Relax

Beautiful stained-glass window by Louis Tiffany, 19th century

I feel great today. Today, tomorrow, and the day after are my days off, and after that, I will only have one more day of Family Medicine before I’m done with the rotation! Today, I turned in all my evals, along with the paperwork assignments that was required for this rotation. I can finally relax these next few days, and go into my last day here not worrying about anything. The only thing I have to worry about is just how to spend my last few days here in New York.

If there’s one thing I learned from this rotation, it is to discover things on your own and take everything you hear with a grain of salt. Before coming into this rotation, I had heard quite a few negative things about the inpatient experience here (vs. outpatient, which most everyone loves). Here are some of the true and not-so-true things that I’ve heard before about this Family Medicine rotation at Bronx-Lebanon Hospital:

  • “Long hours, like 7-7,  5 days a week, + night shifts on every other Saturday.”

While this may have been true with previous students, the rotation coordinators have changed the schedule, starting with our group of students. Now, the inpatient shift hours are only 4 days a week, and there are no night shifts. I feel the 3-day weekends have been great, because it gives me plenty of time to rest, explore, and study. The outpatient portion of the rotation, on the other hand, is 5 days a week, 8-5. It’s not bad at all.

  • “Things get slow in the afternoons and they make you wait there instead of letting you out early.”

While there are times in the afternoon when things aren’t too busy on the inpatient floor, I’ve always found stuff to do. For me, I usually go check up on the patients, see how they’re doing, do their physicals, and talk to them to learn more about them. Because I often check up on patients, even after rounds, I once picked up an abnormal heart rhythm/rate on a patient that was not there before, and because of this, the patient was transferred to get it checked out. I’ve also gotten to listen to many patients’ stories, their struggles, and learn more about their lifestyles. Some patients are constantly complaining, or drug-seeking, or are difficult to talk to, but it’s great practice to try to deal with them. Whenever there is an opportunity to draw blood or do/see other procedures, I also ask my resident physician if I can do it, so that I can get more practice. I constantly ask if there is anything I could do or help out with, and sometimes there is, and sometimes there isn’t. I also bring my books to study or read up-to-date on the computer. I think as long as you find things to do and stay busy, the time will fly by fast. And at the end of a productive day, I treat myself by going out to explore the city, trying a new restaurant, or going to see a show. I’ve rarely gone straight home after rotations.

  • “Dr. ***** grades harshly and gives everyone bad evals.”

I actually got a great evaluation from this attending. I think as long as you try your best, work hard, and be enthusiastic in learning and improving, doctors will recognize it. One person’s experience may not reflect the experience you will get.

  • “Nurses on the 16th floor are rude and mean.”

While I’m sure not every nurse here on the inpatient 16th floor is rude or mean, there are unfortunately quite a few that are in my experience, more so than other places I’ve been. Some people no matter how polite or nice you are to them, they respond rudely to you, unnecessarily rude. It baffles me, and I’m usually someone who would readily say my “good morning’s”, “thank you’s”, “yes mam’s”, and “sorry” without thinking twice, given my Southern hospitality upbringing in rural Georgia and traditional Taiwanese values ;). Although every Monday morning we have meetings on how to better communicate with patients and each other, it doesn’t seem much really changes, and the relationships between nurses and residents/med students remains distant. However, everywhere else, like most of the people in the lab, radiology department, and MRI department have been pretty nice and courteous in my experience. Many of the nurses in the outpatient clinics are really nice too, especially in Wellness Center where I did my outpatient shifts. Over there, they have a great sense of humor and seem happy to be there. I’d love to work in that type of environment.

“Rudeness is the weak person’s imitation of strength.” – Eric Hoffer (1902-1983), American social scholar.

  • “The Bronx is so sketchy and dangerous.”

There definitely are parts that are poor, with drug dealers and drug addicts hanging around, even just right outside the hospital. Crime does happen. Two of my female colleagues were followed and verbally harrassed on the street while walking to the hospital, but thank goodness they were ok. I’d say definitely keep your eyes open to who is around you, and walk with someone if you feel unsafe. On the other hand, however, you do see kids playing on the streets, and people sitting outside their homes on the steps chatting with their neighbors and friends, and old men playing chess on the side walk. While these places may look sketchy to those unfamiliar to the area, it’s important to understand that these places are where many people call home and live their lives, and we must respect that.

The walk from the subway (B, D line) to the hospital on Grand Concourse isn’t bad at all. It’s a major road, a short walk, and it’s safe. For the most part, you won’t need to walk through dangerous streets to get to the hospital from the subway or bus stop.

  • “They make you do so much scutwork, and we don’t even get paid to do it!”

Yes, it’s true there is a lot of scutwork on the inpatient floor. And while much scutwork like billing and making phone calls do not contribute much to our education, others like looking up drug info and guidelines for the residents do. Besides learning and seeing the clinical side of medicine, I think another big purpose of our education here in clinicals is to train ourselves how to endure stress, multitask, stay on top of things, and the old fashion skill of do-what-ya-gotta-do, and scutwork is definitely a part of it. While you do a lot, you also see a lot, often things you don’t often see in other places, like Progressive Multifocal Leukoencephalopathy (JC virus), delerium tremens, rabies, West Nile virus, hepatic encephalopathy… things I’ve never seen even when I did my 12-week Internal Medicine rotation in Miami. There is no pressure of a final shelf exam for this rotation to study for, and so I don’t mind doing the scutwork. I’d rather be busy than bored.

In medicine, you can’t ignore the “pertinent negatives” and only look at the “pertinent positives.” You’ve got to learn from both. And in life, we need to learn from both the good and the bad. I definitely learned what not to be like from the rude individuals that I’ve encountered, and I definitely felt the warm sense of reward when a difficult patient complimented me on how much she appreciated the care I had given her right before she was discharged. It’s experiences like this that reminds me why I want to become a physician.

Personally, I feel a lot of sense of accomplishment with this rotation here in the Bronx, after being so long in Miami where I feel like I’ve gotten it easy quite too often. Here in the Bronx, I got what I wanted: learning to do skills, doing a lot of tasks (albeit much scutwork), understanding better how the hospital system works (and not works), seeing interesting (and sometimes rare) cases, getting great evaluations, and getting a letter of recommendation of the specialty I’m interested in. So while there may be some truths to what you hear, most of your experience depends on yourself. Same goes with everything else in life.

So for my day of relaxation, I put on my earbuds, played some classical music on my iPhone, and walked into the Metropolitan Museum of Art, one of the largest and greatest art museums I’ve been to. Wandering through the labyrinthine galleries, I admired the patience, precision, care, and craftsmanship put into these works of sculpture and painting. Many of the pieces are not famous (or at least I’ve never heard of them before), but you see the dedication of the artists in their works, and that’s what makes them beautiful.

Here are some of my favorites!

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