General Medicine

Woah, where did November go?! Suddenly its December. What happened?!

November was a month filled with general medicine, and December is pretty much the same. I've seen some interesting cases.

Currently on my service are several metastatic colon cancer patients, a few of which we just diagnosed. It can be really frustrating for results to finalize during the holidays; the hospital runs at a bare minimum, only patients with urgent/emergent needs are given priority. So I've been waiting for some results to come up for my patients for a super long time over Thanksgiving. I myself feel anxious about it, even though I am fairly certain of what the results are going to show. I can't imagine how anxious my patients must feel.

Today I sat down and gave the "bad news" talk with a patient and her family. I think most people are in tune with physicians and our work up that they expect the news when they hear it, at least to a small extent. This is especially true if the physicians take time to explain why we are ordering each test we order. For example, if a patient's hemoglobin is low and they are found to be iron deficient and have blood in their stool, we have a high suspician for colon cancer...so we consult GI and get an endoscopy. The patients are aware of why we are doing these things - to rule out colon cancer - so the idea that the diagnosis of cancer is a possibility is there from the start. This makes things a little less unexpected when the report comes back as a mass and biopsy results are pending. Not that it makes hearing that diagnosis any easier, but at least it allows a bit of mental preparation for the patients. Nothing is worse than explaining a poor diagnosis on someone who is completely not suspecting it. That's how I feel anyway...which is probably why I hate strokes and heart attacks and car accidents so much - there's simply no way to prepare for it. We all know we have a chance of those things happening, but no one actually believes it will happen to them. And it is so tragic when it does. But at least for these things, like working up a mass, the patient has time to think about the potential diagnoses and isn't as shocked by the results.

I'm starting to get used to being a doctor. I properly feel like I'm a physician. Once in a while, I am surprised by how quickly I can answer questions or how much I actually know. Believe me, this isn't knowledge that I'm gaining by studying and reading; this is the knowledge and experience I'm getting from working all day every day for the past 5 months. As much as the time commitment can be a drag, there really is no way around it if you want to make good physicians. We've got to be there to experience it all before we're given our wings and allowed to practice medicine without any sort of supervision!

Wednesday is the day when the third year medicine residents will find out if an where they matched into fellowship programs. What an exciting day! Two years from now that will be me...waiting to find out if I matched into an oncology program and where I will spend the next 2-3 years of my continued training...Absolutely crazy to think that will be me in 2 years! I have so much research to do and things to learn before then!! ;)

Still loving my life's calling. Even happier this month because I know I get 5 FULL DAYS OFF for the holidays!!!!!!!!