Friday night I was at Starbucks talking to a friend. It was pretty heavy talk for the start of a long weekend (and especially being Valentine's day), but we were talking about the lovely careers we were both heading into.
During Internal Medicine, I had the the unfortunate experience of having a patient I was seeing pass away. He was a really sweet gentleman that I had the pleasure of seeing daily for over a month. He had a complicated case and through it all, I knew he had a poor prognosis. But still, I formed that connection with him and it was a shock to see him go. I had seen him and talked to him just that morning before he coded. The thing that gets me the most was that I rushed seeing him that morning. He had just come back up to the floors from the ICU that morning, so although I knew I had to see him, I was still dragging my feet and delaying leaving for the hospital and therefore had to see him in a hurry. I figured I knew him well by this point and could always see him after rounds if I needed to. But that was not the case. As a medical student, his care was way beyond my level of training but I still can't help but have a little regret for not giving him the extra few minutes, even though that wouldn't have changed anything. I figured that at my level of training I wouldn't see any patient pass away. And although this happened a few months ago, it is still something I think of often. I was discussing this with my friend and fellow student, who has also seen patients pass away. It's probably the worst thing about our profession and something that I will probably never come to terms with. Friday night at Starbucks, and just discussing it almost brought me to tears again. But I do confess there are definite perks to becoming a physician (at least I hope so, or the last three years would be wasted).
My friend wants to be a surgeon "when he grows up" (a common question posed to us, as if we are still kids), and I confess one of the main appeals of becoming a surgeon is the instant gratification. The patients are so grateful when they wake up for helping them. The cure of surgery is clear. You have an inflamed appendix? Let me take that out for you! Bowel obstruction? Let me go in there and take down those adhesions. Problems solved. If only I didn't get motion sickness from laparoscopic surgeries with the camera and could deal with the extreme stress of surgery it would have been my specialty of choice. I actually enjoy suturing and being in the OR. Internal medicine, which is what I believe I'm going into, doesn't have that kind of gratification. Patients are happy sure, but there tends to be no "cure." It's a path of life-long medications to control certain diseases and conditions and oftentimes you can't see the problem, or it's solution. I'm sure it will be just as rewarding, but in a different way. And hopefully with a lot less stress and anxiety.
Every rotation so far has the difficult patients. The ones that refuse to see they may have a condition like hypertension or a mental disorder. But when I see the patients that are thankful for your efforts; the ones that take your advice seriously, they are the ones that make everything worth it.
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