First and foremost, my apologies for the extended absence. Things like exams, Christmas, travel, stomach flu, and a slow attachment have prevented my updates... though, I'd really like to blame it on the Writer's Strike. Unfortunately, all the bad writing is mine and mine alone, can't pin this crap on anyone else.
So, I'm back on attachment in the hospitals, and I've had an interesting go of it. First, it sucks being sick. Everyone knows that it sucks to be sick, but let me tell you that it sucks to be trying to make other people healthy when you yourself are unwell. Boo on that. It's even more difficult when you're a student. If you're employed and sick, you take a sick day, you're docked pay, and such is life. If you're a student, you take a sick day, miss lectures, fall behind your learning, get chewed out by your instructors, miss more lectures to make a doctor's appointment, argue with people who don't realise you're a soon-to-be-doctor and think you're just a hypochondriac, struggle to stop by the store to get some crackers and soda before you drop or start vomiting again. Thank God for my roommate.
That, perhaps, was the one saving grace. You can't be on the wards in a hospital if you're vomiting. Roto-viruses are highly contagious, and you don't want an entire ward of patients throwing up... that's just wrong. So, now recovered from the flu and able to see patients, I'm finding myself on a Care for the Elderly attachment (aka Geriatrics). Now, it's very laid back, the consultants are brilliant and helpful, the Regs and SHO are lovely and take time to teach and explain, and the intern is so chill it's contagious. But, there isn't much for me to do. This is the disappointing thing with health care. Many of the patients under our supervision (and I purposely say supervision not care) are simply awaiting placement in Long Term Care or Nursing Home. This means that there isn't much we need do for them. There are no bloods to be taken, no X-rays, no exams, no treatment other than maintaining medication. And for a student looking to learn and understand, this is frustrating.
I titled this post "CTD" for a reason. It's a reference to former, crass abbreviations used in the medical community for things that shouldn't be said out loud. CTD stands for Circling The Drain. It's up there with FLK (funny looking kid) and DP (difficult patient) as things that are no longer written in charts, but occasionally are spoken in an exchange between doctors. CTD is one of the the things that I feel epitomizes what I'm taking away from this rotation. End of life (EoL) issues are ever present. They are not easily or happily dealt with, but they must be dealt with. The respect and compassion I've seen from the team I'm working with has made a large impression on me. You cannot teach a medical student how to handle EoL issues, just as you cannot teach a person how to come to terms with their own mortality. But modeling appropriate behaviour and practical thinking can be done. I've now seen it.
I may not want to go into Geriatric work after this attachment, but I can say I've learned from it. I've learned a lot. Most of it has been comforting.
Pax,
~LLL
