Internal Medicine

September 27, 2015

Internal Medicine has been filled with interesting patients and diverse pathology. It has been our longest rotation yet - 12 weeks instead of 6. I've definitely enjoyed it, but we weren't given as much independence as I've had in other rotations. Many people (including me, like 3 months ago) don't know much about what Internal Medicine is, so I will preface this post with that. Basically, the Internist and his/her team are the physicians (and students) that takes care of you when you get admitted to the hospital. That is, if you are an adult and you are there for a reason besides surgery or psychiatric care. Our patients are the people who come into the ER or to clinic who are sick enough to need to stay in the hospital overnight or longer. The admissions can include heart attacks, heart failure, strokes, pneumonia, cirrhosis, pancreatitis, kidney failure, and serious infections of the skin or heart or brain. Sometimes we work in partnership with the surgery team if, for example, a patient needs IV antibiotics after surgery to remove a tumor or to place a rod in their leg.

Maybe because of my interest in psychiatry, I am always intrigued by the things we do to ourselves that harm our bodies and minds. We've had patients who drank themselves into liver cirrhosis and pancreatitis. We've had patients who were brought in by the paramedics because they were found unresponsive after an overdose of opiates and patients who had heart attacks far too young because of their cocaine use. We've seen so many diseases that come along with smoking like lung cancer, mouth cancer, esophageal cancer, bladder cancer, and COPD. I am certain that if a young person who smokes could see what I see that they would never pick up another cigarette again. It honestly shocks me that some physicians continue to smoke. We cared for countless patients with severe complications of type 2 diabetes (foot ulcers, eye problems, kidney failure) that are morbidly obese and have difficulties eating healthy. The quote that comes to mind is: "The food you eat can be either the safest and most powerful form of medicine or the slowest form of poison."

The days sometimes go by slow because we are doing a lot of writing notes and interpreting labs, but they are made memorable by emotional moments. I've been present when the doctors have told patients that they have a new diagnosis like cancer or "spots" in their brain. I've held hands with patients who didn't have family there comfort them. I've had patients who died within a week of them presenting to the ER. I've been told I'm not a real doctor so my opinion doesn't matter but I've also been thanked for the time I've spent talking to patients. I've looked forward to seeing certain patients first thing in the morning because we always share a laugh together. I've tried to keep my mouth shut so I don't get interrogated by my residents but they have also taught me so much about medicine and patient care.

I am definitely starting to feel that my place in medicine is in primary care.

I'm enjoying the town of Houma and the people of Louisiana. It's pretty cool that we are so close the New Orleans too. I don't know if its a city I would have visited otherwise, but it is seriously one-of-a-kind and one that I would recommend to anyone looking for a trip somewhere that is a little crazy.

"Hiking"

Mandalay Wildlife Refuge