futility

although i attempted to be optimistic on gyn-onc, it eventually got the best of me: between the hours, the scutwork, and the overwhelming sadness. during the two weeks i was on, three of our patients died (including one i took care of every day). additionally, i helped operate on a number of women with late stage ovarian cancer who had prognoses of maybe 6 months. i laughed with them. i cried with them. ultimately, there was nothing i (or any of us) could do for them medically.

i will never forget the morning ms. p died. it was like any other day, but it was somehow so different. i went in to round on her at about 4:30am (as i normally did), and she was lying on her side, awake.

"how did you sleep?" i asked her, apologizing as i always did for the early hour.

"not well." she looked different. she was breathing fast. "help me sit up a little, will ya?" she reached for my arm. i helped her sit up in bed as i counted her respiratory rate. it was too fast. we both half-glanced at the infomercial blaring on the tv. it seemed so irrelevant and intrusive.

"any pain?" i placed my stethoscope on her chest.

"nah, sweetie. just trouble breathin'." she was sitting up in bed now, but every muscle in her body looked uncomfortably drawn.

"try to rest, ms. p. i'll be back with one of your doctors."

my resident went to see her. she was a 50yr old lady with known metastatic cancer; our plan was to continue to follow her symptoms and offer any comfort care we could.

around 7am, i went to the operating room to help with a case. we'd been operating for about an hour when we received a call to the OR - ms. p had died. just like that. gone. i was scrubbed in to the operation and my entire job as a medical student consisted of cutting suture and retracting... i was so distracted for the next 10min i had to be reminded to cut.

sigh. her time was coming sooner or later... it was just hard for me in my small understanding of mortality to experience sooner. but here i am. and there she is -- in a better place.

attempt at optimism

i'm currently on my OB/GYN clerkship, 3 weeks in. my first two weeks were pretty cush -- i was on REI (reproductive endocrinology and infertility). as my resident simply put: it was our task to knock people up. the hours were awesome.

starting week 3, i am now on Gyn-Onc surgery (gynecological cancer). we operate on & treat vaginal/cervical/uterine/ovarian cancer. the hours suck. get there at 4am - usually leave around 5:30pm. this rotation is something of a UAB med school rite of passage. we stay incredibly busy all day long, have very sick patients (1 died today), and work with intimidating attendings.

3 days down, 11 to go. in an attempt to keep my morale up, i am dedicating the rest of this post to all the positives i can come up with about Gyn-Onc:

1. no AM traffic & ideal parking spot: getting there before 4am everyday means i have literally no competition for commute or parking.

2. crazy awesome surgery: yesterday i helped take a tumor out of a lady's belly that was the same shape as a football but about 1.5x its size. holy cow. my attending was on a high; it was insane. today i got to watch an operation with "the robot" - the da vinci robot surgery. it's wicked.

3. potential weight loss: it's hard to eat breakfast at 3am when i wake up, and often there is not time throughout the day for a proper lunch. we are on our feet a lot. burned calories > consumed calories? time will tell.

4. fellow students: i'm working with 3 brand new MS3s. they're awesome. i am trying to get them oriented to wards. it is delightfully refreshing how not-jaded they are (and kind of scary how far i've come in that department).

5. perspective & conditioning: nursing shift changes twice while i am on duty and hearing all three sets of nurses complain about their tiredness/workload/etc has rendered me much less likely to complain. lame of them. win for me.

6. it's only 2 weeks. i can do anything for 2 weeks, right?

and because i can't stop singing it (to myself, my residents aren't amused) every time i think about the da vinci robot surgery:

domo arigato, mr. roboto, domo arigato mr. roboto ::incredibly convincing robot dance::