I thought breaking my hip half way through PA school, missing 6 weeks of lectures and being confined to a walker for over 2 months would be the most uncomfortable challenge I would ever endure. And then I started my internal medicine rotation.
I walk as quickly as I can to keep up with the attending and the rest of the team during morning rounds. People fall off the back, but gesture as if to say “Go on without me…save yourselves!!” We hurry along and convene at the patient’s bedside. I listen intently as the resident, intern or med student on my team present their patient to the attending physician. They rattle off the HPI (History of Present Illness) and exam findings, explain their assessment and plan, and we proceed to engage in a comprehensive discussion with the attending regarding additional considerations. We exit swiftly to proceed to the next room, and now it’s my turn. The attending queries me on medications, pertinent positives and negatives, my assessment and treatment considerations specific to this disease process. We wrap up and quickly move on to the next patient
After morning rounds I return to check on my patients or eagerly await the arrival of a new patient from the Emergency Department. Whether I am meeting a patient for the first time, or following up on their progress during their hospital admission, they never seem to mind that I am a student responsible for their care. They are always willing to explain their story and are grateful as I listen while they describe their symptoms. I feel knowledgeable as I explain to my patient the purpose for her being discharged to a rehab facility following her stroke. I can see in her eyes the relief as she realizes how helpful this will be. Her smile, albeit crooked, signifies to me her acceptance of this new reality, and she thanks me for taking the time to explain this to her.
I spend the remainder of the afternoon writing up notes for the patients I have seen that day, and begin working on my case presentations for the next morning. My resident helps me work through the differential diagnoses and quizzes me on the diseases and conditions in question. I read up on the conditions we discussed and develop my SOAP note using a new “cheat sheet” given to me by my medical student colleague. The next morning at rounds, it is my turn to give an update on my patient. I recite the patients HPI and exam findings, explain the current assessment and plan, and proceed to answer the attendings query on the percent of lower GI bleeds that resolve on their own (~75%!). We then proceed to engage in a discussion regarding treatment options for GI bleeding. And just before moving on to the next patient the attending looks directly at me and says “GOOD JOB.”
After six weeks of internal medicine I have learned one very important truth that taking care of people…IS.HARD. On a daily basis, I am pushed to mental dimensions that I did not even know I possessed. And the next day, I’m pushed even further. But I’m being fulfilled in a way I never thought possible. I am elated to be learning medicine on the fly, watching as symptoms and disease processes unravel in “real time.”