The art of medicine is a lot like the art of writing. Our patients each have their own story; we follow them page by page through thick and thin. The book may be arduously long or joylessly brief, with chapters covering only 3 days or 30. 🏨📚 Here in the IM floors, the doctor’s orders can draft and direct the next story arcs. But now and then some stories still abruptly end. 💔
Thank you to my dutymates, my fellow clerks, our great and sobrang maturo interns, the awesome nurses and our residents, the consultants, and finally the patients for the journey. I think regardless of the many other months to come, IM will definitely be up there in my list of favorite clerkship rotations. ❤
Shadowing a resident
A big bulk of our stay in the medicine floors was dedicated to shadowing a first-year resident. Unlike our stay in OsMak or the ER, medicine floors was a lot more paperwork, referrals and clinical decision-making, instead of skills –which is apparently also the life of a first-year resident.
As a lowkey anxious, socially awkward and introverted person, spending one-on-one time with any person for long periods of time (the horror of 3 weeks!) seemed like a nightmare. But with anything, you can always adjust! I got lucky enough to get paired with an R1 who not only showed me the ropes, but also taught me a thing or two about perseverance. The life of a first-year resident seems like hell in terms of work-life balance. But at least for my resident, Dr. Tony, there was still time to teach and energy to tell the clerks to eat or sleep (even if the residents never took the time to eat or sleep themselves).
We stayed largely in the fifth floor, which was theoretically an extension of the OB wards. But as they say, medicine is everywhere. On most duty days we covered many more floors.
I also got a chance to work with several more residents during my last few days before transitioning to the ICU. ❤
Tales from the Intensive Care Unit
The ICU is a whole different beast. Aside from interviewing and conducting a focused PE on one patient, we really didn’t have a direct hand in our patients’ management. After all, their cases were several leaps and leagues ahead of our competencies.
Instead, we spent our time learning through charts and endorsements, lectures, a small group discussion, and just story time with our superman Critical Care consultant, Dr. Cinco. One of the hardest yet most important lessons you learn in the ICU is how to deal with the end of life: with denial, shock and grief.
We also had some of the most chill and educational (??? If that is the right word) interns for our one-week stay in the ICU ❤
The case of Vibrio vulnificus infection
One of the biggest events of the subrotation was the Grand Rounds. Our case may have been a bit of a mess to present (we got through it eventually), but it was an interesting case of shock secondary to cellulitis and septicemia secondary to… Intake of undercooked oysters.
Special thank you to all those who made it possible, especially our resident monitors/mentors and guest consultants.
The privilege of Atenean clerks
One of our consultants remarked how different it was “in their time”. Back then, clerks would only get to interact with residents, and there aren’t usually any teaching rounds or lectures with consultants.
After talking to clerks from other institutions, I’m beginning to think it’s both a generational shift and an Ateneo quirk, to be afforded with so many opportunities for direct learning with consultants. Unlike other schools or generations of clerks, we never had to act as “vital signs monitoring machine” during the medical rotation. Whatever the case, count us blessed!
Part of the “privilege” is also being required to attend big TMC post-graduate lectures and conferences. I attended one on TB and another on pulmonary disease updates; each time there was free lunch. I also got to take home tons of freebies from pharmaceuticals, lol. The insidious nature of medical capitalism.
I really felt the work-life imbalance keenly. I hadn’t been home for around 6 weeks at one point, and I was desperate to go back to Parañaque. Even if my family would visit me regularly, getting to sleep on your own bed in your childhood home is still a different experience.
Every moment I could get away from the (sometimes) drone of clerkship is a rare and precious thing. ❤
I started writing a medical journal. I realized there are so many patient stories that I can’t share or publicize because of data privacy concerns. 🙏 Here’s to more stories and adventures and tireless days in the pursuit of health etc
I’m pretty sure I died in the first two days of Ophtha in Quirino Memorial Medical Center. New places and people and all the returning skills killed me.
But then an OPD patient took his time to seek me out and thank me before leaving, so now I’m alive!
My clerkship journey!
Follow my clerkship journey through this tag. I blogged about other internal medicine subrotations in Osmak and in the TMC ER :)