First M3 rotation - FME (Family Med)

So, I want to try to at least blog once per rotation about stuff. They're really encouraging med students, residents, etc to write to better deal with the tougher issues we face as health care providers. This post isn't going to be super heavy and also, do take what I write with a grain of salt (*this is my disclaimer). This does not reflect the opinion of anyone or any institution.

So, I'm halfway through the 2nd week and I'm REALLY enjoying it. It's family medicine which I had kinda ruled out in the beginning but I'm liking what I'm doing in the hospital (not so much in the clinic) as a family med so we'll see :). Plus, the people here are SUPER nice, always open to questions and open to teaching anything. Now those are the kinds of people I like working with.

One thing I've seen a lot that's a bit of a reality check for me is lots and lots of young women (more like children) who are pregnant. 16 years old is the youngest I've seen so far but one doctor has told me that she's delivered for a 12 year old before in this hospital. 16, 17, 18, years old...in my head, I can think and ask, "Are you truly ready to take care of a child? You are really just a child yourself!". But outwardly, as a professional provider, I must provide the best care for these patients and as a family doctor, after they've had their children, counsel them in good parenting skills, to help their children grow to be able to survive in this world. If there's one thing I'm really learning to admire in any resident or attending physician is the skill of tactfulness (saying what you need to say yet saying it with compassion, gentleness, yet firmness). There's a definite tension there that reminds me of the tension that we as Christians experience (but that's a whole other post entirely. I digress). There's lots of situations where I could really use tactfulness and that's not something I'm very good at. In fact, you could probably say that I'm absolutely horrible at it. I'm beginning to see lots and lots of prejudices and biases in myself, personality flaws that I think would make me a horrible physician even if I had all the medical knowledge in the world. But maybe Dr. House would refute that...I suppose there's a tension in that too....

Now this is not going to come as a surprise to most people. I'm fairly emotional and soft-hearted when it comes to people and seeing people suffering. I came CLOSE to crying about a patient for the first time last night. It was a 17 year old girl who had a history of lupus and was in acute renal failure and was about to lose her kidneys if we didn't transport her to the Children's Hospital in Memphis quickly (our hospital doesn't have a pediatric nephrologist). She was completely asymptomatic though so someone had caught it "early" during the day in clinic because of a routine lab work up. We had to enter the room multiple times to update the girl and her family about the situation (and it took awhile because we had to make a lot of phone calls to set up the transfer). Each time we entered the room, the situation was not looking up and I saw the girl's face drop. The smile left her face and she stared at the floor. After we confirmed the renal failure and set up the transfer, we had to drop the bomb on this girl that it was an emergency because she could lose both her kidneys and she was getting transferred by ambulance that night. She broke down and my heart just broke for her. She was only 17 and diagnosed with an extremely rare disease process. I couldn't possibly imagine what that would feel like. Anger, bitterness, denial, depression, sadness...News like that is a bomb and the explosion leaves emotional chaos and confusion in its wake. I wanted to just put my arms around her and hug her till she stopped crying (but her "boyfriend", her baby that was only a few months old, her mom, and stepdad were there so I thought that would be awkward). I almost cried but because I was trying to keep my calm and be professional, my heart just hurt instead. I wasn't able to go back to the ER to see her before she left but I am praying for her that she lives and keeps her kidneys. I don't know if I'll ever find out what happened to her but I do know that I'll remember her because this case was the first one that rattled me a little bit.