Monday, November 30, 2009

More Good Things in November

Friends and Family!

I feel awful for neglecting to send October's Letter. My excuse: Well, I suppose priorities were a bit misplaced during the first few weeks on Internal Medicine (IM) rotation, which began late October. Long, long days at the hospital with 4 days off allowed during the entire month left me quite spent, and no energy = no letter. Things are better now :)

What is working in a big hospital like? Here is the breakdown of the 2 Fort Worth hospitals I have been in:

Spent my first 4 weeks at Plaza Medical Center in Fort Worth. This is a private hospital that saw mainly old patients with health insurance. I worked with IM residents (actual doctors who are still learning) to take care of the patients belonging to 3 primary care physicians' medical practices. Our philosophy: to provide the best care, cheaply and efficiently. Efficiency was often more of a wish than a reality, and this largely because of communication problems between doctors in various specialties working on the case! Out of many cool cases, the most interesting was a patient with Tylenol toxicity who nearly went into coma, but who completely recovered after treatment besides some physical weakness due to innactivity! After following her from the emergency room to the regular floor and then to the intensive care unit, thinking her nearly beyond hope, I was so amazed with her improvement!

The 2nd month of IM is at John Peter Smith, the county hospital of Tarrant County. Goodnight! This hospital is quite a bit larger, and much wilder! Our patient demographics are different too, people with out insurance, citizens and undocumented, and a more varied age range. I work with family practice residents here, admitting patients to an internist's medical service. We (3 students and 3 residents) start the week "on call" meaning we admit sick people from the ER from noon until the cap is met at 16 patients... which usually happens around 1-2am. Our team then wakes up early to round on the patients with our attending doctor... and finish around noon. Our job is to kick as many patients out of the hospital as possible (if their health improves) because every day in the hospital increases patients' risk of hospital acquired infection, being a patient is not fun or comfortable, the hospital doesn't loose money on prolonged services, and the patient care team can breath easier. As long as we have patients in house, they must be seen every day.

One of my favorite things about November, I'm in a city full of people I love! After 4 months in rural Texas, I'm realizing how much I need friends and church family. Don't get me wrong! I did leave friends in Crockett and Cuero, but 2 months of cultivating relationships is somewhat shallow compared to the roots that dig deep over 2 years. Definitely thanked God for people this Thanksgiving.

Yep, so I hope this helps you understand more about life here in Fort Worth.

On a fun note: during one of my days off in October, my dear friend and fellow medical student, Dan Leverenz, needed manly assistance in fence building. Of course, I needed to dig out the work boots from the closet. 4 hours, 6 post holes and several calluses later, we finished cementing the poles into ground. Not quite as far as we expected. Golly! Manual labor sure felt good after hospital work. Slept well that night. Dan finished it Sunday morning by himself.
So maybe this is TMI (to much info), but I have to talk about something, and I'm "proud" of it. :)

Thank you all for friendship and familyship. Love you,