Week 2: starting to get real

This week was amazing. I'm becoming more comfortable everyday in the clinic but I'm also realizing how much more I need to learn everyday, so it ends up feeling like one big step forward, a tiny steps back. I'm trying not to feel overwhelmed and focusing on improving everyday.

One of my most memorable experiences this week (besides doing a female and male exam all by myself!) was in my family practice clinic when I got to speak with a patient on naloxone therapy. Naloxone therapy is a therapy for preventing deadly withdrawal to heroin addiction. As a medical student the greatest gift I have compared to any other point in my training is TIME. I had the time to really get to know this patient. I got to ask her more than the usual questions about fevers, chills, nausea, vomiting, diarrhea, constipation- I got to find out about this woman's life and how she became an addict. She shared her story with me and cried as she re-lived many of the decisions she wishes she could take back. As I told her I was proud of her for working so hard to get her life back on track, I realized that I was one of the first people to ever say something like that to her. It was with this patient that I remembered why medicine was so exciting to me in the first place- the real opportunity to impact and change a person's life.

My goal for the next few weeks is to remember to be excited and enthusiastic around the patients. I want the patients I work with to remember me as being excited to be able to work with them. Sometimes I'm focusing so much on asking all the right questions and doing the physical exam and remember it all to present to my attending that I forget that my main priority as a medical student is to know my patients better than anyone else around. This week I'm going to change that.

I also want to work on continuing to build confidence- even though I feel like I'm a long way away from being a real doctor, I need to start acting like one around my patients. I want to be more confident and self-assured around my patients this week.

1st week as "Student Dr.Grob"

One week done! It went by so fast! I am doing the next 4 months of rotations at an inner city hospital. It's really inner city... someone got shot in our hospital's parking lot during orientation; someone else got shot outside my family medicine clinic so we aren't allowed to go outside during lunch. I am doing a 4 week rotation through family medicine (Obsterics included!) in a Spanish-speaking clinic, rheumatology, pediatric orthopedics, and urology. So far, I LOVE IT!!!!

I especially like my family medicine clinic where I feel I have the most time to get to know my patients and decide on how to treat them. I have had a hard time learning how to balance listening to patients, writing notes in the computer, doing a physical exam, and figuring out what is the cause of their chief complaint and then how to treat it. It's a big jump from practicing talking to patients and doing a physical exam! I recognize that I have a lot of work to do but everyday I feel like I'm learning something and everyday I feel more comfortable tackling my daily responsibilities than the day before. That said, I know that some days will be harder than others. It's going to be hard not to take hard days personally.

This week I want to challenge myself to act like a real doctor and figure out the treatment for my patients (including drug doses!) before talking to my attendings. I also want to start studying more after coming home from the clinics. Overall, I hope to continue to have my daily focus on being positive and excited about this awesome experience.

In the meantime, it's really awesome to walk around with a pager... even though I haven't gotten any pages. :)

My major gripe so far: how heavy my white coat is stuffed with medical instruments, books, pocket books, cell phone, and PDA.

Learning how to be a doctor... starting tomorrow.

I start my clinical rotations tomorrow! For the next 4 months I will be doing rotations in outpatient clinics, family medicine, internal medicine, and surgery at a city hospital. I'm really excited to get started! I'm also a little nervous! Ok maybe more than a little nervous! I'm excited to get back to medicine and start applying my learning. I just hope that I can keep up with it all.

Before I get overwhelmed with working in the hospital (i.e. tomorrow), I want to set some goals for myself for the next few months.

First and foremost, I want to remember how to live a healthy balanced life. Physicians need to be able to set an example for health. I want to be proud of my health everyday. I hope to work out- even when I'm tired or grouchy after work- because I know that it will make me feel better. An adrenaline rush makes everything seem better. I need to use the time I have as a student to practice being a healthy physician. I hope to work out at least 4x/ week. Even on tough rotations.

The next few months will be challenging. I will be an inconvenience to all those around me (patients, nurses, attendings). My lack of clinical knowledge will get in the way of everyone. Everyone will know more than me. I don't want to take this personally. I want to use this time as an exciting opportunity to learn medicine. I'm not expected to know everything. I am expected, however, to be optimistic, enthusiastic, and energetic. When I inevitably make a mistake, I want to learn from it and immediately adapt. Dwelling on the mistake will hold me back.

I hope that I can remember that for many of my patients, I will be the main physician that they spend time with. I want to be alert, caring, and attentive to each and every patient I see every day.