This second half of my Sub-I went by super fast. After the team change I felt like I had to pick up more responsibility for various reasons. Part of it being that I was the only person on the team with prior experience with the large majority of our patient and knew their cases pretty well, so even with patients I wasn’t directly following, the interns and senior looked to me to get a sense of the patients’ overall trajectories and trends. In one case, we had a patient who kinda kept cycling between health and decompensation (often right before we would be planning discharge), and I had a random thought to ask about potential ingestion that were not on his med list. Turns out he kept getting this supplement from home that was tanking his blood pressure. This was more of my own imagination and the influence of watching House than my personal relationship with the patient, but it still felt good to be the one who figured it out. We also had the most jaundiced, healthiest-acting person with likely terminal liver disease that I had ever seen. It looked like he had been colored over with a highlighter, but he was always in a good mood, feeling good and just overall a nice guy. I’m sad that my sub-I ended before I was could see one of the patients I had been working with the whole time. I had gotten to know the family and was seen as the primary point of contact from the medical team. Our plan for this last week I was on was to have a goals of care discussion with the family. The patient and family asked if I could be there, but sadly my last day was the day before. I hope he did well and is now on the way to a decent recovery.
Having this rotation right after doing a month of inpatient family medicine was nice. I think I definitely confirmed that I want to at least train with inpatient components and possible continue being able to do inpatient after residency.
nANIMOv 