My Top Ten

Over the past few years, I have spent my life preparing for my medical career, and recently I've been thinking about the favorite, the most despised, and the most random things about said career. Some of these things they prepare you for, and some of them they don't.... Here are my Top Ten of each:

Top Ten Favorite Things

10. Procedures - be it a central line, draining fluid, injecting other fluid or sewing someone up, for whatever reason, I really love poking people; makes me feel like a doctor.I will jump at any chance to do one of these, so look out!

-motorcycle+pothole-

9. Knowing that I can fix somebody, and then doing it - when this is possible (patient and disease dependent), this is great. I like seeing blood pressures go down, HDL go up, blood sugar normalize, and patients losing weight after I've given them tips to do so. I like having people tell me they feel "better."

-'all'-fixed-

8. The Busyness - I have always needed to have a million things on the go, so this career is great for me! You have your rotation work, your clinic work, your paperwork, presentations, assignments, meetings, didactics, and then researching things on your own...and that's just the stuff that fills my work-life. I would like to think that I (on occasion) have a life and tasks outside my work as well!! My to-do list has yet to come to an end, and I have yet to find myself with "nothing to do."

7. Well Child Checks - There are few better moments in a clinic day then having a healthy kid come in to make sure they are still healthy. I love playing with them, chatting with them, and even getting a tickle or two in :-)

6. The Learnding - I knew so young that I wanted to grow up and be a doctor. I idolized my dad and what he did for a living, and I looked forward to when I would be there myself. Over the past 5 years, I have devoted my time to learning all that I could about medicine, health, nutrition, exercise, and how to be the best doctor I could be. My resources have been books, the internet, the people who surround me, and the patients I work with....I have yet to have a day go by without learning at least one new thing (minus most of the days I am on vacation....prob about 20 days a year). I know that this will go on for most of my life, as the medical world isn't a stable one, and there are new things to learn on a daily basis - I love this.

5. The Future - This is not to say that I am not happy with the past, or the present, but I feel like everything leading up to and including this point, is getting me ready for the future. Don't get me wrong....my life now is real life, and I do have a real job, but I am still in training, and I am not yet where I want to inevitably be in life. I look forward to when I am in the same city as Hubbs, and we can have a real marriage....one where we actually see each other on a daily basis. I look forward to being able to guide my career in the directions that I want to take it. I look forward to owning a house that I can make my own, and know that I won't be moving in a year or two. And most of all I look forward to one day having a family....if I haven't already made it clear here, I am in full baby-fever mode at the moment - not an easy mode to be in when surrounded by preggers, babies, children and families, but alas, switching modes isn't something I have any control in. I love my past, and I love my present, but my future is where my real life is situated, and I really CANNOT WAIT to get there. In the meantime, I plan to enjoy the ride it'll take to get me there.

4. The people I work with - At work, be it in the hospital, in clinic, in conferences, I am always surrounded by people that I really love being around (this is not to say that there are occasional people I do not like being around, but here, they are truly few and far between. All of these people, no  matter who they are, help me do my job and maintain my sanity. They make it easy to live across the country from Hubbs, and in a different country than most of my family, and away from so many of my friends. They are my rocks, and they rock.

-comedy-for-sanity-

3. Getting to deliver a baby - to the average layperson this seems cool....to many in the profession it is cool....and to others, it's on their despised list. Personally, I find that there is no more fabulous or satisfying thing than getting to deliver and place on a mother's stomach the child they have been waiting 9 months (and usually longer) for, especially when it's the first and everyone cries....including me :-)

  

2. The fabulous patients - They do exist! I have some of the most amazing people in my practice that I get to take care of, and I really look forward to seeing these people. They are compliant, show up on time for their appointments, they quit smoking and lose weight....they are my diamonds in the rough, but they make what I do worth it.

1. The fact that every day, no matter how horrible my day has been, I come home and I truly LOVE my job - every day....no matter what :-)

Top Ten Despised Things

10. Having to spend my time and my efforts trying to help people who have no interest in helping themselves - Nothing pisses me off more than this, and sadly, there are so many people like this in the world. When there are so many people who DO want to get better, it's really hard to care about the ones who don't.

-diabeetus-

9. Sick Children - I hate this, cause I love kids. Don't get me wrong, I love all ages of people, but when kids look up at you with their big, tear-filled eyes, with a look that says "why are you doing this to me? Why am I suffering like this? Help me!!!" Ugh....I HATE it!

-feeder-and-grower-

8. Nightfloat - I am not nocturnal. Enough said.

7. Long Hours - this is not the case with all rotations, and yes, technically I am provided enough hours between shifts to get my 8 hours, but you can't always just leave when your shift is done. Do you know that feeling when you've had so little sleep, and you are soooo tired that you feel nauseous and drunk? Well me and that feeling have become well acquainted this past year. I hate you feeling.

6. 'Problem' patients - be it the drug seeker, the manipulator, the whiner, or the liar, I cannot stand having to deal with these people....but it's my job. The secret is learning to deal with them - be it with rectal Tylenol, counter-manipulation, tough love, or calling them out on their lies.

5. Insurance companies - they are evil....almost all of them. I hate that the medical system is a business in this country, because when it comes down to it, it's all about money. How much money they can save, and how much money YOU can spend. It's sick. I have violent thoughts towards the people running these companies, and yes, I know it's a business and they owe it to their investors or whatever....but these are people's lives, and their health. It's disgusting some of the things I've seen insurances do to people, and I'm still barely wet behind the ears.

4. The idea that because I am a doctor, I must be rich - PUH-LEASE! Now I'm not complaining about pay, but believe me, it'll be maaaaaaaany years before I am anywhere close to financially secure. I have loans...big ones! And I can barely afford to pay the interest on them, even in the delightfully cheap Midwest!! Sometimes I think I should cut-down on my infomercial purchases....and then sometimes I think, never ;-)

-status-post-monthly-bills-

3. The Discrimination Against Foreign Grads - My medical school is "in" Grenada (ie, it's owned or licensed or whatever, through Grenada). I did my two years of basic science (the book learning) down there, and we used the same books, inevitably took the same board exams, and covered the same material as American Grads. I did my clinical studies (the hospital learning) in the US....all of it. I trained in American hospitals, with American Doctors, and again, took the same board exams that covered the same material as American Grads. Then I got a residency position where I'm supposed to be able to be on the same "level" as my fellow residents.....BUT....because my book learning was in Grenada, and my school is based out of Grenada, I have to wait an extra year to moon-light (work as a doc in ERs, clinics, etc) compared to my American Grad peers. In some states, you don't even get to moon-light at all! WTF?!

2. Paperwork - Sometimes I think that if I had known how much of my job would involve random and ridiculous paperwork, hours of note-writing, and forms that need to be filled out, maybe I would have chosen another career. But then I think, no. I've always wanted to do this, and even though I hate it, paperwork wouldn't change that. Seriously though - too much paperwork!!

1. Having to tell someone that they, or their loved one is dying or dead - this isn't something I have a lot of experience with. There was one time as a medical student, and then a couple of times as a resident during or right after a code blue, or with someone who has just received a terminal diagnosis. Needless to say, this situation has led me to tears on multiple occasions, and the images, feelings, and the actual wails from one husband will never be forgotten.... "We've been together for 299 months....300 next month. What am I going to do without her!!"  It's a humbling experience, but in this case, I would rather not be humbled  :-(

-super-oliguria-

Top Ten Random Things

10. It's just anatomy - patients come in with all sorts of weird and embarrassing things to them, but to me, it's just anatomy. Those testicles the size of grapefruits, the endless pap smears of people with some infection, the dreaded prostate exam. It's just anatomy, and I'm not embarassed, and neither should you be. I mean, I know that some weird pimple on your privates seems like a horrible, nasty, embarrassing thing to you, but it's what I do. It's also why I wear gloves.

9. My wardrobe is blue and pajama-like  - When I get up in the morning (in most rotations), choosing what to wear is not a tough thing...lately I have lived in scrubs. The blue unisex scrubs are far from flattering, but they are so comfortable, I really couldn't care less. I do wish, however, that the company supplying scrubs to the hospital made them for the sexes....in order to fit a woman's chest in a shirt, the belly part ends up being huge, and this (although nice to not have a clinging shirt at work) makes things fall out of my pockets all the time. And the drawstring pants are made for someone with incredibly short legs - to fit my legs (barely, cause they are still pretty short), I have to wear pants that are so big, the crotch hangs down to my knees. I feel like Doctah Gangsta. Also, it means I am never having to "fit" into anything....which (believe me) makes it hard to make good food choices at work.

8. Cracking jokes with a dying patient - This is something I find odd, even while doing it, but I feel like my patients appreciate the normalcy of the situation. I don't pretend that these patients aren't in the situation they are in....I acknowledge it with them, talk to them about it, see how they are feeling. But try as hard as I can not to pity them to their face. I don't think they like being pitied. They get enough of this from everyone else around them. Nothing makes my interaction with a dying patient better than being able to get a smile, and even a chuckle out of them.

7. The dreams - I remember when I was a waitress, working like a madwoman, and I would wake up in the middle of the night, out of a dream that I was serving people, and I would hop out of bed, get dressed thinking there were tables of customers in my living room, stand in front of the mirror, and then kick myself when I saw the clock read 4am and realize that I had been dreaming. My dreams these days have me waking up thinking I have an admission waiting for me, and I'll look at my pager, see that there are no messages, and then think to myself "screw that....I'm not admitting anyone until they page me to do so." This makes for restless nights without great sleep. I have, on occasion, had such vivid dreams about some of my patients and things going on in their lives, that I will actually call them to make sure everything is okay. This is crazy. I need sleep that is restful, not nights where I work a whole shift in my sleep so I can get up and work a whole shift in my awake-time. I may need ambien....

6.The feeling of boredom on a day (or two) off - This is not a universal randomness in this career, but more of something specific to my personality; I need to be busy. My activities during a day off will depend on my fatigue level, and how motivated I am. If I'm tired, I'll have 3-4 naps, watch TV, and lounge around...such a rare event these days that I savor these days. There are days, however, when I will clean, do laundry, run errands, pay bills, and when I'm done with it all, I feel the need to keep going; I've had days where I wonder if the people at work need help with anything, and I debate going in to help during these times. I  need help :-/

5. Abscesses - They are like the ultimate zit, and cutting into them ('popping' them) to relieve all the pus inside is such an incredibly satisfying feeling. I can hold my nose on the ones that have a good deal of 'crud' coming out, that smells like something died in it, and squeezing the last drops of said crud out of these artificial orifaces can light up my day. I am weird, I know.

4. OB/GYN - kind of like #10, but imagine a month where you spend your days with your hands and your face between the (often) nervously spread legs of women (and no guys, get your head out of the gutter cause any male resident/doc/med student will tell you that it's not like that). It doesn't bother me, but sometimes I reflect on the number of vagines my hands have been in...too many to count.

3. The things that DO turn my stomach - there are only three things that really make me gag and get queasy (so far).... the smell of a drunk person bleeding profusely (that old, drunk, alcohol smell plus the metallic smell of blood just does not mix well for me), floating joints (when there's a broken bones on either side of a joint, so it's just moving around in directions it's not supposed to go), and certain skin infections (I'm getting chills just thinking of some of the nasty things I have seen in the past). I'll take vomit, feces, blood (alone), and the gore of an amputation any day, but those other three - eww.

-drunk-and-angry-

2. Diagnosing while people-watching - This is something I cannot help but do, and this is something I miss so much about NYC, because my hour long commutes on the train were like an interactive diagnostics lesson for me. You can tell a lot about what's wrong with people just by looking at them. The clothes they have on can give hints of a stroke when those on one side of the body is more worn. Their skin can tell tales of the number of cigarettes they have smoked in their years. Their walks can lead towards diagnoses of neurological conditions, infections in their pasts, or congenital diseases they were born with. The color of their skin can tell of liver conditions, vitamin deficiencies (or overdoses), or medications they are taking. Their coughs can indicate a lung infection or disease, and the sounds it  makes can make me guess which one is the culprit. The way their skin hangs on their faces can tell of weight lost, perhaps recent, and indicative of some undiagnosed malignancy that's hiding inside them. And their incessant rants about the end of the world, or that they were the one who 'caused' some earthquake shed light on the psychological diseases that they suffer from; it saddens me how people judge, or yell at them, or try to argue with these people - you cannot argue with crazy....you will never win. There is an art to diagnosis without interacting with a patient, and it's something that an Attending once taught me.....Look at a person, observe how they act.... I'm amazed at how much I know about people I don't know, just through a little bit of people-watching.

1. Body fluids on my clothes - Some people cringe at the thought of a mother grabbing the boogers out of their kids nose, or wiping their child's face with their licked finger....now imagine coming home with (often multiple) people's blood, vomit, amniotic fluid still on your clothes. Now imagine that this is a regular occurrence. Now imagine that this is 'no biggie.' Welcome to  my life.