Reflections on Family Medicine (Elective)

Ah, my light at the end of the tunnel after a somewhat distressing psych rotation. <3 I looked forward to this rotation like no other, and it definitely disappoint. I had a different preceptor each week, and all four of them were wonderful, super welcoming, and willing to teach. :]! (I wrote a Day in the Life post on it too!)

Reflections on Family Medicine (Elective)

1. I really can’t imagine liking another specialty as much as Family Medicine. <3
   On that note, inpatient FM was interesting, but outpatient FM is probably what I want to do. I don’t know if I’ve ever talked about that here, but I’d love to have my future practice in a clinic, preferably something like what my first FM preceptor practiced in–a Federally Qualified Health Center (FQHC) where she primarily served an under-served population. I like the structure of clinic visits, and I feel like there’s more time to spend with each patient in an outpatient setting.
2. “What if it was your grandma?”
   The hospital is generally not a place where anyone wants to be (unless you’re malingering). It’s hard on the patient to be suffering, and it’s hard on family members to see their loved ones in so much pain, so I went with that mentality with all of my patients: if that was one of my family members lying there in that bed, how would I want the medical staff to treat him/her?As a medical student, what I could do was fairly limited, but if it was something I could do–e.g. getting them a snack or a printout of information on the medications they were taking, or coming back after my day was over to stay with them til their family members came back, I’d do it because I wanted them to know that they were being taken care of, and that their family members could rest easy if they had to leave.
3. “We never stop fighting for our patients, but that doesn’t change the prognosis.”
   One of my preceptors said this, and it really stuck with me. As physicians/to-be physicians, of course we want to do whatever we can to help the patient to recover and feel better, but there is a limit to what we can do, and that can be really hard. Explaining this to family members of someone who’s terminally ill can also be extremely difficult. Sometimes, knowing when to let someone let go is just as important as helping someone to keep fighting.
4. Having autonomy is both thrilling and terrifying.
   This was my first inpatient rotation and the first chance I’ve had to write my own patient notes and round on my own patients. It’s also the first one where I really got to start to attempt to come up with a plan after narrowing down my assessment. (I still feel like I’m terrible at both, but I’m working on it!)
5. Good company is a great cure. :]
   This honestly goes for anyone. Getting to see and spend time with friends I hadn’t seen in a long time really made a huge difference. I already miss living with Aasia (we had awesome cooking adventures and it was really nice having someone to talk to again), and I’m not sure I’m going to see any of them again until graduation. :[

I wanted to play this every time I passed by it. ;_;

Memorable Cases

• A super sweet lady who came in with bilateral pulmonary embolisms but thankfully, she’s okay! :D! She was the first patient I had on this rotation, and I really enjoyed talking to her. I had some stuff to take care of on the afternoon of her discharge, and didn’t get to say goodbye + to wish her well, so I’d been feeling really guilty about that and wondering how she was doing, but she emailed me to let me know she was fine! <3
• Responding to a code in the CCU and doing compressions on a real person for the first time–we actually managed to bring her back (despite what you see in movies/TV shows, this is not common) and heard a faint apical heartbeat on auscultation, but she didn’t make it through the night :[
• An elderly gentleman who was having chest pain + GI issues who was apparently an amazing dancer “back in his day” :P He was really anxious about being in the hospital, and his daughter had to leave on weekdays to pick up her son, so throughout his stay, I’d go up to check on him after I was done for the day. :] I stopped by on the weekend to drop off some water bottles for them because he was perpetually dehydrated (a fellow cactus!) and his daughter was sleeping at the hospital to stay with him. His eyes would light up
• A woman with pneumonia + a suspected osteomyelitis in her foot
• A lady who was recently found to be HIV+ and suspected to have PCP, but it turned out to be community-acquired pneumonia (Matt and I did our case presentation on her!)
• A super nice lady who came in because of difficulty breathing + chest pain–I went in off-hours on a Friday evening to keep her company and we ended up talking til almost midnight; she gave me a really sweet card and told me I’d go far in life, and would make a wonderful doctor <3

Notable Quotes/Conversations

• (I’m so sorry I woke you up! I just wanted to check to see how you were doing!”) “I’m glad you did, honey! I missed you over the weekend! I’d gotten used to you coming in to talk with me. You’re so sweet.”
• “Thank you so much for coming by to check in on Dad. I was so worried about him while I was gone. That was really nice of you.”
• “I was just thinking about you and how I don’t even know your name! My dad was asking about you; he adores you so much. You should see the way his eyes light up when he sees you!”

• K: We need to find someone to take the picture!
  M: I have long arms! I can take it!
  F: Are you saying you’re skilled at the art of taking selfies?
  M: Yes!

Resources

• UpToDate
• AAFP Website
• Matt (he is a wonderful soul!)