The perks to being on a consultation service are getting to see very bizarre things that you'd otherwise never see. You see things like Lown-Ganong-Levine (LGL) syndrome. That's a one in a million. Of course, it's bad for the patient. LGL is a pre-excitation syndrome similar to WPW, except there are no delta waves on the EKG. Essentially, you have to have one hell of a clinical suspicion to find it.
My scleroderma patient from last year is in house again. I want to pop in and say hi, but I feel bad. I mean, I have no relationship with her. It's not my place to pop in. Sometimes, medicine is so confusing. I spend so much time caring, but then when they're off my service, I have to force myself not to care.
Today, while my attending was writing his note, I asked one of the surgery residents about another patient we'd done a consult on. My attending turned to me, and listened to me blather on about this guy because he'd made such an impression on me. I can't help it sometimes. I really like patients. I like meeting them, taking care of them, patching them up, trying to help them out. All that time in pathology and radiology, it can't even touch the feeling of meeting someone and helping them get better. I can't imagine doing something like radiology for my life.
But that's the cool thing about medicine. We somehow find our way to the right spot. I managed to find my way to internal medicine. While all my friends are interested in cardiology or rheumatology, or things like radiology or ortho, I find myself more and more driven towards general internal medicine. The funny thing? Some people tell me that I must be crazy. Internists are a dying breed. Internists are being eaten out from above and below. Internists are slowly becoming either hospitalists or else glorified family docs. And then, the idea of doing academic medicine, that's just nuts.
But on the other side, I get so many good responses sometimes. You know, I had one attending tell me that I should definitely do academics, because teaching is a desire that few people have. Most academic physicians teach enough to be faculty, but their primary aim is research. Even the chairman is research driven, and I think the chair is one of the best teachers in the department. The thing is though, I get so pumped over simple things. I get flat out excited about showing someone how to write up an H&P. I taught one student the basics of EKGs and it was just fun. You know, THAT is finding your purpose in life. THAT is finding your calling. You know you're in the clear when you spend 30 minutes of your life teaching someone a piece of information they may forget in 5 minutes, but you feel good about it.
I really hope that I will eventually find myself in academic medicine. I probably won't be at one of the star institutions, because I don't want to waste my time with benchwork or strict research. I can't write a grant to save my life. What I want is the teaching. Let the other guys do all the research. I want to get my hands on some third years and show them what medicine means to me.
And at the end of the day, when you look at yourself in the mirror, it's nice to know that you did good. Who else gets to go home and say to himself, I didn't give them a fish, but I taught them how.