Assortment

A couple of random thoughts that are floating around:

1. Trauma

During trauma call, around 5:30 AM, I'm 30 minutes away from getting the hell out of the hospital and into my bed after a 26 hour day - I have to go to do a consult in the ED. No prob, I got this. Simple HPI, some ROS, a little bit of the physical exam, grab some history, I can do this. Go to the room, and the poor guy (who has a swelling red arm for the past week, probably going to be called cellulitis) wants to talk. Every single question I ask has a 5 minute answer with an associated story or two. And if I try to move on, he tries to go back to the story.

....
I am utterly, graciously, tired. I... honestly don't really care. I just want these darned answers (specific, short and sweet) so I can go back and write them into the chart within 30 minutes. It is not in my job description to be a quasi-psychologist as well. Or a friend. To listen and be interested in his life outside of his disease. To actively listen to woes and sorrows and family issues and his love life or lack thereof.
Everything I said in that above paragraph is "true".
But I feel/felt so bad. What patient wants to be treated like a disease rather than a person? And how callous is it to ignore a person so desperate for human interaction? That this man would even attempt to go into his life story with a passing medical student.

Truth does not always mean right.

But I was so tired.
I don't like this side of medicine.
In surgery, where residents are worked over grueling hours, you can really see how people act without their frontal brain filters. If they are easily angered, if they have patience or not, if they snap or deflect blame, if they go a little sleep-drunk, more talkative or not - it's all apparent.
When I am tired, I really don't want to be nice. I know that it is not in my nature to be kind or nice or gentle or whatever fruit of the spirits. Those are my "second thoughts" (thank you, Terry Pratchett). And it makes me worried that if you strip away my filters and my moment where I can think and process and make my decisions to be kind or gentle, then I'm just going to be a horrible person by instinct when I don't have the time to think. And who wants that?

I don't ever want to blame my environment for my own actions. I don't ever want to say, I was rude because I was working 26 hours and I was tired. That is true. But it is also just an excuse. There is always room for improvement.

But I don't think I was rude or even technically "mean". But I certainly wasn't nice. Ugh, I hate these types of scenarios. Should I have gone the extra mile and talked to him longer? Spent an extra 10 or 15 minutes listening about his sick father who cooks great food and the events that lead up to his right pinky toe amputation? It's just 15 minutes. Would it have helped? Would it have made him feel better? A chance to connect to patient that I will literally never see again, most likely. What is cynical and what is realistic?

I don't know why this scenario bothers me so much. Most people probably just go do the consult and leave and forget about it.
No, I do know why. It's because I think I know the "right", "good" answer, and I took the easier, maybe "wrong" path. Not entirely, but for the most part.



2. Weekend
I realize that I have greatly changed since college after a college friend came to visit this weekend. People are not static.

And I really, really love balmy days with a hint of sun and a soft breeze. Perfect weather to walk through a farmer's market and enjoy live music. Some couples were dancing triple-two. If I find a boy, I hope he dances.


3. Socializing
 The OR is the weirdest place. You really get to know people through small talk here. I don't like small talk.

Coworker talks. In a team lunch of 6 people, chief resident, one second year, two interns, two med students. Half of us are not-white. Guess which half carries the small talk at the table?
I really need to learn the art of small talk. The kind that goes on extensively for weeks.


4. Personality
I've decided that I'm probably sociopathic. Or on the Asperger's scale.
Maybe.
I really admire [am really jealous of] people who can navigate social situations innately.


5.  Faith
Oh tenuous faith.
I wish that answers were so much clearer.
I feel like a child who asks why? why? why?
And maybe I am the child who asks why, but doesn't wait for the answer.
Can you reconcile for me social issues and Christianity?
Is it true, is it right, is it good?
I want to feel the nail wounds with my own fingers, I want to see with my own eyes, I want to hear with my own ears.
I want to know the why behind all of the reasoning.


6. Finger problems
... I realized just how long/skinny my fingers are. Attending looked at my gloves and said they were too big. But I've tried one size down multiple times and the finger length is way too short - even though the width is marginally better. One size does not fit all. Heck, multiple sizes do not fit all.