Death

One of the new things that this IM rotation has allowed me to do is actually develop a rapport with patients that lasts past the initial H&P. When they're on your list for a week or more, you have no choice but to get to know them and vice-versa. They become a part of your daily routine, and you theirs. When Monday rolls around, you instinctively ask them how their weekend was. When you bound into their room at 7 am, they begrudgingly let you do your exam because by now they know that you're a part of the team that's taking care of them, however small of a part that may be. So a relationship forms somewhere along the lines.

Which is why, it's actually quite the kick in the solar plexus when you find out one of your "long-term" patients has died. I've had this happen twice over the course of my rotation, both times, unexpectedly. At the risk of breaking the sacred HIPAA code, I'm not going to divulge any patient details, but both times, it felt like someone had punched me in the face. Not that there was anything we could have done, or did, that would have really prevented said death but there's still something unsettling about it all. On Peds, Psych, and OB-Gyn, I never encountered death. Sure, there were tons of sick patients, but none that we could not, and did not fix. And OB at least, was all about bringing new lives into the world. No one was really thinking about death at that point. So I guess you could say that somewhere along the way I forgot that as much as being a Doctor is about "fixing" people and curing them of their ailments, there's another less-glamorized aspect- and that is dealing with the patients you can't necessarily help and having to admit that despite all your interventions, there are some deaths that you just can't stave off. The notion that lives are in your hands becomes all the more real when one of those lives is lost. It's a shock to the system. Or at least it is to my fledgling, inexperienced, MS-III system. Just something that's been on my mind...