In a little under two months, my four-year journey through medical school will be over. This last leg of the marathon was by no means smooth, however. You would think I would get used to how hectic and unexpected things can be, but life always has a way of surprising you.
As it turns out, I won’t be going into obstetrics and gynecology just yet. Instead, I am happy to say I am going to be working at UF for another year with the division of internal medicine. While I was disappointed at not being able to go into obstetrics and gynecology the way I wanted to, I am very excited about training with the internists at UF after graduation. I am certain I will learn many new things and have an excellent start to becoming a great doctor while under the guidance of the dedicated staff and faculty here. I’ve learned there are many ways of making your own career in medicine, and I will use this time to work hard, improve myself and do the best I can for my patients.
During these past two months, I finished two of our required fourth-year rotations: anesthesiology and emergency medicine. My time with the anesthesiology team was very educational, and I was able to get a better grasp on how we put patients under and ensure that they are safe while we operate on them. Having been through my general surgery rotation and in other surgical specialties, I had previously only seen what it was like to be on the surgeon’s side of things. But after working on the other side of the curtain, I was able to get a more complete picture of how things work in the operating room. Before starting the rotation, I had already known there would be much more to anesthesia than just putting patients to sleep and watching their vital signs. After finishing the rotation, I had a better appreciation of just how complex their jobs are.
Anesthesiologists are the experts in preparation and vigilance. They leave nothing to chance and always have a backup plan in case something goes wrong. Their job starts well before the surgery begins and does not end until well after the patient is awake. It is up to them to determine: how best to position the patient before surgery, what paralytic and induction agents to use, intubating the patient, determine what kind of ventilator settings to use once they’re intubated, what fluids to give and when, what medications to give and when, monitor the vitals and breathing, watch out for side effects of medications, keep in mind the timing of when they need the anesthesia to wear off, extubating the patient and controlling post-operative pain and nausea. In addition to all of that, they have to chart when they did each of these things during surgery. It’s easy to get side-tracked, and I was impressed by how well the residents and nurse anesthetists fielded all of the interruptions and unexpected demands they came across. As for myself, I was able to learn how to mask ventilate patients, intubate them, prepare medications and help in any other capacity that I could. In fact, I did those things so often that one night I even had a dream that I was mask ventilating myself! Overall, it was a very worthwhile experience.
Emergency medicine was a rotation I was very much looking forward to. I had previously worked in the emergency room on some occasions, like seeing consults as part of a different hospital team or working for a week in the pediatric ER as part of my pediatrics rotation. From my prior experiences, the ER is a busy place where a lot of important medicine happens. There are patients who present for all kinds of issues, from specific complaints that have a known origin, to more vague complaints that could have a wide variety of causes and must be worked up extensively. The ER does not turn anyone away, and its main goal is to rule out and treat any conditions that are life-threatening. As part of the team, I spent four weeks working in shifts that occurred throughout the day, in both the adult and pediatric emergency rooms.
Perhaps the most striking aspect of emergency medicine is the variety of cases that can walk in at any time. Inside of one eight-hour shift, I could see patients with: chest pain, a strange rash, a scalp laceration, eye pain and patients brought in from various traumas. The trauma patients were the ones who left the deepest impressions. There were cases we saw of severe burns, car accidents and gunshot wounds that were all so intense to be a part of. It was amazing to see just how well the ER team worked together to stabilize the patient. It was like watching clockwork, the way each person knew what they were doing; whether it was doing chest compressions, getting IV access, intubating the patient, performing an ultrasound, making notes on the timing of the drugs we administered or charging the defibrillator for when we needed it. Sometimes the patients did well, and sometimes they did not. But as urgent and scary as the situations were, there was always a sense of calm and purpose in the trauma bay, which is exactly where it is needed the most.
My favorite part of being in the emergency room was the fact that I was able to walk back into my patients’ rooms and talk to them while we were waiting for a test to be done or for an inpatient hospital bed to open up. Sometimes all of that waiting can be anxiety-provoking, so I would try to interact with my patients as much as I could. There are very interesting people who come to the ER, each with their own stories and backgrounds. Oftentimes the patients were accompanied by their family members, and I was able to get to know a lot of people. We talked about anything that came up: jobs, traveling, what was on the television. But my favorite part of talking to them was the fact that I was able to keep them up to date on what was going on, what our plan was, and answering any questions they had. They were very appreciative of the time I spent with them, and it reminded me of why I decided to go into medicine in the first place.
At the time, I was still sad about not being able to go into obstetrics and gynecology next year, but I realized that as long as I have the opportunity to continue taking care of people, I would still truly be happy. From my experiences these past two months, I’ve learned that changes can occur when you least expect them. But as long as you don’t lose sight of your purpose, things will have a way of working out.