Don’t let the title fool you. I love Medicine. And I enjoy Internal Medicine. I was referring to the song. The song that the med school choir and Bon Jovi sing. The song that pops into my head whenever I say I am on a Medicine (meaning General Internal Medicine) rotation.
I have not done “real” medicine (no offense to pathologists) in two months. So, needless to say I was a bit nervous (okay, excessively nervous) to start today. Part of it was my routine pre-rotation jitters. But, on top of those jitters were my new “ohmygoodness I haven’t done medicine in two months” jitters. Its not like all of the information just falls out of your head… But, it does get rusty, especially after 5 weeks of interviews/travel/vacation.
My rotation for the next four weeks is my rural selective, so I am camped out in a lovely apartment (bigger than the house I grew up in) with a gorgeous view of the harbor in a town a bit over an hour outside of where we live. Patrick dropped me off yesterday, but ended up staying over because of the weather. The apartment is on top of a GIANT hill. So, the walk home from work is a treat. It is a bonus, though, because there is no gym within walking distance of my temporary home. The hospital is eight floors, but not very long or wide. We currently have 10 inpatients.
I was clearly rusty. The doctor asked me about starting doses for insulin and I hemmed and hawed and said, “I don’t know.” He wanted a guess. I guessed 0.1 units per kg. So wrong. It is 0.5-1 units per kg. Epic fail. But, other than that, it was okay. I found a carotid bruit. I said nothing else really stupid. He sent me this afternoon to do a history and physical on two patients… Who were already admitted… For days. The H&P was done already. It was redundant. And one of the ones I was to see was sleeping and didn’t want to answer questions. So, it was an early day. I hope to not have to do redundant H&Ps the entire time. It is how you learn, but I am up for at least doing consults and following more than two patients. I said that. But this is what I start with. Hopefully I regain my old knowledge and skills… And prove that I can manage a bit more… Soon.
90% of our patients are admitted for heart attacks or other heart related problems. Seriously. This province has the highest rate of coronary artery disease in Canada. Apparently this town has the highest rate in the province. Everyone has a family history of heart disease. Half of them, sudden cardiac death. You get the picture. I will at minimum be really good at reading ECGs and managing CHF, nSTEMIs and STEMIs.
In second place, we have diabetes and all of its complications. Type two diabetes is par for the course and most of the people with heart issues have diabetes and vice-versa.
I can feel my accent thickening already. I swear it is contagious. I am not from here. I shouldn’t speak like this. But, I do. I pick up accents wherever I go. But, the accents are stronger out here. Lovely, but strong. And as a result, my fake accent that I gained when I moved out here (comes and goes with my coming and going) will continue to progress. In a few weeks, it will be tough to discern that I am a mainlander.
Gee, I wonder what I will read about tonight… One of the above, I suppose.
All in all, it is a nice place, I have a fantastic doctor who loves to teach and the staff are friendly. Should be a good learning experience.
And now for that song…