Going to church

Church today was a funny event. My med school church, I sat in the old people section. There wasn't a person in my pew that was within 30 years of me. However, my new church here, I'm surrounded by young women. And I do mean surrounded. It's a tad awkward. And moreover, I've no clue how one goes about meeting people in church. Can you imagine a weirder setting to meet people?

I like my new church, despite the lack of kneeling. It's nice to be somewhere that people like to go to church, but the problem is that it's death trying to get a seat. I remember my college church and the nightmare that occurred when you got there late.

I miss my college church sometimes. The last year there, me and M would go together fairly regularly, and afterwards, we'd meet up with S and sometimes C and get something to eat. It was so very... social. It was pleasant, and I miss that sometimes. Going to church by yourself is a very hollow experience sometimes.

I still find myself in the very bizarre position of being the most... Catholic person I know at my age. That's not quite right. And I've had people heckle me over this, and it's somewhat funny, because I don't think of myself as that much of a die-hard Catholic. I just go to church and give God his props. I try to be good and do right. That's not exclusive to any religion or belief. It's just being a good person. I'd love to find someone that's in my boat, but it doesn't seem like many people are where I'm at, and that's sad, but that's life too.

I did have one funny moment today. I was planning on going to church straight from the hospital, so I was a little dressy for a weekend in the ICU. One of my patients told me I looked nice today, and I replied that I was going to church, and she asked me to pray for her. Is that what all this Catholic stuff is for? For interactions like that?

I had another funny moment today. I drove past a Burger King, and I remembered that in one of my aunt's more lucid moments, she wanted Burger King, so we went to BK after seeing her surgeon. I don't stomach Burger King much, but now I'm a little sad. I have to admit that I cried a little bit. Who'd have thought anyone could wax nostalgic over Burger King?

Strengths and weaknesses

I was talking with my senior resident that I'd like to go into academic medicine, but I'm not all that smart. His words: well, I'd take issue with that. You're pretty intelligent, and you could do academics.

That was kind of surprising, since I really didn't think I was making all that much of a positive impression. Also, his followup comment is that academic medicine is full of people that couldn't cut it in private practice, so he did manage to stick it to me. Ha ha ha. Seriously though, I'm not one who thinks much of myself. I just know that I have certain strengths and I have to play to them.

Knowing your strengths and weaknesses is something that is more powerful than you might imagine. And I'm not talking about that interview garbage. In interviews, everyone's weakness is "I try to take too much responsibility on myself," or crap like, "I work too damn hard!" That's all lies.

I do remember one interview I did for med school. The interviewer asked me what my weaknesses are. So, I told him that I'm not the smartest student he would interview, not even close. I'm nervous and get easily flustered. I have to remind myself to do the most basic things. I like a high level of supervision. I seek reassurance constantly. But here's the deal.

I got strengths. I'm conscientious. I do what I'm supposed to do. I try my hardest. I don't give up easily. I try to talk to my patients, get to know them, because when you care about a patient, your level of care goes up like a rocket. You actually give a damn about how things are going to turn out. I take my responsibilities seriously. I try to perfect everything I do. I try to understand what I'm doing rather than just blindly doing it. I have an inquisitive mind and I'm eager to learn and be taught.

My interviewer's reply was that they were looking for people who were eager and receptive, and had the qualities that make internal medicine doctors great, and those qualities aren't just smarts. The qualities of a good doctor are ubiquitous. People want a doctor who is dedicated, conscientious, caring, compassionate. That's what people want in a doctor, and that was what this program wanted in a resident.

So of course, I didn't rank their program.

Everyone's a critic

Everyone's a critic. I had a patient weaned and extubated because she was getting ready to self-extubate. I ran it past the attending, who sort of agreed, but was mixed in feeling afterwards. He wasn't critical, but I definitely got the vibe that maybe this was too soon. One of our consulting attendings wasn't quite as subtle. He upfront said to me that I had extubated too soon and would have to reintubate her. I won't go into specifics, but anyway, I was vindicated. She's doing fine and out of the ICU. The attending conceded, but the outcome's really not the question.

I'm a first year medicine resident. As such, I have NO clinical judgement. I don't have that gestalt that attendings use for diagnosis and treatment. That's the skill I'm supposed to garner from residency. Seeing as that's the case, there's just about no reason to suppose that I will make the right clinical decision. In fact, I'd bet against me on all questionable treatment decisions. Already, I've had several of my orders changed or otherwise D/C'ed because they were inappropriate or outright wrong.

The point is to learn, and some attendings are better teachers than others. One of my attendings told me that I did the wrong thing, period. And that wrong thing had the capability of jeopardizing one of my patients. I didn't get burned on it; the patient's doing fine. But he didn't get in my face about it. He showed me what to look for next time, who to talk to, what I should consider, and really who to trust.

Y'know, it's all about attitude. Some people honestly believe that criticizing and yelling is the best way to teach. I'm glad that most of these people don't go into internal medicine. Medicine's got all the passive aggressives. Like I was telling my medical student today: medicine's full of asses. All the jackasses become surgeons. All the smartasses go into internal medicine. The dumbasses? Well, someone's got to do psych I guess.

That being said, I think I should've gone into psychiatry.