It doesn't have to be clinical, it just has to help us to become better physicians. I will have no problem making that case - it just feels so irresponsible...and exciting.
ohhhhh dilemma.
Thursday, June 19, 2008
Tuesday, June 17, 2008
five more minutes.
My name is Courtney, and I am a studyholic. I had been on top of my habit for four years until yesterday (June 16, 2008).
I had a "study day" for my first day of orthopedics after a 3-day weekend, and it was sunny, and my first day in a few that I wasn't either coughing or blowing my nose steadily - so my mood was high, and I was feeling eager. These internal factors in combination with a chewable amount of information to know and a plan of how to go about knowing it (a finite list of 75 cases on which our exam is based) - made me want to study - and not stop. This has happened to me before. My thought process will go something like, "Today I should try to get through 8 cases - if I do that each day I should be through them all by the middle of next week. Oh, but what if I do 10 or 11 today - then I could get ahead of schedule..." at the end of case 4 I have to pee, " I really need to pee - I should go at the end of this next case" - next case - "oh I should just look at the topic for the next one, maybe I should take it with me (to pee? it takes less than one minute...) oh - well I have already read half of it, so I might as well just finish this next one, and then pee..." and so on and so forth. Then I start wishing that my study time could be extended - if only I didn't have to have stimulating and rewarding interactions with real people. Maybe I will have time for a few cases during the break in my day tommorrow? And then I start reminding myself that my recently relaxed approach to studying has been more than sufficient, and much more enjoyable, and I should not fall into the medical school/career trap of trying to know everything.
Sometimes it is hard work not to work so hard.
I had a "study day" for my first day of orthopedics after a 3-day weekend, and it was sunny, and my first day in a few that I wasn't either coughing or blowing my nose steadily - so my mood was high, and I was feeling eager. These internal factors in combination with a chewable amount of information to know and a plan of how to go about knowing it (a finite list of 75 cases on which our exam is based) - made me want to study - and not stop. This has happened to me before. My thought process will go something like, "Today I should try to get through 8 cases - if I do that each day I should be through them all by the middle of next week. Oh, but what if I do 10 or 11 today - then I could get ahead of schedule..." at the end of case 4 I have to pee, " I really need to pee - I should go at the end of this next case" - next case - "oh I should just look at the topic for the next one, maybe I should take it with me (to pee? it takes less than one minute...) oh - well I have already read half of it, so I might as well just finish this next one, and then pee..." and so on and so forth. Then I start wishing that my study time could be extended - if only I didn't have to have stimulating and rewarding interactions with real people. Maybe I will have time for a few cases during the break in my day tommorrow? And then I start reminding myself that my recently relaxed approach to studying has been more than sufficient, and much more enjoyable, and I should not fall into the medical school/career trap of trying to know everything.
Sometimes it is hard work not to work so hard.
Wednesday, June 4, 2008
eighth first day
Over the course of the year I have found increasing comfort in my chosen route to be a medical doctor - of some sort. What I appreciate the most is the patients and their stories and the privilege I have, of knowing them for however short the while.
Here is one of my recent favourites:
The other evening I picked up a chart in the ER. The triage form read "lower extremity injury: mild-moderate pain +/- deformity" - so far pretty standard for the area of emergency I was working in. A quick glance at the patient information informed me that this was a 78 year-old male, which made me worried about a fall...and a hip. My next step, before I see the patient is to glance at the nurses notes, for the vitals signs - stable, and any history they might have taken during their assessment. This went something along the lines of: Was pushing car in reverse when he was knocked down by the car door and run over by the front tire. No loss of consciousness...Now, the fact that this person had been triaged to the Treatment side of emergency meant that he was pretty stable - but run-over at 78? I need to see this man right now!
I went to see him and verify his story, and sure enough, he was unable to get out of his alley because of a construction crew, and so when he put his car in reverse, and it wouldn't work, he thought that he would just get out and give it a little help. Well, then the care started to roll a little but faster than he could push, and it was getting away from him. With real concern for the neighbors fences, he thought that he had better try to jump in the car and hit the brakes - there is no way that this could turn out badly - right? He managed to get one leg in the car, but then he got knocked over. As he saw that the car was still rolling, and about to roll over him, he managed to get out of the way - almost. The front wheel still went over is arm and leg. Then the car continued down the alley and was stopped (gently it seems) by a telephone poll. He was fine apparently. Reluctant to let the construction workers call 9-1-1 - and then when they arrived, he arranged for them to follow him back up to his house, as he drove the car back (couldn't leave it at the end of the alley of course).
Turned out he was fine, other than some scrapes and bruises. All of his 78-year old bones were intact. The only thing left to fix was that reverse.
Here is one of my recent favourites:
The other evening I picked up a chart in the ER. The triage form read "lower extremity injury: mild-moderate pain +/- deformity" - so far pretty standard for the area of emergency I was working in. A quick glance at the patient information informed me that this was a 78 year-old male, which made me worried about a fall...and a hip. My next step, before I see the patient is to glance at the nurses notes, for the vitals signs - stable, and any history they might have taken during their assessment. This went something along the lines of: Was pushing car in reverse when he was knocked down by the car door and run over by the front tire. No loss of consciousness...Now, the fact that this person had been triaged to the Treatment side of emergency meant that he was pretty stable - but run-over at 78? I need to see this man right now!
I went to see him and verify his story, and sure enough, he was unable to get out of his alley because of a construction crew, and so when he put his car in reverse, and it wouldn't work, he thought that he would just get out and give it a little help. Well, then the care started to roll a little but faster than he could push, and it was getting away from him. With real concern for the neighbors fences, he thought that he had better try to jump in the car and hit the brakes - there is no way that this could turn out badly - right? He managed to get one leg in the car, but then he got knocked over. As he saw that the car was still rolling, and about to roll over him, he managed to get out of the way - almost. The front wheel still went over is arm and leg. Then the car continued down the alley and was stopped (gently it seems) by a telephone poll. He was fine apparently. Reluctant to let the construction workers call 9-1-1 - and then when they arrived, he arranged for them to follow him back up to his house, as he drove the car back (couldn't leave it at the end of the alley of course).
Turned out he was fine, other than some scrapes and bruises. All of his 78-year old bones were intact. The only thing left to fix was that reverse.
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