Friday, November 14, 2008

More meaning than words...

Do you ever have those in-capturable moments where life has more meaning than words can describe? The times that you are reaching for eloquence to explain the clarity you feel about the purpose of life. I had a glimpse today. A glimpse that filled my inners and rejuvenated me to say the least after my 30 hr shift at the hospital.

Today I followed my patient into the OR (operating room). The procedure was a brochoscopy which is just a camera to look at the airway going from nostril to deep down into your lungs. We talked about the anatomy during his bronch and about the pathology. That is what a floppy airway looks like, do you notice the layer of thickened mucous, what about the edema...you should instead usually see sharp corners these are blunted. We analyzed, we talked about structures and how the patient's breathing was affected by what we saw. During the procedure I didn't look at my little patient I looked at the video screen that showed me his insides. It was separate from him. It was technical, we were focused...no emotion involved only analyzing. This did not feel strange and it was only when I began typing that I even noticed how detached I was during the procedure.

After the procedure was done I followed the attending doctor as we quickly walked into the room where the parents were waiting anxiously. The doc sat down and this is where the reality of what we just saw came to fluctuation. My heart filled when I heard dad say "this last month has felt like we've had massive heart attacks". Mom sat holding back tears. Everything was explained clearly and questions were answered and lastly and most importantly hope was given and shared. It was heart breaking seeing this family and their pain yet also very satisfying all at once as I realized this is why I love medicine. I love the technical evaluation of pathology aka I love thinking about disease but I also love human compassion just as much. The opportunity to share these pivotal moments in life.

You see, I've had these dualistic moments before...I have felt detached and then attached. Although I always looked at the detachment as inhuman or bad in someway. Today I realized it is precisely that a doctor must master both and be able to excel at both in the right moments. This is what makes a competent and compassionate doctor. This is an art for which I look forward to becoming a fine artist.

See for me in these moments my life becomes a tiny bit more clear. I imagine God's plan for me behind a big curtain and at these moments He flashes open the curtains to give me a sneak peek. Just enough to keep going, to keep working those 30 hrs shifts and to remind me when I get paged at 3am about a patient that it's someone's baby and it's worth it. It has meaning.

Saturday, August 23, 2008

Polar opposites from joyful to furious...

My pager went off at 7:46am. It was my first baby of the call day. I was called to a c-section, a highly anticipated c-section to a woman with a very complex past medical history in her thirties. She and her husband were elated at the coming of their first baby. Then at 8:22am there she was their beautiful baby. I reached out for it to dry, suction and assess. She was gorgeous...yes even covered with the vernix. Thankfully she pinked right up with not much intervention and was perfectly healthy. I wrapped her up in my perfected burrito wrap with warmed blankets and headed to the front of the bed where dad was anxiously waiting with is high tech digital camera. He snapped a few and I quickly offered to exchange baby for camera. Now baby was in his hands and the camera was in mine. I snapped dad's love for his new baby in a picture. I captured his hands on her head. Him holding her close to mom and the tears running down mom's face. The first kiss. The three of them. The beauty, the joy, the moment was engraved in my heart and a digital memory card. I was touched to say the least. But this was only the beginning...my next job was to wheel baby way to the nursery while the surgery was finished. I rolled the crib down the hall to be greeted by 11 family members in the waiting room. This is when the tears finally filled my eyes. Grandpa picked up the little one and was all choked up. Aunts, uncles, cousins, and grandparents gathered to welcome this new life. I said to the nurse standing next to me "Wow love made visible." It was a moment for the record books. This is my favorite nice sweet story from the month.

Unfortunately there were more moments of frustration and a little furious-ness. So of coarse I love, value and respect life. It's part of who I am. Part of what makes me act in ways that I do and form my opinions. Let me share highlights of a few sad-discouraging-frustrating-ridiculous moments. "A mom"...wait let me take that back...I can't use the word mom since with it come a connotation of respect and love. "A woman who just gave birth" asks "does the baby look black, mexican or white cuz I'm not sure who the daddy is." We think well actually he looks chinese. We have to laugh at the crazy situations. The same lady's drug screen comes back with positive cocaine drug screen. GRRR...This beautiful baby's future is bleak in our eyes and we(fellow interns and I) feel helpless. We kid about stealing the baby and taking turns watching her on our non-call days. So CPS comes to the rescue...we breathe a sigh of relief...UNTIL we here who gets custody..."Sugardaddy's mom" I'm not kidding you! Who is sugar daddy? Possibly dad? NOPE just sugar daddy! We kid hey can we get one of those sugar daddies?! ;) So ladies and gentlemen this is a blink in the life of newborn nursery. Joyful to furious. Wanting to cry, crying, and laughing. I don't want to be a cynic. I don't think I ever will be but sometimes you have to laugh at situations to keep the sadness and the reality of the darkness in this world at a tolerable minimum. I don't want to forget the darkness and I don't want to stop wanting to change it or wanting to help but I will laugh and try to remain a light in hopes lessen the darkness.

Sunday, July 27, 2008

After a month?!

Residency began June 16th over a month ago. We began with orientation where fifty strangers were put together be begin this new journey. This journey that would involve "saving lives", training through sweat and blood, with tears and laughter. This is what bonded us on day one. After much laughter and fun we were split our separate ways. The path chosen for me was actually the lighter path. My story of residency doesn't begin with grueling call schedules, no all nighters, no fingers in bullet wounds or 3 am pages for a stat colase. It begins with the leisurely schedule of the outpatient clinics. None the less, even though my hours were not sleep deprived the lessons were not sparse.

Fear #1 when becoming a pediatrician..."The impostor!" I always worried that parents would ask me...the intern with no kids...how to raise their 7th kid. They would soon find out I'm an impostor! Well, my fear was absolutely appropriate because I have been asked is my son's biting normal? What about those temper tantrums...he screams and I just can't stop him. Oh and what about potty training? Did I ask you about when to start solids? Oh and what about that car seat law? Sun screen? Insect repellent? Soaps? Detergents? Umbilical cords? Formula? Cereal? Diapers? Belly button outties? Hiccups? Blue hands and feet? Bathing? Breast feeding? Sibling trouble? School preparation? Dental visits? Fluoride in the water? Can I give them water? You get the picture. I quickly realized this course wasn't offered in medical school. How in the world am I suppose to know what to say?! These women have read more parenting books than me. Should I subscribe to Parenting Magazine? Should I have a few kids to figure it out? Then I decided just take a deep breath and ask the experts. I frequently ask the attendings and guess what? Most parents have the same questions so once you get a few of these experiences down you can look like a pro. Most parents just want reassurance that what they are doing is good. I can do that! I can encourage! So fear #1 is not over as everyday a new question is asked but I'm not afraid to say...I'm not sure, that's a new question for me and a good question let me find out for you.

The outpatient world has been filled with lots of adventure and cool cases! The funniest story would have to be the donkey bite. Yes you read correctly. "Bit by a donkey". I walked in the 6 yr old's room and said with as straight of a face as humanly possible. "Hi! Can you tell me what happened?" After about five minutes which included conversation about the bunnies, goats, sheep, which finally led up to the donkey she told the very gruesome story of how "the donkey took only only the carrot but part of her finger and BLOOD SQUIRTED EVERYWHERE!" She's six mind you and I would be exaggerating if I even called it a scrape. None the less it was hilarious and since no parties where harmed (not too much at least) it made it officially a great story!

I've seen some really amazing patients and cases. I still don't know what I want to do with my life. Outpatient world? Inpatient world? Chronic patients? Acute patients? What types of illnesses or all types? I have no idea.

Things I do know. I was inspired by a precious patient with arthrogryopsis-a birth defect causing malformed, rigid joints and bones and muscle atrophy. She was a light! So bright eyed, smart, and determined. Not a bit of sadness or self-pity apparent in her. She was what beauty is.

Things I know. I saw teenagers and liked it. I liked encouraging them. Telling them they can do it. Telling them the decisions they make are so important. Telling them that birth control and condoms don't protect them from all STDs but most important they don't protect their heart. To stay away from drugs and do their very best in school. Showing them someone cares. I loved the moment to share pearls. To try and show them hope and direction.

Things I know. I don't like too much repetition. Too many well child checks in a roll drain me. Too many viral illnesses in a roll drain me. Hmmm...that's all I know.

So I write one month in and about to start my next endeavor in newborn nursery we shall see what else I know or realize I don't know.

Friday, June 6, 2008

Dream becomes Reality

I'm in my hometown sitting in a coffee shop. It's crowded so I grab my stuff and head to the corner of a couch. I couldn't help but notice a sticker on a labtop that said "A Certain Medical School". I asked are you in medical school? "No" he said but I'm working on my admissions essay right now in hopes to get in. I wished him the best of luck and shared that I recently graduated and would love to help him in any way. He probed and questioned for about half an hour. He said the school that I just graduated from was his dream school. I was humbled.
I went back to my business when two people sat in front of me with MCAT study books. It was surreal. Then yet another young guy started talking about trying to get into medical school after he takes a few classes and working. He said "it's my dream".
I just sat back and was dumbfounded. Can this be real? I remember these exact moments in my life. Studying for the MCAT, approaching med students in coffee shops in hopes of getting a tiny bit closer to reaching my dream. It's real alright and medical school is done.
I sat in a lecture hall on graduation day and heard our speaker tell us..."Most people would trade places with you in a heartbeat." That resonated with me as I remembered how much I had yearned and dreamed about becoming a doctor. Well now it's true it's time and it's real. It's not as glamorous as my imagination had made it but none the less it is a privilege beyond description.
To all: Follow your dreams soon they will no longer be dreams but a reality.

Monday, May 12, 2008

the transition...

Today's To-Do List:

Confirm movers

Pack

E-mail about new apartment

Enjoy friends



So it's almost 1am and a long glorious day is done with a completed to-do list. It was a bittersweet day as I see this awesome chapter of my life coming to an end. I am on the brink of graduating from medical school and about to start training at one of the nation's top pediatric residency training programs. Talk about excitement and being in pure ahhh of the experience. That is of coarse how I feel most of the time but today my feelings are changing. You see...I'm leaving my comfort. Leaving my friends. Moving farther from my family. Today was spent with many of my closest friends and after leaving each of them I hugged them knowing the hugs are limited. This is heartbreaking but I ABSOLUTELY know in my inner most being that I am going where I am suppose to go. I have been hand picked and the thought of that is mind blowing.


So here I go. I'm ready. I'm going to do my best. I'm going to be the best doctor I can be. I'm going to treat those kids with the best care I can possibly give. I'm reading, I'm learning, I'm working from now on for those kiddos. I can't wait. What a privilege!