- How did I feel when I got home?
Similar to the satisfaction of unfastening something too tight. I would race home from clinic and burst through the front door to be greeted by those two little chunks of sun. I’d bask in the warmth and the light of those two small humans, soaking up their innocence and honesty and curiosity while they melted my heart like a stick of butter. It was like remembering what the sun feels like. I slowly refueled my empty battery packs. I stroked their backs a minute longer after they fell asleep. I squeezed them tighter before letting them go. I made silent wagers with the universe to slow down for a few years – to please stop them from growing so fast. Somehow, everything else on the rotation paled in comparison.
- Did I feel excited to look up the illnesses and diseases in the patients I was caring for, or to study for the shelf exam? Was there diversity in the conditions being treated?
Absolutely. Family medicine is incredible in that sense – the breadth and diversity is as far-reaching as the eye can see. I ended up keeping a list of all the patients I wanted to go back to check their results, or to look up their weird symptom. I saw a woman with metastatic cancer who’s tumor had pushed it’s way through her abdominal wall – visibly protruding and angry for all the world to see. I saw a woman who was rapidly losing her ability to move her muscles, leaving some of the finest research hospitals in the country scratching their heads. I saw a woman with nagging pelvic pain after her appendectomy (she forgot to mention the stormy black and purple bruising spreading across her belly), who quickly re-visited the operating room. I saw where medicine heals and where medicine falls short. I saw the expansive gaps in our health care system in which we have plugged with glue and gum, when it should have been gardened with diet, exercise, and mental health. I saw the incredible miracles that medicine can provide, tacking years of life onto patients knocking on death’s door. Overall, I loved finally being able to drink in the minutia of America’s ‘bread and butter’ diseases. Turns out, I still love medicine after all.
- What were the main feelings I encountered while working with the patients? The medical team?
An overwhelming sense of belonging. I listened to patients spill their entire lives – their relapsing meth addiction, their embarrassing odor, their breaking marriage, their battle against their disease. They let me place my hands on their skin, push on their belly, feel for lumps in their breasts, stick needles in their joints. They shared words of wisdom distilled from years of seeing the inner workings of the health care system. I didn’t feel frustrated with patients, as I had envisioned myself feeling while coaxing relapsing diabetics and narcotic shoppers. Instead, I felt the same connection that drove me into medicine in the first place – that same window into the human experience.
The medical team felt more like a true team than I have ever experienced. The medical assistants and I grew so close you’d think we’d all grown up on the same street. They helped me finally settle on a prom dresses, filled the clinic with treats for my birthday, covered my back when I slept through my alarm (granted, I slept until 1pm, for which their is no excuse other than my body had literally tried to enter hibernation). Then the incredible physician I had the fortune of working with – I had requested him specifically after I had cared for one of his patients with newly diagnosed mesothelioma (“I just moved here and my new doc picked up the cancer on my first visit!”). I filled a small notebook with observations and clinical pearls during my short time with him – but what impacted me most was seeing the way he interacted with patients. Upon entering the patient room, he would greet them with the same warmth of visiting family, and would quietly sit back, cross his arms, and listen. Sometimes patients would talk for nearly ten minutes, but he never interrupted. He simply listened, quietly nodding and observing. During the entire encounter, he spoke less than most physicians do during the first few minutes. And yet – he was able to narrow in on their diseases with unbelievable precision. He has caught more missed diagnoses than I can even describe. Nearly every patient I interviewed would tell me, without any prompting, how “I just went in for my annual physical” and “he thought he felt a lump/heard a murmur” or “he said he just didn’t have a good feeling about it” and BAM – they were diagnosed with cancer, underwent open heart surgery, or admitted to the hospital for a weird fungal infection. This happened every single day. He was the most remarkable influence on me – instead of dismissing symptoms as I had learned to over the past year, he actually listened to the symptoms I was dismissing and worked them up. I can only hope to retain half of the wisdom he imparted on me, and even a sliver of his skill as a physician.
- How much direct patient contact was there?
So much. So, so much – and I couldn’t have been happier. Except if their had been a scalpel in my hand.
- What were the humdrum aspects in the patient population or workflow that would have to be tolerated for the rest of your life?
DOCUMENTATION. Ugh. And well-child checks.
- Does this specialty address one of the leading causes of death in the world?
YES. In every possible way. I think family medicine is ultimately the answer to most, if not all, of our health care problems. Unfortunately, I am too damn selfish to relinquish my time in the OR.
- How easily can motivational impact be integrated into a career in this specialty?
SO EASILY. This seems so ridiculously obvious that I’m not even going to answer it.
- Does this specialty focus on preventing problems or fixing problems?
Both. See prior statement.