Some days I leave the hospital and I'm almost shaking with excitement. When I roll down the hill toward town I hardly notice the giant, cold induced rifts in the pavement. Those days I know the diagnosis, I can find the treatment, my clinical decisions help guide patient care. Yesterday was one of those days. I was on the inpatient service, my patients were sick, but not too sick to talk with me, and not too sick to get better.
I've realized over the course of the past few months that treating the long, intractable course of a disease like hypertension takes a special kind of doctor. And that I may not be that kind of doctor. I find satisfaction in getting my hands dirty, in fixing a discrete problem. Maybe I'm terrified by the commitment that being someone's internist or family doc implies, or maybe my brain is wired for immediate reward, maybe both.
Yesterday, I was glowing. Today, I was completely stymied by a patient with terrible chronic pain with a clear organic, yet untreatable cause. I can't make his pain go away. I can't even make it a little better. And that's frustrating.
On days like today, I come home to a house that's not mine, in a town where I know one person, and it's hard. And I spend the night studying so I can repeat the process again the next day. It makes me wonder why I wanted to do this in the first place, why anyone would do this. My life has narrowed in the past three years as medicine crowded out things I used to love. I've been uprooted, skipped countless powder days to study, and felt an underlying current of uncertainty about passing exams, choosing a specialty, picking a residency. And yet there are days like yesterday. Yesterday, I came home from the hospital with the conviction that doctors really could help people. Yesterday I wanted to learn more about medicine. I wanted to read journal articles, devour everything I could find that might explain what I saw at the hospital earlier in the day. On those days, medicine is enough.
I've realized over the course of the past few months that treating the long, intractable course of a disease like hypertension takes a special kind of doctor. And that I may not be that kind of doctor. I find satisfaction in getting my hands dirty, in fixing a discrete problem. Maybe I'm terrified by the commitment that being someone's internist or family doc implies, or maybe my brain is wired for immediate reward, maybe both.
Yesterday, I was glowing. Today, I was completely stymied by a patient with terrible chronic pain with a clear organic, yet untreatable cause. I can't make his pain go away. I can't even make it a little better. And that's frustrating.
On days like today, I come home to a house that's not mine, in a town where I know one person, and it's hard. And I spend the night studying so I can repeat the process again the next day. It makes me wonder why I wanted to do this in the first place, why anyone would do this. My life has narrowed in the past three years as medicine crowded out things I used to love. I've been uprooted, skipped countless powder days to study, and felt an underlying current of uncertainty about passing exams, choosing a specialty, picking a residency. And yet there are days like yesterday. Yesterday, I came home from the hospital with the conviction that doctors really could help people. Yesterday I wanted to learn more about medicine. I wanted to read journal articles, devour everything I could find that might explain what I saw at the hospital earlier in the day. On those days, medicine is enough.
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