“The best of people are those that bring most benefit to the rest of mankind.” -Prophet Mohamed (sallalAllah aleyhi wa salam)
Its amazing to realize that in less than 4 months inshaAllah, I’ll be starting my final year of podiatric med school! SubhanAllah, it literally feels like a few weeks ago that I was fumbling in clinic and had no idea how to use a Doppler machine for pulses. This month I am on my internal medicine rotation, which is also my very first rotation where I examine in-house patients. It is a VERY different experience than the traditional podiatry out patient clinic that I’m used to, but as always, I so enjoy a challenge!
The first of February, seven of my classmates and I gathered in a conference room at the medical school building and attended an orientation, in which we were informed that we were randomly selected into a department within the hospital. At the end of the talk, we each were presented with a packet and instructed to find our names and placements. Everyone was silently praying to be placed in cardiology, as we had heard from the fourth years that it was the most interesting rotation with the most flexible time frame (AKA 9-12 PM). However, I opened the packet and found that I was placed in pulmonology, which was according to the upper years the second best. Across from me on the table my best friend groaned; she was placed in general medicine, which was the toughest with the longest hours. I really could not complain!
Right after we figured out our placements, we were handed a list of the residents’ phone numbers and instructed to contact our residents to meet and officially begin our rotation. Although I had months of experience at our school clinic and the VA rotation, I still felt nervous when calling my resident and rushing to meet my team on the floor, where they had already began rounds. I had never attended hospital rounds, and was honestly worried about what was expected of me. Although I have conducted a full history and physical exam, I don’t feel as confident with the other parts of the exam as compared to the lower extremity aspect. Thats just me personally, but as I began this rotation, my ultimate goal was to walk out of the comfort zone and learn as much as I could.
After the first two days, I settled into the routine and learned the ropes bit by bit. I was assigned a patient to examine, read reports on, and present to the team everyday. I arrive at the hospital by 8 AM, where I look up the lab work for the morning, specifically the BMP and CBC. I also make it a point to jot down any meds that the patient is taking, especially if there have been any changes. Next, I check the patent’s chart for any overnight changes, respiratory adjustments, and nursing notes. I then examine the patent, ask the pertinent questions, then make my way to a side table where my team and I meet up until the attendant arrives for rounds around 9. We then commence rounding on all the patients on the list (usually 13 or 14) and in between discuss medications, treatments, articles with evidence based medicine, and generally anything to do with the pulmonary system of the body. We also joke and share anecdotes, while making a to do list of what the attending would like for us to do, such as follow up appointments for discharged patients and D/Cing orders (basically means to cancel them…that was a new vocal word for me!).
Although I was expecting the atmosphere to be strictly and forebodingly academic, I was pleasantly surprised to find that it is quite the opposite. My team is made up of the attending (who is that stereotypical doctor who wants everything in tip top shape), a fellow (who tries to turn everything into an educational amusement park), two residents (who discreetly roll their eyes when the attendant makes unnecessary demands or a patient’s family member is overly nosy), a fourth year med student and myself. A strangely dysfunctional family that make everything work out quite nicely at the end 🙂
The advantage of rotating at a hospital is that you are exposed to a wide variety of patients . From the lady who has no nose due to chronic cocaine snorting to the COPD patient who suffers from smoke inhalation when his drunk son almost burned the house down, I’ve me quite a few characters with outrageous stories. I’ve also learned not to get emotionally attached to the patients as well. For instance, one our patients was suffering from end stage COPD, and suddenly had hameturia. Lo and behold, we consulted urology who discovers that she had a malignant bladder mass. After several discussions back and forth, we decided to take the risk of anesthesia and have the mass removed. With not a bit of trepidation, I checked her chart the day after the procedure while mentally preparing myself that she had not made it through the night. She’s doing well now alhamdulillah, but you have to always expect the unexpected. Something I learned from day 1: in real life, you will RARELY have a textbook patient!
As the month goes on, I hope to continue enjoying the people and the academics, while repeating the words of a recently discharged patient who always had an upbeat attitude, “Jolly good, jolly good!”.