[Album: Single & The Great Gatsby Soundtrack (2013)]
"...your pretty face and electric soul."
First entry of 2014 -- yet another long gap. Yet another hot mess that is (personally) long overdue.
Perhaps I have an excuse. The entire month of January was spent on a Research Elective -- my efforts to frantically finish longstanding projects from the past 3 years and ready them for publication. All in an effort to pad that Curriculum Vitae and be at least mildly presentable in front of Residency Program Directors come this Fall. It was productive, but sadly, entirely devoid of any Clinical exposure.
Oh well. As a Medical Student, more often than not, we have to play the game. Residencies are only becoming more competitive and all of us have to bring our best face forward. Hopefully after all this I'll be ready for my close-up with Mr. DeMille.
"I've seen the world, lit it up. As my Stage now."
Fortunately, I'm back on a Core Clerkship. In actuality, I just finished the 2nd week of my 1-month rotation in Family Medicine. Quite possibly the polar opposite of Surgery...wow that seems so long ago now (what? a month and a half?). Regardless, what is known as my Primary Care Block is well underway. I follow this month with 2 months in Pediatrics and conclude my 3rd year of Medical School with 2 months on Internal Medicine.
The bad? I miss the OR (and scrubs).
The good? The Patients. Up close and in your face personal.
"Channeling angels in the new age now."
There are opportunities to converse, connect, and build genuine rapport within the Specialist and Surgical settings, but I'll admit that it is more challenging. The biggest constraint is Time and the toughest obstacle is lack of Continuity. Though there are numerous intangible lessons and experiences -- Hippos -- they are more like snapshots...fleeting images stuck in time. In Family Medicine, and I predict for the next 4-5 months the Hippos seem to be more like a movie. Time is taken for setting the plot and character development is paramount. In fact it's so much like a movie I'm glad I've made this metaphor, because in Primary Care every Patient is your favorite protagonist -- you pump your fist with every triumph and cringe with every mistake.
"Hot summer days, rock'n'roll...the way you play for me at your Show."
Of course there is a staggeringly large amount of information to master...the Crates this time around aren't any less massive and burdensome (this is still Medicine after all). Ultimately, though I miss operations and I miss procedures (and I would really love not having to wear a tie everyday) I have been enjoying this rotation more than I thought I would. They say Primary Care is the 'front line' after all -- and that means death and victory and a whole lot of Stories. Bring it. YOLO.
"Hot summer nights, mid July...when you and I were forever wild."
the crate --
Growing Old
When I say my experience now is the polar opposite of before, I realize just how appropriate that statement was. Whereas my last clinical rotation was in Pediatric Surgery, the Family Medicine practice I am currently at consists almost entirely of Geriatric Patients. Go figure.
"I've seen the world, done it all."
It does allow me to draw stark contrasts between Pediatric Crates and Geriatric Crates.
I'll admit that one of the best things about any Pediatric rotation, I assume, is that histories are blissfully short or non-existent. Children don't usually have chronic medical conditions, nor is it usual of them to have had multiple surgeries. The best part for Medical Students? Having to look up and memorize a hella long list of medications. Oh wait. There usually aren't any. #winning.
As for Geriatrics...
"Had my cake now."
I'm going to save time and stave off the onset of carpal tunnel by saying nearly everything is flipped for the 65 and over crowd. It's staggering how extensive of a history each of my Baby Boomer Patients has accumulated in the past half century or so. Even the healthiest Patients I've seen -- those who eat right, do right, and know what is right suffer from at least one medical condition...usually Hypertension, Low Back Pain, or Diabetes.
"Diamonds, brilliant...and Bel Air now."
If I've learned anything on this Family Medicine Rotation...if I could only carry one Crate away from all of this...it's just how profound the effects of aging can be on one's physiology and mentality. To be fair none of this should be surprising. I knew to expect what is commonly called 'Polypharmacy' and we have had numerous lectures throughout the first two years of Medical School on the changes that occur with aging -- be it the natural hardening of our arteries, the gradual decalcification of our bones, or the creeping progression of forgetfulness.
"Will you still Love me?"
Maybe it's because none of it is no longer theoretical. Maybe it's because those lessons and exams are now flesh and bone sitting in front of me -- telling me about their grandkids and asking me what kind of Asian I am. Likely, it's all of the above and hearing about their journey through life motivates me to do my best to manage and understand the myriad of conditions each of them has...and each of them, of course, has their own unique combination platter of ~20 common conditions from the elderly buffet.
"When I've got nothing but my aching soul?"
From an impartial, non-human stance these Baby Boomers present a very enticing intellectual puzzle for all the Dr. Houses in the world. For those who want to be doctors/physicians/healers these are the Patients we hope to continue serving and empowering. It's almost like a thank you -- thank you for building our cities, thank you for fighting the evil in Nazi Germany, thank you for raising me.
That aching soul is more than enough.
the hippo --
Growing Bold
It's all about the Stories.
My favorite thing about all this Primary Care business is that we have just a little bit more time with our Patients. (Not nearly enough mind you.) We are, however, encouraged to solicit as much backstory as we can and to gather as many puzzle pieces as possible to complete the bigger picture.
I like that. A lot.
It's as if you're asking me to go on an African safari and to document every Hippo I see. You bet I'll search high and low for those massive intangibles. Those unique unmentionables and look-past-ables.
"Will you still Love me?"
Hippos are massive though...and if I'm not mistaken they're not endangered as of yet. So it's safe to take away only one for now. What would I take away from Family Medicine? Well. It's kind of cheating but part of it lies in the name of the Clerkship itself, and that is Family.
"When I'm no longer Young and Beautiful?"
I'm not necessarily talking about husband, wife, 3-4 children, white-picket fence, dog, and suburbia. What really struck me was the dynamic at the core of the family unit -- the husband and wife. It probably goes without saying that I've seen married couples while on this rotation...and it's incredibly endearing when they come on the same day for their usual check-up and argue over who's going to be seen first.
"I know you will."
Many of these couples have been together for 40+, 50+, and yes 70+ years (I saw a 97yo last week). These Baby Boomers took their vows in an age when 'courting' meant something and divorces weren't handed out like flyers on the Las Vegas Strip. This is the Hippo that hit me. To see and hear about the sturdiness of Love -- no matter how rough it got...and I've already heard some jaw-droppers.
The most heart-wrenching? Those spouses who stand by the Love of their Life despite the opinion/fact that their Loved one may be long gone or beyond reach. On a Hospice Visit last week this was all too common a scenario. Frail and aging spouses faithfully visiting their soulmates even though they could never get a response, never know if they are getting through, they just never know...but it never mattered.
Even though they are combative. Even though they are drooling, and vomiting, and soiling their clothes incessantly. Even though their spines have disintegrated into extreme kyphosis and the lack of connective tissue no longer has power over wrinkles and deep creases. None of it matters. Let's be real here -- eventually none of us will remain Young and Beautiful. If we find the right person, however, maybe we can at least stay Beautiful to the only person that matters.
"Oh that face that makes me want to party."
Even if it was a different time I still hear similar stories. Nervous first dates. The rapid onset of freedom at 18 and college parties. The victory in scoring a job and buying a home, and yes, raising that Family to the best of their initially naive abilities.
It really is like a thank you to care for these Patients. If nothing else thank you for reminding me that the deep and indestructible Devotion of True (and I mean legit) Love can or did exist at one point. You know what? I like that...True Love? That's fairy-tale B.S. There are going to be bumps, and potholes, and detours...none of this Tinkerbell happy ever after junk exists.
Give me Legit Love or give me nothing. Thanks for the lesson Baby Boomers.
"She's my sun, she makes me shine like diamonds."
