Sunday, December 22, 2013

All I need to know about being a doctor I learned from Buffy

1. We all need friends. Even when we're called, chosen if you will, to enter the medical profession. Probably even more so. We need our Scoobie gang, the people who will keep us grounded, take us toboganning, help us get drunk and dish about sex. Our cheerleaders who make us feel invincible when we need it.

2. Keep your head when everyone is losing theirs. It's up to me to have a plan of attack. I need to slay the demons run the code, even if it's on my friend and neighbour. Even if it's the vampire man I love.

3. Magic and medicine don't mix. Follow evidence based practice, accept no substitutes.

4. Always carry a beeper in case the apocalypse comes. That's fairly '90s though isn't it. Now I make sure that my cell phone is charged and the ringer is on. My colleagues may need help at the hospital, my nurses may have questions about patients. Unless I'm post call, I need my beauty sleep.

5. Get your beauty sleep or you get cranky.

6. Love makes you do the wacky. If you love your patients, you won't have perspective. I'm not saying don't continue to love them, just be aware your brain is wacky.

7. Be confident, even when you're not, or you your patient may get dead.

8. Plan ahead like the good slayer. Faith went dark without a plan. Docs without a plan, without friends, who don't listen will also go to the dark side. They become TOO confident and patients die then too.

9. Wear lipgloss.

10. While not everyone will notice what I am doing, treading like mad under the surface, saving lives, when they do they can be quite gracious. And sometimes will give you a toy surprise.

Sunday, December 15, 2013

Things no one tells you about your first year of practice

I've disappeared for a while again. A couple of reasons why. One is that BlogPress's iPad app isn't working. I'm not able to blog on the go like I used to be able to.

The bigger reason is that my practice is getting up and running. By running, I mean running over me while I desperately try to keep breathing, completely giving up on keeping up.

I expected that I would end up with a larger than usual number of patients with personality disorders. I've been shocked though at how many there are. Most of the time in our "meet and greet" appointment is spent putting their supplements, meds, and "medical problems" into my EMR.

Something I hadn't counted on, were the high number of patients who are incredibly unwell but haven't seen a doc in 20 years. These are patients who have had their illnesses slowly progressing so they didn't notice how unwell they were. Some come into my office stating they've never felt better, but I can hear water on their lungs from across the room. Determining the cause of their illness and treating it takes time and all my training.

I've been giving all my new patients questionnaires to fill in before we get started. It helps to guide our first meeting and has been really helpful IF the patient isn't coming in already broken. Rather than being able to be on top of what is happening right away, I've had to hire someone with some clinical smarts to enter all the answers to my questions for me so that I can spend our first appointments dealing with acute medical issues.

Something else I wasn't expecting was needing to put a hold on my new patients while I get the ones that I already have a solid plan. I don't know who half my patients are. I've met them, I have notes in the chart about them, but have no idea what face goes with what name. I wish there was a photo component to the chart to help me with that.

I still think I have the best job in the world, just surprised by how overwhelmed I've been.

Saturday, December 14, 2013

Talking to people who are chronically ill

Those with cancer wish that they could spend time feeling carefree. Their entire lives seem to resolve around hospital appointments, medications and their side effects, support groups, and planning for their family's future without them in it.

This is why when I'm around those with chronic disease, all I seem to talk about are silly, frivolous, light hearted things; my kittens tearing my house apart, the recent adaptation of a children's book into movie, the way pink and purple make me feel happy, whatever moment is captured in photos around the room. Not just for the one with the disease but for their family too. Leave space for all of them to talk about seriousness, but give the give of pretending it doesn't exist, if only briefly.

Remind your friends, patients, family what it's like to be care free.