Forgetting. And Remembering.

Despite all the napping and procrastination yesterday, I really hoped was totally confident I’d managed to do a decent job preparing for rounds this morning. This feverish hope utter confidence, combined with just coming off a rotation with, like, the Nicest Most Confidence-Buildingest Attending Ever had me feeling all……..

Nurse, MD: (Almost) Doctor. Bring it.

Then, rounds actually started. And I realized, after weeks of working solely with Dr. SuperNice, I had totally forgotten about pimping, and apparently, almost all of what I learned in the last three years of medical school.

There I was standing in the middle of the ward, surrounded by staring, erstwhile peers, and Dr. LessNiceAndMoreScary while I struggled desperately to retrieve some arcane rule about hypercapnia and something about 10’s. Some information I’d surely had down pat at some point, but had since carelessly tossed into an abandoned synapse like an empty can of Busch light or an unwanted puppy out of a car window onto the side of a dirt road while blissfully road-tripping my way through fourth year (not that I would ever do that, I mean litter, or throw a puppy, or not want a puppy).

I quickly devolved into…….

Oh my GOD. I am SO not ready to be a Doctor. Help. Me.

This was rewarded with “Even an obstetrician needs to know that.”

Ouch.

I hate being pimped. Actually, I hate not knowing the answer to Absolutely Everything, when I get pimped. I had forgotten how much.

Flash back to last year. Small group and I’m up. At the white board furiously scribbling. And the group leader, a deceptively Santa-resembling retired MD, pipes up to ask a question. I stop scribbling to hem and haw, standing in front of the class doing the med student’s version of the pee pee dance. I tentatively venture an answer, am completely wrong, and my shoulders slump in defeat.

“Yeesh,” says Dr. NotSaintNick, “if you’re that sensitive, I hope you’re not going into surgery.”

Righteous Indignation.

Who are you call...I am NOT sensitive....sniff.

Okay. Maybe I am a little sensitive. I’m working on it alright.

The point is, I remembered some very Important Things today.

  1. There is lots of pimping in medical school. There is going to be even more in residency. Get used to it.
  2. Just like crying in baseball, there is no place for sensitivity in medicine. (Wait, that doesn’t sound right.) Doctors are very sensitive towards patients, just not each other. (Wait, no, that’s not right either.) Medical students and residents can’t be sensitive. When they get pimped. They just need to buck up and learn and…..(Good grief….Ahem.) You will get pimped (a lot) in medical school and residency, don’t take it personally and try to learn something from it. (Aha!)
  3. Even though you studied your brains out in medical school, you are not going to remember/know everything. Keep studying.
  4. Do not get all over-confident as a practitioner. Fear (at least a little), and the persistent knowledge that you do not and will never know everything, is healthy. It will keep you on your toes, keep you studying, and constantly striving to check and double check, to make sure you are making the right decisions in regard to patient care.

Right after the pimping disaster I ran into one of my nurse buddies who was visiting a friend in the hospital. She is one of my favorite people ever. A sort of overly sensitive, perpetually naive, grandmotherly type, who makes me think of homemade chicken noodle soup, hot cocoa (with mini marshmallows), and cuddly knitted afghans. Patients ask for her by name, and without exception, love her. So do I. As soon as the other stuffy doctor-types were out of eyesight, she told me how proud she was of me and gave me a big hug.

I’d forgotten how awesome her hugs are.

Like warm sun shining on your face on a cold, snowy day.

My bruised ego balmed, I walked away, from a part of my (more sensitively acceptable) nursing past, towards the group of white coats huddling up around another chart, my future.

And now, I’m going to keep studying, and try to remember.

 

*Note: As an added bonus, today I also re-discovered Natalie Dee and her awesome comics, which I had completely forgotten about.

HOW could I have forgotten??? They are so awesome!!!!

QOD

“If you are open to the experience of a ‘Cancer Movie,’ this is a pretty good one.”

~ Reveiwer on Rotten Tomatoes, talking about 50/50

 

"So, wait, what do you use these clippers for anyway." "Uhh, my body......"

 

I went and saw 50/50 last night. We had planned on going Friday, but frankly, I’m currently at the mercy of my hormones and some rather unpredictable, monster PMS mood swings and I just wasn’t up for a ‘Cancer Movie’ that night. Frankly, I usually don’t like highly-emotional, tear-jerker, Nicholas Sparksian movies at all. I see enough real-life drama at work every day, thanks. But, I girded my emotional loins and headed to the theater for this one.
 
Because, it seemed like it would be different somehow, from the previews and what I read about it. First of all, its a true story, not someone’s imagined, dramafied portrait of some poor cancerous wretch, purposefully painted to wring out my limbic system like a wet wash rag. Secondly, Seth Rogan is in it. He’s in it because its the true story of his best friend’s bout with cancer. He plays the same character he always plays, a goofy, bumbly, inappropriate but well-intentioned, pot-smoking, horndog buddy character, which he seems to do in all of his movies, but it is completely warranted in this film (and strangely, its not as annoying as when Brad Pitt does it ala, Moneyball – yeah, he did a good job, but its still Brad Pitt). It might be a ‘Cancer Movie,’ but with Seth Rogan involved there’s no danger of it turning into Terms of Endearment. And third, because I liked Joseph Gordon-Levitt for the main character. He worked closely with the film’s creators Will Reiser (the main character, real-life cancer victim, Seth Rogan BFF) and Rogan to transform himself and be a true as possible to the character, and he is the kind of low-key, unassuming but super-talented, underrated, non-matinee-idol, actor that can pull it off. And pull it off he did. The whole time watching the movie, I felt like I was watching an honest-to-God, real guy going through Cancer and everything that goes with it. The testosterone-feulled denial and minimalization, struggles with girls (sexual and motherly) and loneliness, the THC-laced post-chemo giggle-fest stroll through the cancer ward, and his eventual complete breakdown in Rogan’s Jeep. Not gonna lie, the agony was so real it was f*#?ing hard to watch.
 
The other, biggest thing, that was hard for me to watch was the representation of the medical community throughout the film. The first thing The Writer said when we left the theater was, “Wow, they sure didn’t make the medical community look very good did they?” Nope. No they did not. And to my sadness and disgust I cannot say the portrayl was completely unwarranted or that it isn’t how the medical community is actually percieved by the public at large. The worst scene for me was when G-L is diagnosed. He’s sitting in the Oncologist’s (?) office, waiting to hear the cause of his persistent back pain, when the Doc walks in, picks up his dictaphone, and without so much as sparing the patient a glance, starts dispassionately dictaing the devastating findings using as many big, ugly, medical words as possible. I sat in my seat watching and shaking my head, struggling with the alternating desires to reach through the screen and b*tch slap the guy or sink as low as humanly possible into my chair, cover my face, and pray I wasn’t giving off any “medical personnel vibes” lest the audience sense my doctorishness and turn on me after the horrific display. The worst part is, I am absolutely certain that kind of crap actually happens. I found myself quickly siding with the family in the ongoing people v. medicine struggles. When Angelica Houston faced off with a nurse over the temperature in the aforementioned, Ridiculousy Inhumane MD’s office,  I wanted to tell G-L to let her have at and give Mama Bear a big high five. I wanted kick the impatient anestheologist in the nuts when he basically ripped them apart before G-L’s big, very likely disabling or fatal surgery.
 
Not all medical professionals were portrayed quite as negatively in the film. There was the slightly more-human-than-robot neurosurgeon, who still only showed up minutes before the big surgery to meet the patient for the first time (The Writer leaned over to ask me at that point, “Uh, does that actually happen?” Sigh. Yes, I am sure that kind of crap actually happens too.) and delivered news post-surgery with “this is all the really bad, scary sounding stuff that happened and, oh, btw he’s going to fine” aplomb.
 
El cringe.
 
Not gonna lie, this movie made me ashamed to be associated with the field.
 
At the same time, it only makes me more determined. I honestly do not believe that most physcians or medical professionals act like this on purpose. Especially not when they start out, but I do believe that many end up exactly as the film shows them. Most probably do it unsciously, after years of patients (and pressures to see as many of them as possible with factory-assembly-line-like efficiency), scads of devastating diagnoses, immersion in CYA politics, etc. I am more determined than ever to not succumb. To make an ongoing, concerted effort to be the kind of doctor that lives and works daily to fly in the face of, and smash such public perceptions. The kind of doctor who always takes the time to talk to patients, in terms they can understand, to listen in turn, and treat them like human beings deserving of the best possible quality medical care that CAN be delivered, with a modicum of empathy, kindness and gentleness, WITHOUT compromising any clinical or professional standards. A highly effective, evidence-based, disease eradicating, hand-holding, hug dispensing, patient-centered medical ninja. Oh yes, it CAN be done. Because I believe that mix is the real secret to being a Good Doctor.
 
I, Nurse, MD, hereby promise, to never forget this.