Saturday, February 24, 2007

The Red Line To Our Personal Hell

I spent last night working at Washington Hospital on the northeast side of the city. In doing so, my travels took me aboard the red line Metrorail. I have found my time on the Metro to be an opportunity to reflect on the day. Grant it on the way back from the hospital this morning my time was mostly spent just trying to stay awake...I stood and watched the buildings in the crisp morning's sun. Irony of Washington Monument being in the same field of view of run-down housing can really put a spin on your day if you let it.So last night I worked in the Emergency Room (ER) or Department (ED) (pick your poison). Now that the shift is over I can say this, it was a surprisingly, relatively quiet shift. I worked with a really cool attending physician. The guy sincerely cares, which tends to be the theme around here, mind you. He and his staff worked hard to teach me, which was great in itself. He allowed me to do as much as I want to do, so I was prepping patients in no time flat. Fortunately, I will be working with him throughout the rest of the semester. Last night, I saw a lot of different diseases. What sticks with me through all the minutia is mostly the images of scared patients. Fear rests on our shoulders and grabs at our throat, perhaps one of our most important signs of humanity. I feel as long as I can identify with the fear associated with each patient, whether he/she be conscious or unconscious, dead or alive, sick or healthy, I will be guided. Things become complicated when drug addicts faking pain looking for a score, child/spouse/elderly abusers, individuals trying to get out of work, or looking for a reason to sue, etcetera enter the mix. Patients can have 10 of 10 pain no matter how bad it really is, which is frustrating but also very enlightening. Patients can be extremely scared despite what their disposition 'looks' to be, and fear can drive a person to do many things they normally wouldn't do. The patient with the perirectal abscess in Room 10 may be a jerk to everyone. He may be homeless. However, he needs help, so you jock up, try your best to overlook the fact that he is practically screaming at you, because he has had to tell the same story 4 times in the last 4 hours. By the way, waiting times of four, five, six, seven (you get my point) hours are the norm for non-immediate life-threats in major city hospital ERs. The truth of the matter is that he has probably lived with a bleeding abscess for quite some time, but last night was pretty damn cold. So you tell me, if you were in his shoes, which would be an extremely difficult image to picture, then what would you do...cold night out with a slow bleed in the area where sun doesn't shine or a warm Emergency Department with a bunch of questions thrown at you after a 4-hour wait followed by some medical student sticking you, swallowing some barium filled cranberry-like juice, and then being taken off for an image study and a likely surgery to fix a persistent abscess...oh yeah did I mention receiving a few meals. So, the Emergency Room is a place of battles. Some battles are fought and either won or lost in minutes, while other battles are almost purely ethical. The fact remains: people need help.

Tuesday, February 13, 2007

I Just Want To Be A Doctor.

I Just Want To Be A Doctor.

When standing face to face with a demon many thoughts may surface once you get over the whole shock and awe factor. I found my Achilles heel thus far on my journey through the world of medicine. Apparently, biochemistry takes the helm of this demon’s ship. Undoubtedly, another beast will replace this sinister creature, but for the time being biochemistry will do. After just barely passing the first exam as did most of the class, I stood there face to face with this vile gatekeeper. In all its wicked breath, it haunted me through the winter break, through January, and into February. Over a slow course consuming the last two weeks, the beast lies still, slain at its throat. Unfortunately, this story does not hold true for many of my fellows. The beast won many times over, a sad fact of the matter. I’m left with distasteful thought. At times when I can reason no rationale behind some of the necessary conquests on the horizon of a medical student or resident, a few thoughts come to mind. Most presiding of which remains to be: “I just want to be a doctor.”

I just want to be a doctor. At three A.M. with my notes and flash cards spread out all over my desk and highlighters gone wild, I just want to be a doctor. Spending an entire day in the same lecture hall listening to lecturer after lecturer speed through their bit, I just want to be a doctor. With my arms shoulder deep in somebody’s bowels, I just want to be a doctor. At eight in the morning running off of 5 hours or less of sleep for the sixth day in a row, I just want to be a doctor. As I slowly accrue more debt than I care to admit, I just want to be a doctor. While I put my life in a holding patter at 10,000 feet, I just want to be a doctor. Watching my friends, at times, struggle right along side of me, I just want to be a doctor. Damn it you wretched demon, don’t you get it…it’s going to tell a hell of a lot more to get me to even budge.

I’ll leave this commentary with one final thought. Why is it that we allow some of America’s brightest and finest students to walk such a gauntlet? These souls live so that they may make the lives of others at least just a little better, so why is that we try to bury them along the way? I just want to be a doctor.