Last stretch of medicine

Bluntly put, I'm pretty tired and worn out. This isn't to bitch and moan or say how rough life is. Just a little tired and doing what I have to do to survive and do well.

I've been feeling a little lost lately. My whole life I've had this picture of what I wanted to do and who I was. I thought I'd be that community doc that did it all. I don't think so anymore. I'm not even sure if I like internal medicine. That plus my refusal to kiss anyone's ass and my cavalier attitude toward everything = not so hot scores. I'm been told I'm a little too informal with the team and patients. My patients love me and let me know each time I discharges one of those suckas home. Now whether my attending thinks I'm intellectual enough or professional enough...well that's another story.

It's weird, everything in medicine comes in waves. The patients roll in in waves. The badness and the sickness come in waves. Usually I roll with the punches and I'm good to go. I put on my cynical mask, joke and talk a lot of shit in general. Every once in a while, that all comes tumbling down and I ache all day. I want my alcoholic patient with liver failure to stop drinking and somehow get on the list for a new liver. I'm sending him home to die next week. I want my diabetic kid to get his insulin and stop coming home looking like those starved african children. I want my heart failure patient who thinks that he is doing well because we took off his fluids with lasix to go home and do well. His duke score sucks ass.

Those days are the toughest...and it just literally hurts in my chest all day until I can wall it off and go back to being an asshole. When I am an asshole, I do well in medicine. I'm on top of my game, not intimidated by anything or anyone. I tapped a guy's ascites and stuck my finger up some guy's ass without batting an eye. No thought about any consequences or badness...just rolling through the day. I was in the proverbial often wrong, but never in doubt mentality.

Joe, I don't know what kind of doctor I'm gonna be. Hopefully a good one. I'm supposed to schedule rotations in a couple of months in whatever I'm interested in. To be honest, I haven't found anything yet that I'm crazy about. Nothing that I'd be happy to sacrifice my 20s to. I'm so burnt out that I just want to sleep in or have a weekend off to play in the snow, grill up some burgers and drown myself with some suds.

Maybe things would be easier if I didn't take everything so damn personally. I need to stop quoting you've got mail...but shit. What's so wrong with being personal anyway? Shouldn't everything start with being personal? When I present my patients, I have no idea who my team is talking about. I've got nicknames for all of my patients and that's who they are. Some of them go by their middle names. They've got tattoos of long loves that left them and children at home who need them.

I apologize that this blog is a jumble of random ass thoughts.

I'm sort of stuck on what bothers me the most about the hospital. Sandwich effect...I love my daily soup and talking shit with my cashier Omar. Things I can't stand. I hate roaming through the halls in the middle of the night. My mind starts wandering and I get confused. I still get lost in the hospital in the middle of the night. I avoid the back entrance of the hospital like the plague in the middle of the night. There are some long creepy ass stretches that ruffle the skin on my neck. In the night, I see them carting off the biohazard red bags...it smells just like the thousands of mice I used to sack. I can only image what those bags are filled with. I'm haunted by our superstitious society. Our elevators don't have a 13th floor...goes from 12th to 14th. I like to think that there is a 13th floor, like in being john malkovich, for tiny people. In the night, the elevators creep me out. I hate davis tower, 6th floor, cardiology unit. The patients there are scared out of their lives...I imagine it must be like that all across the hospital. Seeing grown men cry and hold in their shit for a week because they're so damn scared of their heart surgery...and they lash out at me when I try to talk to them...like a cornered animal. Those memories haunt me every time I start rounding in the morning. Davis 12, room 63 creeps the shit out of me. More people have coded, died in that room than god knows what. 3 Since the past week and a half or so. Some of the nurses are scared to go in that room and some say that it's haunted. Thanks a lot...whatever. My patient made it out ok. I know that she is gonna come back with altered mental status changes because of her liver failure. Once she gets back to lucid, it's gonna kill me again to have to ask her what the date is and have her start crying on me once she realizes that her time is short, but the last month has been wasted with her in a perpetual haze of confusion. I usually take pity on her and redirect her by talking about the superbowl. Sometimes I wonder if I should've let her have a good cry.

Sometimes I wonder if people ever get well at the hospital. When you're rounding on your patients at 4 in the morning, there's a certain light headed feeling that you feel. You feel like a ghost drifting through the halls of the hospital. In the beginning, you smile at everyone. As you start to fit in, you just try to stay out of everyone's way, but that just makes you look like an asshole cuz you don't smile or say hi anymore. Sometimes you spend every second of your waking moment wishing for just another wink of sleep. Sometimes you blow off your friends and family just so you can get a little more sleep. Then you get some sleep and you realize that the past few months have been a haze in your life, and you cry because it's most lost time. It's the reality of your life and all that you can see for the near forseeable future.

My fantasy basketball team is doing well. yay...what was I talking about before?

-bender