Eyes Open

This afternoon, we had to have a difficult conversation with one of my patients and his wife about goals of care. His wife brought up the subject: they were thinking about stopping treatment, going home and letting him die in peace. The conversation was good and I was like wow, this is so straightforward....until the patient opened his eyes (he spends most of the day asleep) and began looking around, and looking at me. He was a very different looking person with his eyes open, I thought to myself. He looks so alive with his eyes open. His eyes made me sad for him. When his eyes were closed, I thought it was good that he was going to die soon; he's been through a lot and he's only at more risk of us killing him if we try to continue treating him. But with his eyes open, I wanted him to live. For his wife, who had eyes red from sleeping in the hospital every night with him, who is the one giving him his tube feeds and suctioning his mouth so he doesn't continue to aspirate.

When the attending was done talking to her, I left the room because I didn't want my eyes to water. The intern was stronger than I, he stayed a few seconds longer and gave the wife a hug; she was in tears.

I can't imagine how this wife looks at her husband like this. Most likely his last days since we'll be stopping antibiotics soon. She remembers their fifty years of life together. She thinks of how different her life will be without him. She probably thinks of her own death as she watches her husband die. How quickly life passes. Tonight, I lift a prayer for my patient and his lovely wife.

Mid-Year Crisis

So I've finished a week of Medicine (not even actually) and although our patients are interesting, I'm starting to wonder if Internal Medicine is really my calling. First, I realized that I just might miss the surgery culture.

"Doris, you look different with clothes on." That's what my resident told me that a surgeon said to one of the nurses when he saw her in the elevator with her normal clothes on (not her scrubs, cap, etc.)

I also miss Surgery rounds. For the most part, I have three questions to ask the patient. Are you in pain? Can you eat without throwing up? Are you pooping? And then I would check if their Foley was in place and look at the wound site/dressing. Life was so easy. Now, I have to listen for heart murmurs, try to localize abnormal lung sounds, and look at fundi! Ahhh. Whyyyyyy. I mean, Plastics patients were some of the most complicated I had dealt with at the time, but my medicine problems lists are insane. I don't mind it but.....

Sometimes I feel like we talk about the patient and what we should do with the patient more than actually BE with the patient. I usually only see my patients when I pre-round and then randomly during the day if I need to see if they're really agitated or the nurse just wants Seroquel to make her life easier or to get their mom's cell phone number to update her. People criticize people that don't go into medicine because they have limited interaction with the patient but....I don't call that much interaction with patients!

I also don't like spending the post-rounds day waiting for lab results to come back only to tweak meds or to decide to order the next test. That and is it just me or is there a TON OF ADMIN WORK in medicine? Ughkk...the whole day we're just documenting stuff, telling other people what we've documented and then repeating the process. Lame.

So, in recap. I'm a 3rd year med student and I'm having a mid-year crisis. Notably because I thought I would fall in love with medicine, but now I'm having doubts....

Can't do surgery because I can't do the lifestyle, hours, lack of food.
And possibly, can't do medicine because there's not enough excitement in the day...

Whyyyyyy is my life changing so dramatically all at the same time?! Change in relationship status. Change in future specialty. Whyyyyy???

Hoping for some inspiration....

Me Time

Last weekend, I had lunch with a good friend who shared with me some of the things on her "singles' bucket list"--basically a list of things she wants to do or work on during our time of being single. Being single again is hard, but I'm going to use it as time God has given me to work on myself and do things for me that I didn't necessarily have time for before.

Tonight was my first night back in Charlottesville, alone and without any one to pass the time with. So I went to the gym, and after I showered, decided I would treat myself tonight. Pajamas on, I watched a movie, lit my favorite Sandalwood incense, put on an aromatherapy face mask, and made myself french-vanilla coffee (yes, at 9 pm) to go with my biscotti.

I'm going to try to cook an actual meal at least once a week (I'm used to going to the grocery store and picking up Lean Cuisines for the week). More studying at Barnes & Noble instead of my room. Reading spiritual books and leisure books (I'm dying to read Of Love and other Demons by Gabriel Garcia-Marquez...but I have to wait until Medicine is over). Doing a better job of keeping in touch with my friends back at home while I'm at school.

What else should I add to my list? (My friend's list was a lot more exotic, adventurous but ...I'm not going to try to kid myself...this girl is not backpacking Europe anytime soon.)

AIM

I'm actually a bit sad that AIM is over. Not only was the schedule good, but I actually liked the work (most days), thought my patients were interesting and ....I got to live at home!

Two favorite moments among many, of course:

"Doctor, my fasting glucose was 99 in this last lab.....I guess I should cut back on the chocolate." "No....I don't think that's necessary ma'am. You're 90. You can have as much chocolate as you want....as long as you're having chocolate as every meal I don't care how much you have." Awesome...can't wait till I get older!!!

Another patient:
"Do you drink coffee?"
"Nope."
"Soda?"
"Nope...."
"Ok good..."
"Well....I usually need 2 Red Bulls a day in addition to my Provigil."

That being said, on the last day, my preceptor told me, "Grace I'm flattered you're interested in medicine....but....you could do better." !!!????!!!! WHAT. "You should obviously choose something you are somewhat interested in academically or whatever but I would suggest you think really hard about lifestyle and income....so you know, just don't forget that I told you that."

dumdumdummmm.....

The Good Ole Days

I had a patient, a 80-something year old man tell me how his wife's condition was deteriorating. She was having memory problems and was starting to become a danger to herself. He was a director of a big association here in NoVa, often traveling around the country.

"I've never missed a meeting. We have about 50 meetings a year around the nation but I told them, I can't come to Texas next month. They told me it's just a week-we'll pay for everything so it won't be a burden, just come. I told them, I'm not going to leave my bride home alone for a week for work. I have my priorities straight."

They are celebrating their 60th wedding anniversary next week. My patients are truly inspirational, I pray that God has a husband like that for me.

Honey and the Moon

Some times of the day, I feel like I'm managing well. I have a feeling of peace that God let this happen, this unexpected turn of events. And other times, I wonder what happened.

"God loves Grace." "Tell her to not be upset about 2.5 years, my husband left me after 22 years telling me 'we are different'" "Bi'ism il-salib (in the name of the cross)

It's also not easy when people say, "You will find someone better" or point out little things that were not perfect. The truth is I loved him. He was amazing to me. Now that we are no more, I'm trying to think of times when I can look back and say "Yes, thank God we're not together anymore." But all our memories are beautiful, at least they were for me. From how I felt when he held my hand during our walks, to him driving 7.5 hours to see me, to cooking together, spending time in Barnes and Noble reading magazines, emailing and texting all day, talking at night, not wanting to leave each other's presence. He loved me so much. I loved him so much and I knew he loved me. So what happened?

"Someone else will make you happier than I can." Is that possible.