Ok, it’s early, and I can’t sleep and I feel a long post coming on, so bear with me (or feel free to disregard if it’s TLDR
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So at this point I have 3 hours left on call, then I’m with residency duties forever! I’m on a rural elective on one of the “outer lands” islands in New England, and I’ve been on 24h call’s for emergencies every other day on average this month.
Last night the radio went off for a boat fire, it was a larger yacht with a full tank of fuel, and multiple propane tanks and it was moored out in the water. I thought for sure that my last night on call was going to be full of burn trauma. But in the end, everyone was off the boat when it burned so I got a decent rest after all the radio chatter died down.
This month I’ve provided primary care and emergency care here, diagnosed a ton of tick borne illnesses, talked people through life crises, triaged and evaluated a bunch of tourists with injuries and a few islanders too. Sent people off island in medivac helicopters and sat on the floor of a Beechcraft next to other patients strapped to stretchers while they were transported via air Taxi to the mainland for less emergent things that still required a fully equipped hospital (surgical issues etc).
I’ve been out in town and people have begun to recognize me as one of the town doctors, and when the radio would go off, they’d drop everything to offer me a lift back to the medical center ahead of the ambulance. It’s been a cool experience.
Yesterday as our primary care clinic was winding down, I went in to see the next to last patient. The MA was flustered and said that this patient was notoriously difficult. She was in her 70’s, had survived cancer, and couldn’t ever explain her chief complaint without first telling her whole cancer story (you know the type...start out their HPI with “so 8 years ago I had surgery...”) and trying to tie it all into that. The MA couldn’t figure out what her issue was, so I pretty much went in blind.
I let the patient talk for a few minutes, before gently interrupting her and asking her “so what brings you in TODAY?”, and from there was able to quickly assess her complaint, allay some obvious anxiety, and with her, come up with a good plan for her complaints.
She asked me if I was the new Island Doctor. And when I informed her that I was not, and that I was here as a visiting medical resident at the end of my residency, and that she was likely the last patient I’d ever see as a resident, she burst into tears, hugged me, and sympathized with all the work she assumed I must have put in. She thanked me profusely for being so kind to her. As I came out, the medical center staff had fashioned a graduation hat out of cardboard, decorated it, and were waiting in the hall to present it to me. They’d all signed it, and this patient signed it too. Bittersweet moment to be certain.
Guys, this is what being a physician is all about. I have the coolest job in the world; you’re all working toward it too. I’m excited for each of you! I hope you find the same kind of fulfillment in whatever field you enter that I have in mine. Always try to stay centered and remember why you’re doing this.
I’ve been a college or medical student or a resident for more than a decade.
In that time I’ve amassed an obscene amount of debt, I’ve experienced the birth of 4 of my own children, and watched them grow, I’ve had high and low points in my relationship with my wife, I’ve purchased and sold a home and a few cars. I’ve lived in 4 different states on both coasts of the country, I’ve struggled with severe burnout, depression, fear and uncertainty, and a lot of self-doubt.
But I’ve also learned and experienced more than most people do in an entire lifetime, more than I believed I had the capacity for. I’ve followed a dream that I’ve had since I was like 10 years old, one that I spent most of my teens and 20’s thinking I’d probably never have the chance to do. But I made it in, and I made it through. And it feels great.
For once in my life I feel ready, adequately prepared for the next phase (so to speak). Sure I’ve got things to still learn and experience, but I’ve been well trained these past 3 years and I look forward to what the next 20 or so have in-store.
Tomorrow I officially take my first step into that next phase, as an attending physician. It’s a surreal feeling!
Thanks to everyone here, this forum is a great resource. Despite all the back and forth, the DO vs MD stuff, the endless complaining (we all do it); when you boil it down, this site is one of the main ways I learned to “be” a medical student. I have no family in this field, so I came here and read about the application process, what to expect, how to study, what to try to learn and experience etc. it’s been invaluable to me. I hope that between all the randomness of what I’ve put out on this site, I’ve paid some of what I’ve gotten from this site forward to folks coming-up behind me.
I’d like to stick around and continue to contribute, as long as people feel I’m useful, I’m happy to stop in from time to time.
And if anyone wants a rural family medicine elective, PM me and we can see how that might happen!
