Showing posts with label M4. Show all posts
Showing posts with label M4. Show all posts

Tuesday, October 4, 2011

Cornbread and Greens

I just finished up my M4 internal medicine rotation (which is what I want to do with my life). It was an exhausting month, but I thoroughly enjoyed it. I learned so much about so many things, not just disease processes, but also the interdisciplinary aspect and business side of medicine. I had a fantastic team- Team Green! I had a great resident and intern. They were very supportive and took the time to teach us. I was partnered up with another M4 who has been one of my dearest friends throughout med school, and he always had my back-although he never brought snicker or chex mix. It was a fun month.
It is hard to describe to you the bittersweet feeling of the last day of a long, hard rotation. On one hand, I was so glad I was going to be able to sleep past 5:30. I was looking forward to eating breakfast with my husband again. On the other hand, I spent 30 days with these 3 team members. 315 hours. Do you lnow how well you get to know someone working almost 12 hours a day with 3 other people from headquarters the size of a broom closet? You get pretty close. You know their spouse's name, their kids' names and what sports they play, what they drive, what they would drive if price was no object, how they like their mugshots burger, their aspirations, their fears, their struggles, their hope, and their faith. Then after 30 days is up, as my partner would say, "you just throw them deuces and say peace". That is really how it is... we work until everything is done... we shake hands... Wish each other good luck... and leave. Then the next day, you move on to the next month's rotation and start over with a new team.
Just a little side note... I'm so glad to know that UMC has amazing internal medicine residents and that I don't have to worry about team dynamics and being stuck with a rough crew when starting a new month. Every one at UMC in internal medicine seems to have plugged in to the team mentality. There is not "Well I'm done, I'm going home," it is everyone helping everyone get their work done-because we all desire to get home at a decent hour. In my expereince no one gets stuck with a heavy work load alone. The team has got your back.

So... The reason for my post:
My favorite patient of the month is a lady who has been at the hospital for 8 months. She has not been outside those hospital walls since last winter (can you imagine?). The hospital walls have become her prison. I'm going to call her Sassy.
I came on to the medicine service at the beginning of the month and I had heard from those that were participating in Sassy's care how difficult and demanding she could be.
I went in to see her the morning on the first day of the month with those comments looming in the back of my mind. The idea of her that I had formed in my mind from other's comments had caused me to have a flippant attitude concerning her. She is constantly complaining of itching and pain around her PEG tube. She has a trach and it is difficult to understand her when she talks. She had been laying in the bed since February, not really participating in PT/OT. She has been labeled as a “rock” and thought of as someone who would stay her until she died. She was doing well and was still here due to placement issues. There was not a lot that we were doing for her. So I took her complaints with a grain of salt for the most part. It was when she stopped complaining that people would get worried.
I don’t know what caused me to change my attitude towards her. Maybe it was seeing her everyday and God moving my heart to feel miserable FOR her. Whatever the reason, I began to listen to her, spend extra time in the room with her, pop in her room serveral times a day, and attempted to meet her every need-whether it was moving her pillow around, putting her back scratcher within reach, or covering up her toes. Whatever she asked, I attempted to do it. She was exhausting me in the beginning, but after mixing in a little “tough love” when it was appropriate, she and I developed an understanding. I expressed to her that I was working as hard as I could to get her well and get her home to her family, and I told her that I needed her to work with me, to work with the nurses, and most important, I needed her to work with her OT and PTs. When I mentioned going home to her and that it was not an impossibility, her eyes lit up. I honestly think she thought she was sicker than she really was. It was like she thought that UMC was going to be her new home. After this little talk, she was a much better patient- not perfect, but much more motivated. The end of the month came. I told her good bye and passed her care on to one of the M3 ladies that I knew would be sweet and give her that tough love she needed.
I look back and cringe at the approach I took with her the first week. I let other opinions creep in and affect my judgement before I had time to form my own opinion. I wasted a week with this lady. In the last three weeks of the month, Sassy and I bonded. We can now communicate without her saying a word. I can read thoughts by her by her facial expressions (which is why I call her Sassy in this post) and I have learned to read her lips when she needs to voice a concern. She has been participating in OT/PT and is now able to stand up and take a few side-shuffle steps. She prefers to sit in a chair during the day instead of laying in the bed all day long. She started eating a soft mechanical diet the day before I left. Before then she had been getting tube feeds through a tube in her stomach, called a PEG tube. She had a set back near the end of the month and was sent to the MICU and she still wanted the therapists to do therapy in the ICU every day. She is a different woman from Sept. 1st. She has hope. She is motivated. She is trying to get home.

She was sitting up in a backless chair eating greens and cornbread the day I left. I never thought greens and cornbread could make me tear up- but I sure did when I saw Sassy sitting up, eating, and grinning that sassy little grin she has.


Pin It A few pictures as always:

These are all from last weekend at the deer camp...We had a blast as you can see!




Wednesday, August 24, 2011

Ms. Bright Eyes


Yesterday, I was in pulmonary clinic... dealing with the usual there- lungs. I was about to leave for the day, when the attending physician asked me if I had ever seen discoid lupus. I had heard of it before and I knew it was an autoimmune process, but I didn't know how it was different from normal lupus. With normal lupus, you may or may not get a rash on your face that looks like a bad sunburn. With discoid, that rash flakes and scales and after it heals as well as its going to heal, it looks like someone burned the skin with acid. It is disfiguring. Google it. I was not prepared for what I was about to see.

This lady was a young african american woman, not much older than me. Her face was scarred up. Her cheeks were varying colors of brown, pink, with the occassional white spot. The skin was leathery and not smooth. She had wrinkles, but not like the wrinkles old people get. She had the tight wrinkles. The wrinkles scars and burns make. She had ulcers and sores hiding under her bangs. You could see the white scar tissue forming around the pink open sore. It looked painful. I imagined that it would sting to get it wet, like a strawberry from sliding on the basketball court or in the infield. I imagine that her sweat on these hot summer days stung so bad and that it hurt to wash her face.

I didn't say much. The doctor just took me in and introduced me and asked if he could teach me about her history and her disease. She smiled and enthusiastically agreed. He explained her disease to me. She had been in and out of the hospital many times. She had been in ICU once for lung complications. She was on several immunosuppresant drugs that keep her prone to infection. She had to take a large amount of pills ever morning and night and she came in every six months to get an iv infusion of a drug that is similar to chemo. After he explained things to me, the doctor thanked her for the learning opportunity she gave me and we left.

I learned a lot about discoid lupus. But what got me was her attitude and sweet spirit. I was not even in there five minutes with her, but I could tell a lot from her smile and her eyes. Her eyes were SO FULL of life. They had the twinkle in them that let you know she had plans. She has a terrible disfiguring diesease that will keep her in and out of hospitals for the rest of her life, and might possibly be the end of her life one day, but she didn't let that phase her. Her bright green eyes were determined and motivated. Her sweet spirit let me know that she had made peace with the cards she was dealt. I felt so sorry for her but she did not feel sorry for herself.

As I thanked her and walked out of that small clinic room, tears began to well up in my eyes. I don't know Ms. Bright Eyes... but she touched me yesterday. She was a living version of James 1.

James 1:2-4
"Consider it a great joy, my brothers, when you experience various trials, knowing that the testing of your faith produces endurance. But endurance mst do its complete work, so that you may be mature and complete, lacking nothing.

It Is Well With My Soul
Lyrics: Horatio G. Spafford
Music: Philip P. Bliss

When peace, like a river, attendeth my way,
when sorrows like sea billows roll;
whatever my lot, thou hast taught me to say,
It is well, it is well with my soul.

It is well with my soul,
it is well, it is well with my soul.

Though Satan should buffet, though trials should come,
let this blest assurance control,
that Christ has regarded my helpless estate,
and hath shed his own blood for my soul.

It is well with my soul,
it is well, it is well with my soul.

My sin, oh, the bliss of this glorious thought!
My sin, not in part but the whole,
is nailed to the cross, and I bear it no more,
praise the Lord, praise the Lord, O my soul!

It is well with my soul,
it is well, it is well with my soul.

And, Lord, haste the day when my faith shall be sight,
the clouds be rolled back as a scroll;
the trump shall resound, and the Lord shall descend,
even so, it is well with my soul.

It is well with my soul,
it is well, it is well with my soul.

My Bachelorette Party
The bridesmaids and Huck!