Tuesday, October 11, 2016

When the (Student) Doctor Becomes the Patient

This picture has no real relevance to anything in this blog or elsewhere. I just saw it and liked it.

My schedule has been changed once again. I'm sure that whoever is in charge of making schedules is starting to hate me, but none of this is happening at my request. Beyond that,  all the people on the payroll --  not including my peers or me, as we're not getting a red cent other that the free meal (and I'm using the term meal  loosely, as what comes out of our cafeteria posing as cuisine is probably closer to soylent green than to actual food, but that's another. topic for another day -- that is provided if we're stuck on the premises for more than eighteen consecutive hours -- are lucky to have jobs in this economy. So he or she should suck it up and not complain about having to revise my schedule roughly three times each week, right?  

In any event, it was determined that it would be imprudent to put a clerkship student  as weak as I am into the psych ward. At my strongest, I could barely hold my own against someone who went bonkers and decided to go into attack mode. Right now, I would be unconscious before I even realized there was a problem. I may be stronger next week, but it's not realistic to expect my improvement to be substantial. I'll still be having the drugs injected into my body on a daily basis. I now have twenty-three more treatment administrations to go. A week or so after that, I should be within  reasonable distance of where I was before this fiasco began.

Hence,  on Monday of next week I shall begin an eight-week rotation in Internal Medicine. It's not the most exciting rotation on the planet, but neither is it the least exciting, and it's the basis of what all of us will someday do, no matter what our eventual specialty.  It's a requirement for anyone completing his or her first twelve months of clerkships. I was originally scheduled for it in the spring of 2017, but it's been bounced up a bit for me. The timing is actually good in that I will miss out on less by only talking to patients and observing for a couple of weeks until I get my medical clearance. There'll be plenty of time for greater involvement later.

I'm sad about not getting to OBGYN until later now. My psych rotation would only have been for three weeks. Now OBGYN in delayed until January. I'm more excited about the OB part of OBGYN.  Who wouldn't be, other than maybe Donald Trump?  All the content must be covered, though. 

I didn't pass my physical for pediatric oncology today.  They looked in throats , checked temperatures, and looked for obvious signs of contagious illnesses.  In checking temps, they were looking for fevers, but my temp was 95.6. A slightly subnormal temperature is normal early in the morning (several of my peers were running in the 97-degree range), but it shouldn't be three degrees below normal.  When someone checked my pressure and found it almost impossibly low, the lead doctor asked, "Does she even have a pulse?" He told Professor Larry Bakman that he wasn't sure whether to send me home, to the E.R, or to the morgue. He was aware of the status of my medication regimen but didn't expect the situation to be quite so grim.

I told them that my dad was finishing up a shift in the E.R., as he does ten times per year to ensure that he has sufficient patient contact hours for licensure. Someone  called for a wheelchair, and Larry [not his real name; I would never be so disrespectful as to refer to a professor by his actual first name] rolled me into the elevator, out of the building, and into the E.R. at the adjacent hospital. The problem was primarily dehydration.  Much to my chagrin, I had to be hooked up to in IV again. Th one good thing is that since I'm hooked up to an IV anyway, I didn't need and injection yesterday and won't need one today, either. I'll probably be off the IV at some point today, but at least two painful injections have been avoided.

Larry and my dad decided I will not accomplish anything by trying to work in pediatric oncology this week. If I don't make it to the staff restroom before hurling with each episode, I risk exposing them to body fluids. I would make it to a trash can, but there's still potential splashing. In a best-case scenario, I'll spend one-third of my time throwing up and recovering before getting back to the children. The director of third-year clerkships was consulted. It was determined that next year I'll need to complete a clerkship in oncology, but it's assumed that I'll pass the pediatrics exam next week at the conclusion of the rotation. If I don't and if the sections I fail are related to pediatric oncology, I'll need to spend four Saturdays or Sundays working on the pediatric oncology floor, then  re-take the exam. I don't anticipate the exam being a problem as exams are my forte, but if it is, i'll gladly give up the four weekend days. 

I'm now confined to my house util Monday. I'm not being expected to make up the lost time because it happened as an occupational hazard.  If I were an intern or resident in the same situation, I would continue to receive pay.  If I didn't have medical personnel here, I would possibly have to stay in the hospital, but my parents are here until Monday, at which time they leave for a Pacific Northwest cruise. Matthew, when he's here, can deal with IV s as well, and so can I. I can both change bags and reinsert my own IVs if necessary. I've done it before.

I slept so much yesterday that I'm awake now, but I can barely make it from my bed to my recliner or to the bathroom. My dad piggy-backed me up the stairs tonight while my mom held the IV pole. Pretty much everything I need is within my reach. 

At some point I'll probably grow bored, but right now I feel too yucky to even contemplate boredom. I'm just grateful I don't have to figure out how I'm going to get myself to work tomorrow.

The effects of this drug regime have been described as being a great deal like chemotherapy except that a patient doesn't lose his or her hair.  If a person continued with the drugs for long enough, supposedly he or she would lose hair.
It's a real quandary. If I were a private citizen, I could make the choice as to whether or not to go through the treatment. Because I work with patients, however, the choice is not my own. I could drop out of the program for two months, then be tested and re-join, but I wouldn't graduate with my class. The source of my contact has tested negative and presumably will continue to do so. She's an extremely low risk for HIV. Still, she's a teacher. Teachers CAN be exposed to body fluids, and they may not even remember it having happened. My mom says she's been bled, drooled (the drooled on was by a special-needs kid), and barfed on by students, and she only taught for two years before moving up the food chain to psychologist and administrator. If a kid needs help and a teacher is in a place where rubber gloves are not readily accessible, a teacher usually goes to the kid's aid anyway. While my source is of low risk, she's not of zero risk. It's probably smartest to go through this treatment regimen. Now that I'm spending a third of my time either throwing up or recovering from the immediate after-effects, it doesn't feel very smart.

My dad brought home four different anti-emetic (anti-barf) drugs to try.  If one seems to work, great. If it doesn't, I need to wait four to six hours before trying another one. I can at least take Benadryl, which helps to some degree and doesn't interact negatively with anything else I'm taking. There are also a couple of benzodiazepenes I can take. They don't really reduce the level of my nausea. They just cause me to care less.

In the event that you did not know this, it is only fair that I warn you: learning to be a doctor can be hazardous to your health.


  1. Ugh... I hope you are spared the barfing.

    But I'm glad to see yet another mention of Soylent Green.

    1. The barfing is every bit as consistent as is Old faithful.

  2. If you must vomit, at least you're predictable.

  3. If you must vomit, at least you're predictable.

    1. what a way to put a positive spin on this. Thanks!