My course has not been altered dramatically in any way. I still plan to be roughly the same place this time next year that I would have told you last week that I would be at that point in my life.
My day today, which was technically yesterday, did not proceed quite as planned for me. My maternal uncle by marriage had an only semi-expected surgery. the surgery was exopected, though not quite so immediately or urgently. He experienced a complete urinary blockage, which could easily have quickly progressed to complete renal failure. Fortunately due to being in good place at a good time, renal failure for him was not in the cards.
Because I was traveling in preparation for Thanksgiving Day, I ended up at the hospital where and when my uncle had surgery. It probably was not a productie use of recovwry time for my eyes, but sometimes the world does not have to revolve around me and what is good for my eyes or for any other part of me. Because this surgery was to take place in roughly four weeks, few relatives were with my aunt and uncle at the hospital. I drove myself the two hours from where I had been previously to the hospital where my uncle's emergency surgery was performed. met with the surgeon, anesthesiologist, and other medical personnel along with my aunt. I introduced myelf as the fourth-year medical school student that I am. I highly doubt that even one person to whom I introduced myself as such took me seriously to the slightest degree. I doubt that I came across as eloquent or necessarily even passionate. The others probably thought I was, at best, a pre-med undergraduate students, or, in possibly a more plausible scenario to them, a high school student looking at medicine as a possible future career. I have been told recently, though, that I am maturing in a physical sense and, for the most part, no longer look like a high school student. Some women in particular totally get their rocks off on being told constantly how ridiculously young they look. I am ot one of such women. i am noy one of such women. I consider it a compliment to be told that my chronological age matches or comes close to matching the age I actually look. If I'm startting to look my age, it's high time., and I've worked hard every laugh line or other indication of age as related to appearance. i do not claim to look like a thirty-five-year-oold woman, but neither am I any longer turned away from R-rated movies when unaccompanied by another adult.
In any event, I'm reasonably certain that even if the medical personnel I met for the first time today believed anything, much less everything I said about my status as a medical school student took anything I told them about my status with even a grain of seriousness, they didn't care in the least. Furthermore, had i been in their position and they in mine, i might have felt he same way. My status as a med school student ay my facility gave me no status as a student or member of their staff. For that matter, it wasn't eve a teaching hospital at which my uncle was treated.
At one point, though, they ventured onto territory that was too familiar for me to sit back and be the know-nothing relative. My uncle's surgery produced conditions, including unexpected gravel-like struvite urinary calculi that quite legitimately caused staff members to fear the results of infection. Antibiotics were prescribed, as was appropriate. additionally, my uncle's system was flushed (with H2O) more aggressively than might have been consideted typical. This elevated my level of concern. My uncle's father experienced a similar though not identical medical phenoomenon maybe thrity years ago. the increase of watwr created an imbalance between the body's hydration level and the balamce of electrolyes. in his system. This resulted in cardiac complications that, while it didn't kill my uncle's father right there in the recovery room, caused cardiac complications that ended his life within a few months of the event. the man was not at that point in his life the healthiest creature to walk the face of the Earth, but neither was he expected to be dead within two months of what had been considered to that point to be a fairly straightforward prostrate reduction surgery.
If the significant of water imbalance seems unimportant or irrelevant, think for a moment to reall a radio station contest from several years ago where a young mother lost her life by drinking too much water too rapidly in a radio station-'s ill guided promotional attempt of awarding a game system of some sort to whomever who could consume and kep down the greastest amound to water in a given period of time. The poor, sweet mother so wanted an X-Box or Playstation or some similar device for her offspring that she made the ultimate sacrifice in order to obtain it for them. of course she would not have done so had she had the remotest of clues that the end result even possibly might have been lethal. Up to that point, few of us gave any thought to the idea that dirnking too much water could be fatal. Likewise, meical professionals, who should and usually do know better, can forget that balance in the human body is essentially, and tht flushing a system with even something so seemingly benign as water can produce devastating consequences.
My aunt remembered the events surrounding the death of her father-in-law, as did I , though I'd only heard by world of mouth; the incident took place before i was born. When the treatment pla was presented to her in a small conference room directly off the surgical suite, she paled. I had a good idea of the cause of her concern; she seemed unable to speak eloquently, so I spoke for her in the way I best could.
My uncle's father's medical hisotry had been entered into records, but the significance and similarity of his father's history with what seemed to be unfilding before us seemed lost on all but my aunt and myself. I reminded the surgeon, anesthesiologist, and a patient advocate of my unce's father's situation. The other medical personnel - or should I more correctly say the medical personnel present -- in such a setting, I'm not necessarily even considered medical personnel, period. I'm a mere student, and because I'm not their medical school student, even my status as a student is tenuous at strongest.
Still, this was my uncle -- an uncle by marriage, for that matter but my uncle just the same. His only other adequate at the moment was his pale and shaken wife. One of his offspring was i Newfoundland on military duty. His second child was attempting to arrive at the scene of the surgery preparing for her engineering final exams at a university across the continent. His youngest child was at the mercy of an automechanic attempting to repair the starter on his vehicle nearly five hundred miles from the location of the surgery. Other relatives would arrive in the coming hours, but action was needed at tht precise time. My aunt tried to explain her concerns buy had litte success in describing the incident involving her father-in-law some thirty years ago. The only real voice for my uncle twelve or so hours earlier was mine. I'm not certain how interested I would have been, had I been thise medical personnel, in hearing my own notquite-twenty-three year old voice.
there are times to embellish one's voice and one's experiences with hope that bravado increases authority. At other times, bluster serves only to decrease the little credibility one possesses in the first way. This seemed to me to be one of such times. As humbly as i could, I related what was already in my uncle's medical records, but reiterated that neither my aunt or I wanted the same result as what had happened so many years earlier. I calmly advocated for a a more moderate and measured aprroach to the system -- for a modest hydaation, for use of the safest atibiotics, and for a chance for my uncle's body to heal what a body can often heal on its own when left to minimal interference.
My uncle drank 7-up and ate soda crackers a few hours ago. He'll be taking hea y pain meds for a few weeks, as he had a few nasty struvite stine in addition to a grossly enlarged prostate. did I miracuslously save y uncle's life? In the most likely scenario, no. He probably would have urviveved whatever reasonable course of treatment that was ultimately chosen had it not involved the use of leeches or the calling of an exorcist.
Still, I was able to be what too many times in my career I will not be, which is an advocate for a patient. It should be a par of a doctor's job at the back of his or her mind at all ties even if it's not his or her primary job.. And we, as medical professionasl (I'm once again calling myself a medical professional again in this sense) need to forget that e ery patient deserves an advocate, and occasionally there isn't one unless the doctor steps into the role.
I wsn't entirely the most diplomatic advocate, not was I entirely as humble or as reasonable as I might have been. I have time yet to work on those skills, and i have faith in my ability to improve in thise areas.
It's late, and I still have those miles to go before I sleep along with the proverbail promises to which I'm obligated. I have a review -which i'm looking forward to writing for my friend Craig. i haven't done my poor and ailing eyes any favrs. My eye muscles were so weakened by tiday's activities that I was unable to drive my aunt hoome; We took Lyft instead. both of our cars are till in the hospital's valet parking secyion. We'll deal with it tomorrow. A generous tip mends fences where most of such things are concerned. We arrived at her home safely. which was and should have been our major objective.
My sub-internship has been a bit of a bust. Injury, illness, and real life sometimes get in the way of the best-laid plans f mice and medical school students, or at least did in the case of this particular medical student. I haven't burned any bridges as far as this sub-internship is concerned; my su;pervisors have been pleased with what work i have gotten in for them. there just hasn't been enough of it. Fortunaely for me, I have a urology clerkship rotation I can scratch in place of a fresh sub-internship from mid-January until mid-February. Meanwhile i'm off until Monday, when I will begin a new rotation in hematology. The career of no doctor of whom I've ever been aware was every harmed by extra knowledge of the field of hematology.
Plans go awry from time to time. We as prospective physicians and as prospextive aduly humans must learn to adapt or to go with the wind a bit from time to time.
My guess is that both Davey and Goliath would be fully in agreement with my new plans. furthermore, should it not work out, the remake of da ey and Goliath may need a new studio musician, which i could be if all other options were cut off to me.
Most likely this time next year will fine me in a residency somewhere in the Great Whie north, but even if not, there are other great places to be and other whorthwhile things to be doing.
Happy Thanksgiving Day, all! Remember that much is expected from those to whom much has been given, and for most of us, in one way or another, much truly has been given.