Wednesday, June 28, 2006

whoa

so i guess i'm officially a 4th year med student now. it's pretty ridiculous how quickly things are going -- clinic is already starting to feel routine, and it's only been 2 days! although, i'm still as rusty as . . . a tetanus-covered nail. i have to say so far my experiences are really interesting! because the clinics i've been working in are highly specialized and duke is a tertiary care center, i've seen patients with a pretty ridiculous array of exotic diseases over the last 2 days. so far:

- old southern gentleman with desmoid tumor
- tons of people with carcinoid
- youngish yuppie whose mother had huntington's and wanted genetic testing for himself
- and a whole bunch of ALS (lou gherig's disease).

these diseases are rare, and i could probably use some practice dealing with the LESS rare at this point, but whatever. when am i going to get the chance to work with these kinds of patients again? who knows. i can see kids with ear infections and ADHD anytime, and that would get old fast anyway.

i am adjusting quite well, i think, to the new routine. i've been trying to get up on the early side to study in the morning (focusing on the area that i will be working in that day, which could be anything from HIV to inflammatory bowel disease, since i'm working in so many different clinics). then work, then running, then cooking for/taking care of poor josh who is probably working twice the number of house that i am, and then sleep.

i am relearning how to be a med student -- how to organize information, integrate into the flow of the clinics that i'm working (ie: have a pleasant, informative experience while being helpful when possible and not getting in anyone's way). i am relearning more concrete things, like how to perform a decent physical exam (i, um, forgot how to properly test for reflexes) and which antibiotics to give when.

and i am learning and remembering larger life lessons, too. seeing patients with devastating diseases (like ALS or pancreatic cancer) going through painful therapy just to extend their lives a few months -- this made me so sad, and it also made me think about how there is no reason that the months we are experiencing NOW are any less precious than those at the end of our lives, and yet so many people (including me) forget this, and forget exactly how short and finite (yet unpredictable) life is. these patients reminded me to be thankful for what i have and to put things in perspective when little things go wrong. because most things ARE little, incredibly insignificant, when you compare them to things like motor neuron failure or insatiable tumors.

i know. i'm all cheesy now that i'm in med school. but better that than mean and hard and bitter. if i ever get all mad and resigned and cynical like that, i'm going to quit. it is obvious that life is too short.

ps: it is not 3:27 am, it's 6:44. do not worry.