Saturday, April 14, 2007

Growth

I have seedlings!

Operation seedling might be a success! Over half the seedlings have sprouted. For those of you with some experience - do you know when I should thin them? I dropped multiple seeds into the cells, so now I have multiple seedlings in each cell. Should I wait for them to get a little bigger before thinning? Very exciting. It seems that the weather has finally decided that it is springtime - a welcome change after the couple inches of snow we received earlier this week. I am ready for some warmer days.

More good news - I have both Saturday and Sunday off this weekend! Three weeks down, and three weeks to go on this Internal Medicine rotation. Here, Internal Medicine is a 6 week rotation, and you spend 3 weeks at the university hospital and 3 weeks at the Veterans Administration hospital. So, on Friday, I finished my 3 weeks at the U and my senior resident was kind enough to give me the weekend off. On Monday, I start 3 weeks at the VA. I have heard that the patient population is drastically different between the two hospitals. I foresee lots of older men with interesting histories and cardiopulmonary disease in my future.

I have learned so much during the past three weeks. And I also feel this experience has really aged me - these three weeks feel like years. I have to remind myself that I am lucky - I am tired, and I have to work long hours and oftentimes life is stressful, but I am very lucky to be having these experiences. Medicine is fascinating, and the staff physician on my team at the university hospital is an exceptional teacher. It is inspiring to work with someone with such brilliance and such passion for teaching. And so kind to patients. And to his colleagues and residents and students. Physicians/residents are not always kind to patients or to each other. I have observed and been on the receiving end of unkind actions from people in positions superior to mine, and I suppose that these are good learning experiences as well. A classmate remarked that you can see the quality of a person in how they treat those that they are able to abuse.

For those of you wanting clinical details re: my patient care experiences, your wait is over. I participated in the management of a patient with diabetic ketoacidosis - these patients are typically severely volume depleted and require 4-5 liters of fluid IV as well as insulin and other electrolytes. I had the opportunity to care for another patient with a metabolic alkalosis due to spells of intractable vomiting associated with binge drinking - these patients are also very volume depleted and require a significant amount of IV fluids. It is a funny perspective to see a patient as a learning experience rather than a person. But I must say that in treating these patients (and a few others), kidney physiology has finally become my friend. I also saw a very interesting case of gallstone pancreatitis (where a stone from your gallbladder moves down through your bile duct and occludes the opening of your pancreatic duct. Ouch!) I still have so far to go and so much yet to learn, but it is exciting to have some understanding of the pathophysiology and management of complicated disease states.

And how could I almost forget! I did my first procedure last week. Albeit only an arterial blood gas (and given the low reported oxygenation level, I likely pulled the sample from a vein rather than the artery) it was my first procedure nonetheless. Here is a graphic photo:

And here's what I did:

2 comments:

Grandma Lorrel said...

So happy to hear you had the weekend off before you started the VA session. Ya, I'm sure you will be involved with 'old' men. Golly, you are learning so much and what good experiences. Love ya. Grandma

Grandma Lorrel said...

Must be so exciting to watch your plants grow. I'll ask Pat about the thinning because I don't know. Will get back to you.
Love you bunches. Grandma

 
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