Drug reps coming to the office for lunch is so awkward. My attending clearly doesn’t want to talk to them, but obviously they are there to try and do their job and talk up their medication. I know it’s all about getting free lunch or whatever, and I don’t think anyone should feel bad about taking resources from pharmaceutical companies, but also I can’t help but feel bad for these folks who are being given a hard time just trying to do their job.
There’s going to be a lot of advancements in neurology in the coming decades I feel, and so maybe it is a could be a good place to be, I just need to find the kind of practice that matches what I’m looking for.
I’m learning. Each day I come in, I (we the students collectively) are answering more questions correctly. Today I impressed the attending by adding Lesch-Nyhan syndrome to the differential of a hypothetical patient. It was the first time I saw him say, “That’s a good thought,” non-sarcastically.
Being back in this community setting I think I am getting a better idea of what my ideal practice would look like in the future. Right now I feel like one of my biggest concerns is not having the bandwidth to do all the things I want to do in both my personal and professional life.
I was told several times today by patients that my Spanish sounded good. Part of that could be just because I always start this interview in Spanish with and introduction and do some simple history taking before explaining to them that my Spanish is actually not very good and that I will need to call a translator. Is this kinda fishing? Maybe, but also if I call the translator right in the beginning then I am missing and opportunity to practice my Spanish, and ultimately I verify everything to make sure patient care isn’t being compromised. Plus the positive affirmation is encouraging for me to continue practicing.
Anyways being back in this community clinic setting is reminding me how much I enjoy outpatient medicine. Neurology is growing me a bit, the puzzley aspect of it can be fun sometimes, but also much of the rest of medicine is pretty puzzley.
I found out that my attending is friends with my uncle. I don’t know if it’s a good thing or a bad thing that my attending knows that. Today one lady accused me of curing her tremors with my presence. The clinic was otherwise pretty standard, the usual Alzheimer’s, neuropathies, seizures. Been getting a lot of Spanish practice which has been nice, definitely getting more comfortable.
Still not sure how I feel about the pace of the clinic. On one hand things move fast, and the day goes by fast and it kinda feels efficient, and I the volume of patients and number of students spreads out some of the pressure, especially since we don’t even really present. On the other hand, sometimes I feel like the patients need more time, if nothing else to express their concerns in general. But maybe that’s the ~beauty~ of specialty work, you don’t really concern yourself with problems that aren’t related to your specialty, you just kinda hope they have good primary care.
It was my first full day in the clinic and there were 5 of us students total. It’s a busy clinic so it actually wasn’t terrible; I don’t feel like any one of us was just sitting around the whole time. In terms of what I am seeing in the clinic, it’s about what I expected. A lot of strokes, carpal tunnel, Parkinson, seizures, headaches. Mostly pretty straightforward stuff and the attending moves very quickly. Whether its a new consult or a returning patient, he typically doesn’t spend longer than 5 minutes in the room.
Lunch was provided by a drug rep today and all us med students sat with the attending for lunch. We had a pretty interesting conversation about how to “survive” after medical school. He was giving us all these tips about maximizing our deductibles and stuff.
Neurology seems like a decent lifestyle. Pretty predictable work, good clinic hours, possibility of inpatient work. I’m just not sure yet if I like the medicine, but I haven’t ruled it out yet.
Today was the first day of neurology. The morning was jus orientation and some review lectures and then I was told to go to clinic in the afternoon. I switched into this rotation a little late so I missed some emails with info from before, but mostly I was brought up to date. Originally I was primarily supposed to work back at the county hospital, but last minute they switched me to be primarily at a site in Downey which is close to where I’m living which I thought would be a good deal because I would have lighter commute. I was told to go in after lecture at 1330. I got to the clinic and there were already 3 other medical students working there with the attending I was assigned, and that isn’t even counting the 3 other 4th year USC medical students who are supposed to be working there, but were apparently told not to come in today and have their first day on tomorrow. The clinic seemed a bit hectic and fast paced. I got to see one patient, and the expectations for presentation weren’t well laid out, but probably partially due to the fact that I came in mid day. I got to meet the other students, and sounds like I may not have to come in every day. This will definitely be an interesting experience, logistically.
Last day of surgery, and it was a call day. Thankfully it was only a day call, and actually our residents let us leave early. Overall I’m glad to have had this experience. Surgery is really its own world. Honestly if the school was less and the lifestyle was better I would definitely consider surgery, but that time is necessary to become a good surgeon. There are a lot of other things I want to do with my life which is evidenced by my performance not always befitting a future surgeon. It’s not over though, I still have my exams, but we’re almost to vacation.
(1) People who decide to make lifestyle changes when they are already older.
(2) Quinoa salads.
Weekend swing shifts are the best. No clinic, just rounds and floor work. Get to spend time with patients without having to go to the OR. Today we discharge one of the ladies who’s been on our service for pretty much the whole time I’ve been here. She was a very sweet lady and I was happy that she was able to finally go home. There was another guy on our list who was here longer that I have who we’ve been working on getting a wheelchair. It is surprisingly hard but we finally got one and we went to go work with him to get up and try it out. It was gratifying. Almost done with ACS, thank goobness.
(1) Being alive in a time of video calling.
(2) Cute puppies.
(3) Cozy sweaters.
It was a crazy one, and I got the trauma case I was hoping for. The majority of the daytime was relatively chill, but after around 4 pm everything started rolling in. Had some motorcycle accidents, falls, assaults, stab wounds. The big case was a gunshot wound to the abdomen. When we were all looking into this guy’s belly, trying to figure out it injuries it was almost reminiscent of a group project. Everyone had their own thought and suggesting of what to do. Different responsibilities were getting passed around and everyone was joking around despite the gravity of the situation. It was good kind of group project.
Another thing I thought about though was how many resources were pouring into saving this guy life. 4 people with 6 figure salaries, 1 student with 100k debt, countless (actually carefully counted) disposable and plastics just being consumed with reckless abandon. And I get it, we are trying to save this man’s life, so maybe it makes me a little psychopathic, but that’s just where my mind went.
It was a super cool surgery and glad I got to be a part of it. Overall it was a busy night in trauma, we didn’t even get a chance to rest our heads for a teeny tiny bit. Cheers to the last 28-hour call of the rotation (maybe of my life).
(2) Ethics discussions