The Phoenix

After a rather lengthy hiatus / forgetting I had a blog, I've finally made my way back. Given how separated my friends and family have all become, this still seems the best way to keep people up-to-date without lots and lost of phone calls.

So....

Much has happened since January 2005, let's sum up.

The second year of medical school was tedious, but I finished.

The third year

Family Medicine
Did it in Maine and it was the best experience of 3rd year.

Internal Medicine
Done at Dartmouth and I discovered that I really don't like taking care of people in the hospital.
You hardly get to spend any time with your patients, and spend most of the day ansewrwing phone calls, doing paperwork, and generally followong up on the things that other people are supposed to be doing. If you don't and something doesn't happen the patient doesn't get what he or she needs and it's your ass. Plus I see hundreds, if not thousands of dollars wasted on needless tests and inefficencies every day. If you want to know why healthcare is so expensive in this country today, one of the reasons is all the money we're pissing away in our hospitals.

Psychiatry
This was definately something different than I'm used to. I spent a month at the State Psychiatric Hospital in Concord, NH {Lightning flashes behind the old stone building on the hill} on the child psychiatry unit. There were some children with some organic, physically caused mental illness, but it was here that I got a chance to see, up close and personally, what happens when parents fail there children. The behavioral issues, the insecurities, bouncing from foster home to foster home. It was definately an enlightening experience. After my month in Concord, it was back to Dartmouth for a few weeks on the Psychiatry Consult team. Basically, if someone was hospitalized with a physical illness and just happened to have a mental illness as well (or the medical team was too lazy to help a patient work through some emotional issues), we were called in to help.

Surgery
Ah yes. It's now after Christmas and January of '06. My day starts when my alarm goes off at 3:50AM. It's dark outside. I get to the hospital an hour before the rest of my surgical team because, well, because I'm the medical student {end sarcasm - there was actually a good educational reason for me to get there before the whole team so I could see how each patient had done overnight - resume sarcasm} We started rounding on patients (visiting them) at 6AM to make sure they were alive. We then wrote orders for the nursees to keep our patients alive until we came back to see them in the afternoon. (You see, surgeons have a ...reputation... for seeming less concerned about how their patients are actually doing and addressing their needs other than air food and water). We would then head off to the operating room. It was a Hell of an experience. There's something to be said for discovering someone's problem, opening them up, fixing it with your hands, and then closing them back up. After the surgeries are done, we then chcek on our patients in the afternoon and evening, make sure that they're alive, and write orders that they be kept alive until we see them again tomorrow. It's now 5PM, 6PM, 7PM, 8PM. I leave the hospital. It's dark outisde. I do this 6-7 days a week for two months. Despite all the above sarcasm, I was this close, this close to choosing orthopaedic surgery as my specialty. I just don't think I could survive the above schedule for the 5 years of ortho residency. I'd lose my mind.

Pediatrics
Ahh Peds. Inpatient Peds (taking care of kids in the hospital) was difficult and frought with some of the same concerns I had about Internal Medicine. Outpatient peds was fun. There were a lot of stuffy noses, ear infections, crying toddlers, and tedium, but it was a great chance to get to know a family and see how I could help.

OB/GYN
Baby catching. Lot of hours, lot of uncomfortable Moms, learning that childbirth has its own unique smell, but WHAT a payoff.
Gyn - lot of pap smears, lot of menopause, lot of diseased genitalia. Enough said.

...And that wraps up the third year of medical school. All of the above experiences are things that Dartmouth requires to graduate. Everyone does them. From here on out, all the experiences I pick are things that I want to do, not that I have to do, so....here's my upcoming schedule.

Palliative Care
Radiology
Family Medicine
Dermatology

I'm two weeks into my Palliative care rotation and have two weeks to go. I'll have a lot more to day about it when it's over.

Outside of school, there is some semblance of life as well.
I just celebrated my two year wedding anniversary with a trip to Water Country in Portsmouth, NH. Next weekend, Stef and I head to Boston to meet up with the ol' gang for a couple of days, and the week after that, I fly out to Kansas City for a few days to attend a National Family Medicine conference (If you couldn't tell yet, Family Medicine is where I think I'm headed). So, we're still out here in New Hampshire and I'll try to keep the posts a little more often than every 18 months!