, like Gary Cooper hanging up his guns and riding off into the sunset with Grace Kelly in High Noon (1952). Physical medicine is where her heart lies and once a person finds that place, it's time to stake their claim. For me, nowhere else have I been even as remotely happy as I've been the past week. I am so looking forward to Monday.

Yesterday, while chatting with an internist on the chemical dependency unit, I used the phrase, "our patients," referring to the ones my preceptor and I have been working with. On strictly medical rotations, I've always tended to think of patients as under the care of my attending while I tag along, wearing shoes too big for me to fill. Yesterday, rounding on my own, I knew I had something of my own to offer, something I'd made my own by hours and days, weeks and months of hard work, and my shoes were a perfect fit. That, I can tell you, is an incredibly good feeling, indeed.


(Creative Commons image "Line Study at St. Mary's (Lewiston ME)" by Jody Roberts via Flikr)

6 comments:

  1. Thanks! It's a learning experience on a lot of levels and like all good rotations, self-discovery is one of them. :-)

    ReplyDelete
  2. i really liked this particular post, especially when you referenced a friend who was torn between psychiatry and internal medicine. i too am drawn to psychiatry, but while i truly enjoyed my six weeks at st mary's, i felt naked without my trusty stethoscope draped over my shoulders. thus i too am choosing a specialty that allows me to do physical medicine.

    ReplyDelete
  3. Thanks RH, I appreciate it! I think we're entering an era or maybe we've been in one for a long time and didn't know it, where psychiatry is wedded to physical medicine in ways it conveniently used to ignore. The more we learn about the effects of clinical disease on mood, thinking, and behavior, as well as the integrative principle of the mind-body interface, the more we're going to realize how much psychiatry is "real" medicine.

    ReplyDelete
  4. Beggar, I agree that psychiatry is fast becoming more based in physical medicine as science is able to catch up to hypotheses that have been around for quite a while. Another contributing factor, I think, is that I have a pretty extensive psych history myself, and sometimes it hits too close to home for me to take care of some of the psych patients. My familiarity with some of their ailments makes it difficult to be objective, and probably causes me to give them sub-optimal care.

    That and I love doing physical exams. Love, love, love it. Especially abdominal exams.

    ReplyDelete
  5. RH, when I was doing my psychotherapy internship, one of the psych residents in our program told me my phobia for getting injections would make me a more empathetic doctor when I had to give them! He was right -- I was always more concerned about hurting my patients when giving injections during my rural medicine rotation than they were about being hurt. What it really comes down to, I think, is discovering where we feel most comfortable and where we feel happiest. Everything else is secondary because we're going to be lousy practitioners if we're not happy with our choices. I feel the same way you do about physical exams when performing psychiatric ones -- that's not to say I don't enjoy doing physicals, because I do, but I enjoy them more when they're part of a psychiatric exam. :-)

    ReplyDelete

Related Posts Plugin for WordPress, Blogger...