Friday, August 12, 2011

So much to do, so little time

I absolutely love doctoring. I've said it before, and I will probably say it again and again. Helping someone deal with sickness is really rewarding. The challenge is, that we can always do more. We can always improve the science, we can always improve our communication, we can always improve the delivery of care, the cost of care, the equality of care. Frankly, these last 8 weeks I've been really overwhelmed by how much more can be done. How much we have left to do. Medicine has gone a long ways by many measures, but all I can see is how far the road ahead is for us in terms of delivering really high quality care. I feel like I'm this little newborn baby in the middle of a rainforest trying to find my home that is 10,000 miles away. It is that intimidating of a challenge! I've found this state of frustration to be not very conducive to anything, and so I've been trying to develop the personal mantra of "Do what you can, when you can, with what you have." Still-very difficult!

 I see how it is so easy for a doctor to make their work all-consuming. But for me, the value of relaxation, the outdoors, reading, family, and friends is priceless. For me personally, and also for me as a doctor. It reminds me of why I think medicine is such an amazing profession. I get to help out family and friends. They may not be my family and friends, but they are to someone, and I always try to approach a situation by thinking "what would I want if this was my child, or my mom".  I find it much easier and much more fun to deliver medicine in this way.

I'm working on some solutions, in my spare time. Maybe one of these days I will share them with you on the blog! In the meantime, here is a quote that continues to energize me:

Some people see things that are and ask, Why? Some people dream of things that never were and ask, Why not?

Friday, August 5, 2011

NICU: Babies babies everywhere!

Babies on the mind, caught another 2 today, 8 for 8!

Most interesting about babies is how they all start out the same. You can't predict which baby you hold will become the next President of the United States, the next doctor, or school teacher. You can't predict who will have mental health problems, obesity, or breast cancer. Just by looking at them, you wouldn't know who will live in poverty or who will be the next billionaire. We all start out the same: sleepy, hungry, and naked. We know the world by what others teach us about the world. If you teach me that I can do anything, I'll believe it, because why shouldn't I? It's all I know. Each baby I caught, I said a silent prayer for and greeted them with a big smile. It may not be much, but they came into the world into loving arms, and I hope we continue to show them how great life can be.

Thursday, August 4, 2011


Yes, I've finished boards, my preclinical years, and entered clerkships. If you get sick in the Bay area peninsula region, you might just see me knocking on your exam room door. My first rotation is pediatrics. I started in July with a month of outpatient pediatrics clinic. I was in the Endocrine specialty clinic, the Acute Care Center at Packard, the Adolescent Health Clinic, and even the Well Baby Nursery. It is such an honor  to be serving patients and working alongside such outstanding professionals. I've seen many interesting medical cases, from hypothyroidism, hyperbilirubinemia, DiGeorge syndrome, ataxia telangiectasia, to the mundane viral gastroenteritis, pneumonia, and constipation. Much more interesting, and more meaningful for me, have been learning about all the people with these health problems. Hearing what they like to do, their take on the latest Harry Potter movie, and what fears they have about their illness. I absolutely love doctoring, helping patients and families to understand the healthcare process, understand their illness, and understand what role they can play in their health. I am in my element!

That's not to say I haven't hit my own challenges. Even though I've been studying diligently for the last two years, clinical diagnosis and management is another beast. I know I'm a rookie, so I take it in stride, confident that I will continue to learn so much in the years to come. The challenges of providing good care in a chaotic healthcare "system" is what most frustrates and upsets me. "System" is absolutely the wrong term to describe how people in the US get healthcare, and everyday I see more problems and try to think of more potential solutions. The good thing is, that I have been so utterly impressed with the majority of my colleages and other health professionals I've had the opportunity to work alongside. The people aren't the problem! Unfortunately, well intentioned, good people in a convoluted health system can still deliver poor quality care, which I absolutely cannot tolerate. We have so much work to do!

Pediatrics is so much fun, I LOVE winning over the shy 3 year old, or teaching the 9 year old about their asthma, or being an ear for the frustrated 15 year old whose parents just won't understand. It can be crazy at time, and sometimes the crying is just too much, or its just plain mean to have to examen the ears of a 2 year old, but even the challenges are rewarding when you're finally able to overcome them by looking for Minnie Mouse in the 2 year old's ear canal!

When patients declare you their new best friend, or moms ask if you can be their child's permanent doctor, or when you get a grateful look from dad because you found a fun way to look in a kid's nose that doesn't totally freak them out, it just makes my day. At its core, medicine is about helping people, and sometimes that means grabbing some juice for the new mom who fainted, or remembering to let the kiddo pick out their favorite sticker before leaving the clinic, or congratulating the new parents on their beautiful baby. I get to do things like this for the rest of my life! I've already had my challenges, and the whole 5am wake up is not really my cup of tea, but ultimately, I know that this is exactly what I want to do, for the rest of my life. I have the coolest job in the world.

I haven't even gotten to my inpatient experience, but this is already a long post. Helping deliver and resuscitate babies in the NICU has been amazing. I'm 6/6 in catching newborns! The intensity of the NICU at times is overwhelming, dealing with life and death is not something that is easy, but learning the skills to truly save lives is so inspiring to me. I can't wait for the day when I have developed these skills to a point where I truly can make a difference. In the meantime, catching babies is just fine with me. :)