Officially back from Bardstown. I had been meaning to write a nice little note about cute kiddos and how much I learned this month, but last night I started to come down with a wicked sore throat (seriously, I think I'm swallowing knives) and feeling generally crummy, so my outlook on things may not be quite so bright today. Everyone says you'll get sick on peds, but I naively thought that since I made it back to Lex without a single sniffle I would be off the hook for getting sick. Darn you, incubation time! I wanted to have a fun weekend of pumpkin carving and cooking and generally having a good time. Now I can't sleep and have to drink icky tea to make myself feel better. Bummer!
Anyway, I'll do my best to write about my month.
Staying with my grandparents was pretty fun. Grandma was sort of sick in the beginning (just really tired) since she had just gotten out of the hospital, so I was glad that I could help with cooking dinner and things. She did get better, though, so I was glad of that. I think they had a lot of fun with me there--my grandpa wants to adopt me!
Last weekend Chris came up to stay with us and we did all the "touristy" things we could think of. We went to Bernheim forest and hiked around a little bit...then we went to "downtown Bardstown" and window shopped (we did get some delicious donuts from a bakery there!) We also went to church and I met the priest that married my parents and all of my aunts and uncles. On Sunday, we tried to go to the Abbey of Gesthemane (where the monks are) but unfortunately they were closed on Sunday. We then went to Nazareth (where the nuns live) and took a walk on their grounds. We finished off the trip with a trip to Maker's Mark and Chris got to dip his own bottle in the wax, which was pretty sweet. Hopefully I'll have pictures to come soon.
The rotation itself wasn't bad, I saw TONS of patients (seriously, over 20 patients/day!) and learned a crazy amount of stuff. I am still not sure how I feel about the kids (as in being their doctor) because I feel like there's a lot of stuff that I just don't really like to deal with. I did think that the kids were cute and I had fun getting them to let me examine them...but I don't know if I want to do ONLY peds for the rest of my life. Some of the days just seemed really long.
It's kind of disheartening because I had hoped that I would fall in love with Peds and that would be the answer I was looking for...and I didn't. I like peds, it was fun, but maybe not what I want to do forever. Thankfully, though, I have another month of kiddos (really sick ones this time) to decide.
Well, I better go take some medicine, I'm hurting all over! :(
Sunday, October 26, 2008
Saturday, October 4, 2008
post from b-town #3
I’ve officially started my AHEC rotation. For those of you who don’t know, AHEC stands for “Area Health Education Center” and means “away rotation.” I’m in Bardstown, which is southwest of Lexington and almost exactly an hour away from Lexington. I’m working in an outpatient pediatrics clinic with a doctor who is actually the father of a girl in my class.
It’s perfect timing too (makes you think the guy upstairs had a hand in making this one happen) because my grandma got sick about 10 days ago. She had a UTI that ascended into acute pyelonephritis (a kidney infection) and actually went into her bloodstream, causing her to get septic and almost die. She was in the B-town hospital but got transferred to Lexington, went to the ICU for a couple days and then a regular bed in the hospital. She actually just got home this afternoon (and I came in the evening) so I can hopefully be here to take care of her (when she lets me) and make sure she’s not getting any worse.
There is no internet here.
I’m allergic to the cat, and even though I’ve only been here a couple hours I think IgE & friends are starting to kick in. My throat is itchy and I just sneezed.
However, it’s hard to tell if that’s due to the cat allergen or just runoff from my normal allergies. I helped Chris move this weekend (which should get it’s own post) and got about six pounds of dust up my nose. I’m actually starting to feel a little wheezy, so this may be a really terrible month. Hopefully not, though.
I’m getting pretty sleepy so I guess I’ll go to sleep. There’s not anything else to do here anyway. :)
It’s perfect timing too (makes you think the guy upstairs had a hand in making this one happen) because my grandma got sick about 10 days ago. She had a UTI that ascended into acute pyelonephritis (a kidney infection) and actually went into her bloodstream, causing her to get septic and almost die. She was in the B-town hospital but got transferred to Lexington, went to the ICU for a couple days and then a regular bed in the hospital. She actually just got home this afternoon (and I came in the evening) so I can hopefully be here to take care of her (when she lets me) and make sure she’s not getting any worse.
There is no internet here.
I’m allergic to the cat, and even though I’ve only been here a couple hours I think IgE & friends are starting to kick in. My throat is itchy and I just sneezed.
However, it’s hard to tell if that’s due to the cat allergen or just runoff from my normal allergies. I helped Chris move this weekend (which should get it’s own post) and got about six pounds of dust up my nose. I’m actually starting to feel a little wheezy, so this may be a really terrible month. Hopefully not, though.
I’m getting pretty sleepy so I guess I’ll go to sleep. There’s not anything else to do here anyway. :)
post from b-town #2
Okay – this entry is for things that happened while on FM, and what I did with my “free” weekend between FM and Peds.
1) My birthday: this was on September 6. I turned 23 which makes me officially “old enough to be in med school” even though all the Hospice nurses told me I didn’t look a day out of high school. Thanks, ladies, except for the fact that you deal with 90 year olds all day.
Chris and I went to celebrate at Alfalfa’s which was a very delicious restaurant if you’ve never been there. We got the house salad, and I got a grilled sandwich with tomato, avocado, and mozzarella cheese and it was unbelievably good. Chris got fish tacos. And we got blackberry cheesecake with chocolate mousse on top. It was heaven!
I also got to go out shopping which was actually quite fun and turned up a few good deals.
2) Chris’ birthday: this was on the 19th and he turned old. Just kidding, he’s only a little older than I am, but I still make fun of him for it. His dad stopped by on his way from TN to IN, and I made a bruschetta chicken bake (which was fabulous!) and red velvet cake – I’d never had red velvet cake before but that’s what he wanted and that’s what he got. And it was tasty!
3) We also went up to Indianapolis for a weekend but I don’t remember much of that except that it was a nice time.
4) Race for the Cure: Chris and I ran RftC again this year (hoping to beat our time from last year which shouldn’t have been hard but was). We crossed the finish line at 33:33, but that doesn’t really count our time since we had to walk for a while in the beginning. I made Chris stop a couple times because my allergies were very bad and I had trouble breathing, which wasn’t fun. So, I didn’t do as well as I wanted but I didn’t die so that’s good. My dad got some sweet (read: awkward) action photos so maybe I can post those.
5) Moving: Chris and Kateri decided it was time for them to move houses. Their old one was nice and in an absolutely wonderful location but it was very very cold in the winter (with electric bills over $200!) and they had a number of plumbing problems that weren’t going to get fixed. So, they moved – and they’re my neighbors now! The front of my house can see the back of theirs, and it’s pretty convenient since we hang out so much. Unfortunately, now that they’re all moved in I’m gone for the month, but it will be nice when I get back. Moving wasn’t the most fun I’ve ever had, but it wasn’t really that bad. Just bad for my allergies but you do what you gotta do.
1) My birthday: this was on September 6. I turned 23 which makes me officially “old enough to be in med school” even though all the Hospice nurses told me I didn’t look a day out of high school. Thanks, ladies, except for the fact that you deal with 90 year olds all day.
Chris and I went to celebrate at Alfalfa’s which was a very delicious restaurant if you’ve never been there. We got the house salad, and I got a grilled sandwich with tomato, avocado, and mozzarella cheese and it was unbelievably good. Chris got fish tacos. And we got blackberry cheesecake with chocolate mousse on top. It was heaven!
I also got to go out shopping which was actually quite fun and turned up a few good deals.
2) Chris’ birthday: this was on the 19th and he turned old. Just kidding, he’s only a little older than I am, but I still make fun of him for it. His dad stopped by on his way from TN to IN, and I made a bruschetta chicken bake (which was fabulous!) and red velvet cake – I’d never had red velvet cake before but that’s what he wanted and that’s what he got. And it was tasty!
3) We also went up to Indianapolis for a weekend but I don’t remember much of that except that it was a nice time.
4) Race for the Cure: Chris and I ran RftC again this year (hoping to beat our time from last year which shouldn’t have been hard but was). We crossed the finish line at 33:33, but that doesn’t really count our time since we had to walk for a while in the beginning. I made Chris stop a couple times because my allergies were very bad and I had trouble breathing, which wasn’t fun. So, I didn’t do as well as I wanted but I didn’t die so that’s good. My dad got some sweet (read: awkward) action photos so maybe I can post those.
5) Moving: Chris and Kateri decided it was time for them to move houses. Their old one was nice and in an absolutely wonderful location but it was very very cold in the winter (with electric bills over $200!) and they had a number of plumbing problems that weren’t going to get fixed. So, they moved – and they’re my neighbors now! The front of my house can see the back of theirs, and it’s pretty convenient since we hang out so much. Unfortunately, now that they’re all moved in I’m gone for the month, but it will be nice when I get back. Moving wasn’t the most fun I’ve ever had, but it wasn’t really that bad. Just bad for my allergies but you do what you gotta do.
post from b-town #1
Well I’m long overdue for a post, but now that I’ve finally decided to write something, I don’t have internet access. Bummer! I kept thinking I should write about my Family medicine experience, but I never quite found a good time to do it. It’s ironic, though, since I found time to write when I was on OBGyn and working 14-hour days but when I was working 8-6 in the clinic I couldn’t quite find the time. I was too busy having fun, I guess.
Family medicine wasn’t what I expected it to be. I really had no expectations for it, except that I was pretty sure I didn’t want to be a family doc. I have met quite a few during my time here in med school and I didn’t think that I had their personality.
I was so wrong!
I really, really enjoyed FM. I liked the variety of patients – I saw everyone from pregnant women (and their soon-to-be babies) to 97 year old women in the nursing home! I saw just about every complaint imaginable – cardiac, psychiatric, musculoskeletal, etc – and the amazing thing was: we could do something for almost all of them! I had imagined that we would do tons of referrals to other doctors since FM docs don’t have a specific specialty. Instead, we handled a majority of complaints, and when we did refer out, patients would come back to us looking for answers and explanations that their specialty doc didn’t give to them.
I loved spending time with the patients, discussing things that were going on in their lives and what was worrying them. I felt like this is what a “doctor” should be - you should be able to treat just about everybody (and know when you’re out of your league) and be able to really know your patients one-on-one.
People throw around the term “continuity-of-care” but I never really paid much attention to it – but I found myself wondering about my patients when I went home at the end of the day. I wonder about the 21 year old guy who lost 35 pounds in the past few months without trying, I wonder what happened to the poor old lady with the bowel problems that we sent her to the hospital for, I wonder what happened with the little boy who was taking seizure meds that had delayed his speech development…If they were my patients, I wouldn’t have to wonder!
I felt like I had a purpose being there as well. I was there to listen. The doctors had only 20 minutes to see each patient, but my time was unlimited. Some patients just need to be listened to, especially those with chronic pain, depression, and stressful living situations.
Chronic pain is another issue I learned a lot about. Not necessarily medical knowledge, but I got to spend time talking with multiple patients about their daily struggles with pain. It’s a sticky subject in the medical profession because doctors are afraid to walk the fine line between creating drug dependence and really helping those in need. Some of the residents I worked with refused to give out narcotic pain medication altogether. I think that it should be what it is - a controlled substance – but I think that it has a purpose and it works for some people. Going to pain clinics can work for some, physical therapy for others, but some people just need a pain pill and I think they deserve that. I read that one of the most undertreated diseases in the US is chronic pain because doctors are scared of prescribing someone too much medicine and creating addicts. But if I were in chronic pain, I’d rather be an addict than live my life hurting all the time. I think doctors need to step out of their own shoes once in a while, take off that white coat, and imagine what it would be like to have crippling pain all the time. Waking you up in the middle of the night. Preventing you from being able to do things you love. Making you cranky and irritable and no one wants to be around you. You would want to take some Vicodin too.
Whew…Back off the soapbox. Thanks.
The only thing that I didn’t like about the specialty itself is something that others may say is silly – but I feel like FM docs are sort of looked down upon. “FM is the specialty you go into if you can’t get into anything else.” “Smart people don’t go into family medicine.” While I know these things aren’t really true, I dislike the fact that the sayings exist. I also don’t like that my FM doc could spend 45 minutes with a patient discussing different issues, and get paid pennies compared to what some specialists get paid in a few minutes of seeing a patient. We took some skin tags off a patient and billed about $150, a dermatologist would bill over $300 for the exact same procedure! Hopefully with the shortage of PCPs (due in part to the striking difference in reimbursement) things will change. I know things aren’t all about money, but when I graduate I’m looking at a debt of over 100K – that’s a lot of money. I want to pay it off so I can get a house, a family, a car with air conditioning, and someday afford to send my kids to college. Will I really be able to do that with a FM salary? Yes, but I could do it much quicker and easier if I spent an extra few years specializing.
Okay, off the other soapbox.
Anyway, in summary, I really, really, liked family medicine. I surprised myself I liked it so much. I was happy to go to work every day and help the young and old, the sick and healthy, the rich and poor. I enjoyed the continuity of patient care, and the variety of issues that are brought up. No two days were the same. I had a great time, and even though it’s still early in the year, I think that this was a rotation that is hard to beat.
Family medicine wasn’t what I expected it to be. I really had no expectations for it, except that I was pretty sure I didn’t want to be a family doc. I have met quite a few during my time here in med school and I didn’t think that I had their personality.
I was so wrong!
I really, really enjoyed FM. I liked the variety of patients – I saw everyone from pregnant women (and their soon-to-be babies) to 97 year old women in the nursing home! I saw just about every complaint imaginable – cardiac, psychiatric, musculoskeletal, etc – and the amazing thing was: we could do something for almost all of them! I had imagined that we would do tons of referrals to other doctors since FM docs don’t have a specific specialty. Instead, we handled a majority of complaints, and when we did refer out, patients would come back to us looking for answers and explanations that their specialty doc didn’t give to them.
I loved spending time with the patients, discussing things that were going on in their lives and what was worrying them. I felt like this is what a “doctor” should be - you should be able to treat just about everybody (and know when you’re out of your league) and be able to really know your patients one-on-one.
People throw around the term “continuity-of-care” but I never really paid much attention to it – but I found myself wondering about my patients when I went home at the end of the day. I wonder about the 21 year old guy who lost 35 pounds in the past few months without trying, I wonder what happened to the poor old lady with the bowel problems that we sent her to the hospital for, I wonder what happened with the little boy who was taking seizure meds that had delayed his speech development…If they were my patients, I wouldn’t have to wonder!
I felt like I had a purpose being there as well. I was there to listen. The doctors had only 20 minutes to see each patient, but my time was unlimited. Some patients just need to be listened to, especially those with chronic pain, depression, and stressful living situations.
Chronic pain is another issue I learned a lot about. Not necessarily medical knowledge, but I got to spend time talking with multiple patients about their daily struggles with pain. It’s a sticky subject in the medical profession because doctors are afraid to walk the fine line between creating drug dependence and really helping those in need. Some of the residents I worked with refused to give out narcotic pain medication altogether. I think that it should be what it is - a controlled substance – but I think that it has a purpose and it works for some people. Going to pain clinics can work for some, physical therapy for others, but some people just need a pain pill and I think they deserve that. I read that one of the most undertreated diseases in the US is chronic pain because doctors are scared of prescribing someone too much medicine and creating addicts. But if I were in chronic pain, I’d rather be an addict than live my life hurting all the time. I think doctors need to step out of their own shoes once in a while, take off that white coat, and imagine what it would be like to have crippling pain all the time. Waking you up in the middle of the night. Preventing you from being able to do things you love. Making you cranky and irritable and no one wants to be around you. You would want to take some Vicodin too.
Whew…Back off the soapbox. Thanks.
The only thing that I didn’t like about the specialty itself is something that others may say is silly – but I feel like FM docs are sort of looked down upon. “FM is the specialty you go into if you can’t get into anything else.” “Smart people don’t go into family medicine.” While I know these things aren’t really true, I dislike the fact that the sayings exist. I also don’t like that my FM doc could spend 45 minutes with a patient discussing different issues, and get paid pennies compared to what some specialists get paid in a few minutes of seeing a patient. We took some skin tags off a patient and billed about $150, a dermatologist would bill over $300 for the exact same procedure! Hopefully with the shortage of PCPs (due in part to the striking difference in reimbursement) things will change. I know things aren’t all about money, but when I graduate I’m looking at a debt of over 100K – that’s a lot of money. I want to pay it off so I can get a house, a family, a car with air conditioning, and someday afford to send my kids to college. Will I really be able to do that with a FM salary? Yes, but I could do it much quicker and easier if I spent an extra few years specializing.
Okay, off the other soapbox.
Anyway, in summary, I really, really, liked family medicine. I surprised myself I liked it so much. I was happy to go to work every day and help the young and old, the sick and healthy, the rich and poor. I enjoyed the continuity of patient care, and the variety of issues that are brought up. No two days were the same. I had a great time, and even though it’s still early in the year, I think that this was a rotation that is hard to beat.
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