Sunday, January 28, 2007

Ok!! So I thought for a while there that my blog was down...I couldn't log in to at all, and I had tried to post the video a few times and it sort of broke my blog, but then it seems like a few days later it sorted itself out, so we're back in business! Thanggod...who knows what would happen if the Internet lost my wisdom.

I'm still on my medicine subI. I was really loving it at the beginning, but now I'm just sick of all the bullshit. Medicine wards has made me think a lot about healthcare in America and where all our money is actually going. I'm starting to realize I'm a huge cynic. I love helping sick people, and I think everyone is worth the effort to treat. When you can actually figure out what is causing someone's illness and help make it better, it's the best feeling in the world. Unfortunately, so much of what we treat for is chronic illness. And when your patients feel great, you're their biggest hero.

Unfortunately, 3 days in the hospital can't undo the consequences of a lifetime of bad habits, like smoking, drinking, eating poorly, and not exercising. There's no medication to fix someone's congestive heart failure. We can just give them medicine to help them pee out excess fluids so their heart doesn't get overburdened by volume and more medicine to help their heart beat a little harder to push that fluid out. We practice medicine, we don't work magic.

Like I said, I love medicine when you're actually practicing it. Making the diagnosis of a medical mystery is the most heady feeling in the world. There's no greater privilege than taking care of someone who's actually sick -- key word there being ACTUALLY.

Anyway, the long and short of this is, I can't do internal medicine. Give me a surgical subspecialty any day. I get frustrated having to deal with the unretractable results of people's bad habits when they can't take care of themselves, and it pisses me off even more when they hold it against US that we can't fix their bullshit. Clearly, I'm far too judgmental to make a good primary care doctor.

I'm bringing this up because I got fired by a patient for the first time 2 days ago. He was upset because I dared to suggest that he could go home because we were doing nothing for him at the hospital that he wasn't doing at home. He got all pissy and said, "Do I look like I can go home?" Um, well, no, I think you're the perfect candidate for subacute rehab but you refuse to go. You are, however, inappropriate for the hospital. We take care of acute illness here; we don't kee people here for physical therapy, which is basically what he wanted. He's a good friend of some hospital administrator though, so he got to stay here for a few extra days, after threatening to have me "dealt with." Um, ok. I'll be upstairs waitin' for my whuppin'.

I don't get it. Do people LIKE being in the hospital? I can barely stand it and I work there. To be sick enough to be admitted to the hospital means you are REALLY FUCKIN' SICK. Eh, whatever. This is actually nothing. When I was a 3rd year we got fired as a team by 2 separate patients.


trAcy said...

I think some people do like the idea that "someone" is taking care of them, that someone is there to constantly monitor or hear complaints or fill in all the gaps of their relationships or whatever. Regardless of how much it costs them (unless they are used to not paying/I don't know your hospital or whether you are helping indigents in a public health situation).

Lots of MDs are harsh on people's emotions; it's one of the top complaints, but you're new, you said you "get it," and so yeah, it'll be okay. Just remember to fund or talk about or promote all that preventative health care crap that people like me "know" and yet don't listen to, stuff like "heart disease is the #1 killer of women" (in general, I suppose) and that exercise is ESSENTIAL to preventing it, etc.

: )

We all live so for "today." And somehow, eating, drinking, smoking, etc. seem much more popular that healthy habits. More needs to be out there about exercise and endorphins and how "fun" it is.

Anonymous said...

I think every person ought to read it.
you may 6 | nice 6 | also 2 you may 5 | this 6 | superb 8 superb 3 | look 4