Several months ago, I was asked by an attending about my future plans. “So I can pimp you,” he said. I told him that I am pursuing further training in addiction medicine. “Isn’t that just for psychiatrists?”
Writing is the greatest self-excavation tool I have found. It was always something I enjoyed, but during my medical training it became something much more important than that.
A haiku about screening for colon cancer.
“Compassion” / A pale moon hangs above / The workroom clock reads six, but / Is it day or night?
Shrouded in a plastic blanket / Raising the temperature of your / Frail limbs and famished core
Residency is hard. Anyone who tells you differently needs a stat GI consult because they’re full of it. You will be tired physically, mentally, and emotionally, regardless of what specialty you enter.
“Bunny!” my mom shouted from the foot of the steps, hurrying me out of bed the morning after my medical school graduation. She used the childhood nickname that came from my brother who was unable to pronounce “Dominic” as a toddler, a name that had stuck well into adulthood.
With just a few months left of residency, I’ve started to pay a lot more attention to what is going on around me. I’m realizing what a unique perspective we have as housestaff physicians. The best way for me to explain what I mean is with this story of one particularly busy shift in the ER.
One of the most poignant and gut-wrenching examples I’ve witnessed of the interplay between the social determinants of health and clinical practice arises in a particular patient population: those who suffer from addiction.
As a child of immigrant parents, I had limited exposure to the American military. Ironically, my sole memory of the American military exists outside of America — in Japan. I spent part of my childhood in Tokyo and fondly recall the excitement that came from visiting the American Naval Base in Yokosuka to buy “American groceries,” specifically Eggo waffles.
“Direct Admit: bounceback 72M recurrent pleural effusion, new diplopia,” my pager beeped with our new admission. As a “bounceback” admission, this 72-year-old male would be returning to our service after recently discharging from the hospital. This type of admission often indicates that a problem recurred or an issue was not fully addressed during the most recent hospitalization.
Realizing that we have both inpatient and outpatient months, which require different skill sets, I feel that it would be better to split these lists into both outpatient and inpatient suggestions. After a few month of being on outpatient rotations, here is my list of eight things to master in order to break the successful intern barrier in the outpatient world.