the transition is complete

Today for the first time, I looked up at the clouds and saw what reminded me of a muscle spindle. I also realized the other day that the acronym RBC has totally shed its previous meaning of Royal Bank of Canada and has now officially become referenced in my head as “red blood cell”. Yikes. I’m counting the days til the end of my internal medicine rotation. Or at least the ward work. I can’t put my finger on it exactly but I’m finding it’s sucking the life and any happiness from me like a dementor from Harry Potter books. It’s not good. A few things that are tending to have that effect may be:

• The sheer volume of people in hospital that are there because of the lack of long term care beds in the community vs a requirement to receive acute care medicine. Some mornings it feels like we’re working in a nursing home. Which isn’t terrible, it’s just not that interesting. Plus, since they’re in hospital and under our care, we need to continually make sure they are in an ok state of health. Which at times feels like they morph into our little science projects to draw bloodwork on and then try to get their lab values looking good. Sometimes it feels like a bit too much focus on lab values vs the big picture (though I realize that if some key lab values get too outta wack it will affect the big picture). This is particularly true for deaf, demented patients that are nearing the ends of their lives and who can’t really communicate clearly to you at the best of times with anything other than a perplexed look. Argh.
• Lack of relationships with anyone other than nurses. In Peds, I got to know the occupational therapist, the physiotherapist, the nutritionist, etc whereas here, we just seem to write orders for the nutritionist to see the patient and/or advise us on diet and we never seem to meet them. Not exactly sure why that is, maybe a combination of office location, poor space design (we’re in the oldest of the old part of the hospital which had been previously closed for the last 10 years until this fall – awaiting the new tower to be completed in 2010) and lack of time. Not sure, but I don’t like it. Makes for less job satisfaction and less of a sense of team.
• The darkness that has come with fall which makes evyerthing a little more dreary.

Anyway, I’m just hoping I can make it through this week with no major disasters so I can move along into medical oncology (cancer) which I think I will enjoy much more. Last weekend a friend asked me a question on sustainable business that she had regarding a project she’s working on. For the first time in a long time, I felt like I could actually give her some good information off the top of my head that I didn’t feel the need to verify numerous times to confirm its accuracy. It was quite a relief. Looking forward to more times like that in the future, say 5 years from now? Or maybe in 10 years. Just about the time when I start thinking about career #3.