Two months has really flown by. Sorry I haven’t been as consistent with what’s been happening during this awesome time known as M4 year but let me catch you up.
September- INTERNAL MEDICINE
I realized very quickly in my medical education that being a resident is nothing like Scrubs and sure is hell is not like Grey’s Anatomy. It is WORK. Residency is the time in medical training where you come into your own as a physician, crafting the skills and forming the foundation of what type of physician you want to be when you’re out on your own. So these moments are critical. It’s also the first time when you get patient responsibility and that is a real eye opener.
So as an M4 on Internal Medicine, we are deemed “sub-interns” meaning that we have all the responsibility for our patients that we follow in the hospital. This is the time where we learn the inner workings of what it means to be a resident and the logistics of admitting a patient to the hospital, formulating treatment plans and ultimately what it takes for them to be discharged from the hospital.
Now this being my second inpatient month this year, I was already comfortable with understanding how to write orders, some admission criteria and how the hospital works. So this was just a refresher course and a crash course in how an academic hospital works. I took this time to focus on the areas I needed improvement on: formulating treatment plans, being able to manage all of a patient’s needs, how to become more concise in my patient presentations. Luckily I was blessed and fortunate enough to work with an upper level resident that I worked with during my 3rd year. I knew how he operated and it made the month extremely laid back. He’s a straight forward guy that was easily approachable and answered my questions outright and truthfully. The thing I remember most from talking to him was about when I actually am a resident and taking care of my own patients: “You’ll know what to do from experience and whatever you don’t know you’ll look up and find out. Because it will help your patients.” It’s impossible to know everything there is to know about medicine, it changes every day. Knowing that is both frightening and comforting. Comforting because there is always the opportunity to learn which is why I entered medical school in the first place.
October: Pediatrics Ambulatory Clinic
I knew I wanted to see kids because for the most part kids are fun! They keep you young and they just say the most ridiculous things. Seeing children as a physician was the major reason that put me down the path to family medicine compared to internal medicine. I learned so much during my month in the pediatric clinic. I learned a lot about myself. I figured out that pediatric medicine is vastly different from adult medicine. There is much more frequent interaction with the patients be it because of well child checks and yearly physicals or just the mindsets of parents just wanting to know that everything is okay. In pediatrics you have to more at the full picture because the patient can’t necessarily tell you everything that is going in. It takes more time and effort to tease and dig up the hard evidence and information.
The month was exciting and I got to play with a ton of well babies that were just cute beyond belief. Well worth it.
That’s it for now, until next time.
Future Successful One Out
First off, let me fully disclose that I am 100% biased. We all are. To be unbiased in today’s society would require living in a social vacuum or under a rock. But then you’d always be biased towards vaccums and rocks so there’s nothing we can really do. That being said, the subject of today’s post will be about the current state of R&B, what it has become, and the final glimmering light of hope that may be able to resurrect it. But remember, I’m so biased.
R&B has really transformed over just the past 10 years. Let’s give some examples:
In 2003, Beyonce and Jay-Z had arguably the biggest “R & B” song of the year with Crazy In Love:
10 years ago, this is easily classified as an R & B song. However, today I would think this relates more to a Pop Song than anything. Maybe it’s the racial bias of the music industry. That’s an entirely different topic that warrants its own entry and time. Not the purpose of what I’m trying to do right now.
Fast forward to 2013, and we have entries in the R & B charts like the following:
Now don’t get me wrong. Anybody that knows me knows these 2 songs are in my top 5 for favorite songs of 2013. But they don’t have the same feel as what I would consider an “R&B” song. Honestly, Crazy In Love and Suit and Tie could have been released during the same year to a person that didn’t know any better.
So now we get to the purpose of this post: I think R&B is dying. It is slowly being assimilated into the Pop genre and has lost its identity.
Let’s get some hard evidence in here. And I’ve got the perfect artist in mind: Ne-Yo.
2013 Ne Yo ( I know this isn’t a perfect example, I just like the song. Calvin Harris does good work.
Now that the dance break is over we can get to the most recent Ne-Yo R&B song:
Maybe I don’t like how “R&B” has changed in 10 years.
Maybe I’ve grown to only like a particular sound/style of music.
Maybe I’m weird for even thinking about writing a post like this.
I think the state of R&B is on its last legs. There’s only one person out there that I believe can save it. A man with the best name in the business: John. Legend.
Legend recently released his latest solo effort Love In The Future, executive produced by my favorite artist and everyone’s favorite lunatic, Kanye West. The combination of West and Legend just absolutely speaks to me, like no other R&B song can imagine. Legend’s velvety voice and West’s production take me on a journey into my own mind that just relaxes me and brings to the utmost ease and tranquility: Love In The Future definitly gives the 20/20 Experience a run in my opinion. But you don’t have to take my word for it:
In 2013, John Legend keeps doing what he knows. And I’m loving it. If you made to the bottom of this post, thank you and do yourself a favor and listen to Love In The Future. R&B isn’t quite done yet. Not if LEGEND has anything to say about it.
Future Successful One Out,
I have a little time right now to reflect on what I did for the month of August. Hard to believe we’re 2 months into this year already. Time surely does fly! So here we go.
At the beginning of the month, I got the opportunity to go to Kansas City for the American Academy of Family Physicians National Resident and Student Conference. It was a great opportunity to be around so many like minded individuals and advocates for family medicine.
Although the conference only lasted 3 days, I came back to Mississippi reenergized and extremely confident that I was choosing the best specialty for me. Nothing else could give me the satisfaction that family medicine does.
For the month of August I decided to do another rotation with Family Medicine, this time in the clinic. Now I absolutely love being in clinic for the following reasons:
1. I love the mystery of not knowing what’s behind the exam room door. You see, on an inpatient service you admit the patient from the beginning and work them up. In the clinic, any average Joe could walk up off the street and be seen.
2. The one on one interaction with the patients is the perfect opportunity to build very personal relationships with each patient. Giving the patient the opportunity to confide in you through the safety of the four exam room walls.
So I spent a month getting to know the patients of the Lakeland Family Medicine Clinic. I would spend each morning and afternoon with either an upper level resident or an attending physician just seeing patient and formulating my own plans for them and running it by them to see just how correct and just blatantly wrong I was. In my opinion, clinical learning makes much more sense when you can put a patient’s face to a diagnosis or disease process. Knowing that any changes you make have a direct impact on that person’s life make you want to question every uncertainty and proceed carefully. This is one of the reasons I love medicine. To analyze, evaluate, and make the most informed decisions in order to benefit another human being just fill me with so much hope, pride, and responsibility.
At the end of the month, I felt like a more competent medical student and more and more like a physician. I believe that’s the true purpose of the M4 year. To evolve the way of thinking from medical student to physician. By the end of the year, we’ll no longer be students but doctors and we’ll be ready for the next chapter in our lives!
Until next time.
Future Successful One Out
So I figured this being my final year of medical school, I would take the time to chronicle my exploits through the final stages of transitioning from Medical Student to Doctor of Medicine. Along the way I hope to give you a glimpse into what my life has been like, the challenges that I face, and the life changing decisions that must be made over the coming months. So without further ado, let’s get started.
July 1st, 2013. 8 AM (I have to chronicle this particular day because a lot happened in a short amount of time and I just have to get it out in order for you to understand what I was thinking.)
The first day of a new year. Earlier in the year I decided to front load my schedule with the most time consuming of rotations so that the end of the year I would have all the time in the world to basically do whatever I wanted. So I have two inpatient Medicine months to start off my year, one with the UMC’s Department of Family Medicine as an elective and the other with UMC’s Department of Internal Medicine as a graduation requirement. My M4 journey starts off at “The Baptist”, a hospital less than a mile from big daddy UMC that seems the majority of Family Medicine’s inpatient service. With high aspirations of staying with UMC for residency I wanted the opportunity to experience their inpatient experience before making an informed decision.
On the first day I arrive to the resident’s workroom on the 4th floor and see that the patient list is 20 patients long. Now for those of you that don’t understand, a 20 patient list is a nightmare to round on. Each patient requires a daily note and it can be a difficult task to get every consult, lab test and procedure accomplished for each patient every. single. day. I came to work and this was definitely the place to be. I had the previous month off for USMLE Step 2 studying and I was tired of reading books and answering practice questions. I wanted to get back to the patients. So I hit the ground running with the residents and didn’t look back.
This first day seemed like it went on forever. We would round with our attending, see a few patients, write some notes, order some tests, and take a break. Everyone has the assumption that rounds are like the rounds they see on Scrubs or on Grey’s anatomy or anything else like that. While there is some truth to that, in a non teaching hospital you are a lone wolf. Not obligated to teaching students, or quizzing or “pimping” them on the latest guidelines of treatment. No. You get in, see the patients, make your recommendations and it is on to the next one. And that’s what we did.
July 1st, 2013 1:30 p.m.
After a quick lunch we go see another patient. Obviously I can’t give you any personifying information as that is against the law, I can tell you this patient was elderly, and very sick. Had a long history of heart failure, COPD, and lung cancer and was under our care for an exacerbation of his heart failure with fluid on the lungs. So we enter the room and see the patient sitting up in a chair hunched over a pillow, huffing and puffing as hard as possible. All I remember is the patient saying “I’m having trouble catching my breath. It’s harder to breathe.” To be fair, not an unusual complaint given the patient’s history. We decide as a team to give the patient a little diuretic to hopefully get some fluid off and ease their breathing trouble. Problem solved.
We finish rounds with a quiet victory and proceed to the ER to see some patients of ours that came in. Now Emergency rooms are for lack of a better term, a glorified free clinic. People come to the ER because: 1. They don’t want to go to clinic because they have to pay. 2. They can be seen in the ER without paying anything. possibly ever. 3. If you come to the ER you are required to be seen. There are some other reasons but I’d rather not discuss those with you right now. Bottom line is barring major trauma or true emergencies the majority of ER visits can be handled in a primary care clinic.
July 1st, 2013 3:30 p.m.
While we are wrapping up the discharge paperwork for a patient we hear the intercom “Code Blue, room such and such”. UH OH. That’s our patient. More specifically, that’s our patient that couldn’t breathe when we saw them 2 hours ago. So we’re rush up to the floor. Now, on television codes are portrayed differently than real life. The chest compression/ bag mask ventilation is the same but with one difference. There is a literal TON of people in the room. The back ups for compressions, pharmacist preparing medicines, nurses documenting administration of meds, ER physician supervising the code, House physician whose patient this is. And a gaggle of sorts. So I watch from the hallway. 10 minutes. 15 minutes. 25 minutes. Nothing. They’re gone.
Now I had seen people die in front of me before. As far back as my physician shadowing during my USM days. And a few times during my clerkship rotations the previous year. But this is the first time that I have seen someone pass away that I was able to conduct a conversation with only 2 short hours previously. This patient was really sick and nothing we were doing was helping. That is the dark side of medicine. That is one of the ways we as physicians could lose our compassion for our patients. We are fighting a losing battle from the beginning and that just hits closer to home. But I say this not to discourage anyone, but to reinforce my point. We must persevere and never lose sight of the things that make us who we are. Never forget the feelings and emotions that influence the decisions that we make. Always keep in mind the memorable moments. They define who you will become. This moment has shaped me for the better. Experience is life’s best teacher. You always have the choice in the type of person you want to be, just like I refuse to lose my compassion for any of my patients, friends, loved ones, strangers and whoever else matters. Because if I do, I know I will not like the person I would have become.
This is what was going on in 2008.
I admit to placing Lil Wayne’s Tha Carter III on the same level as Kanye’s 808s and Heartbreak. BAD.
I was excited about a Flo Rida album. BAD.
The Dark Knight was the best superhero movie I had ever seen. GOOD
I saw Quantum of Solace and Jumper without seeing Slumdog Millionaire. BAD.
I got on an airplane for the first time and went to Rwanda. GOOD
I saw High School Musical 3. In Theaters. More than once. BAD (to everyone except me.)
Extra long blue jean shorts were a thing. BAD
I had no clue what I would be doing in 5 years let alone where I would be doing it. Neutral
Now the purpose of this post isn’t to bore you with the terrible decisions that I made 5 years ago (especially anything Lil Wayne related) but to 1. get back to posting to this blog since it’s been quite a few months, and 2. To just visually explain in text what I’ve been thinking. I’m not the same person that I was in 2008, driven by the college life and wherever the next adventure was going to be. No, I’m 25 now. I have attained five more years of experiences both good and bad and if I could have a conversation with myself from 2008 I would tell him: Good job. Those people that you see, the ones that hang around the most? You still see those people. Not as much as you’ll be used to, but enough to know that they cherish your friendship. Continue to do everything you can for people. Although your peers may not see it now, when you get to the next level there will be people that won’t help but take notice. And finally, don’t worry about a thing. When the going gets tough, you dig deep and continue to do what you were taught.
Now in 5 more years, when I’m looking back to this time in my life at age 30, I get the feeling I’m going to just be laughing at myself and thinking “Man, you overthought everything WAY TOO MUCH.” Because that’s what a 25 year old me does. But I just know 30 year old me will have it all figured out from top to bottom because that guy is awesome.
This post is just to get back into writing again. I promise you the really juicy stuff will come at the end of the month. SO BE READY.
Future Successful One Back
Future Successful One Out