The city of brotherly love

This time last year I was a 3rd year p.a. student. I was also president of our student society, which among other pro's and con's, bought me a free ticket to our national conference in San Fransisco. Being the big homo that I am, I was pretty thrilled it was in the city by the bay; especially since I had (have) dreams of living there. I went with a few other classmates and it was the first time in my academic life as a budding young p.a. that I was able to sit and listen to people lecture about medical topics without furiously taking notes; second pass. I'd heard all of this before at least once and now larger bits and pieces were starting to sink in as I sat, willingly, lecture after lecture, learning about heart failure, the dental emergency and 10 things you need to know about diarrhea (lol).

It was luxurious. We stayed in a 4 star hotel, ate out breakfast, lunch and dinner, heard all these great lectures, and walked every inch of San Fransisco. In fact my good friend D and I would eat in a new neighborhood every night for dinner, then walk home from it after. It's a wonderful city if you ever get the chance to go, and go again; I would.

This year, I am a nationally certified P.A. and the conference is practically next door to my home in Philly. I have a little pocket CME money from my job that paid for the hefty registration fee. Aside from that, it's piecemeal this year. I have to work fri, sun, mon and I'm going to the conference around that work schedule; sat, tue and wed. I'm borrowing a car to come back and forth and while I thought I'd spoil myself and stay the one night on Tuesday, I had to cancel that for other obligations here in the city that evening. So it will be a bit more like work, than play; but I'm still excited.

I love what I do and I feel as though the folks that make the effort to go to these things also love what they do. I think I will feel more at ease mingling and talking shop with other P.A.'s instead of last year when I felt like an imposter. In fact this year I forked over another 250 myself to take some workshops on reading x-rays and EKG's and my favorite - suturing. I'd like to get back to the ER someday soon, and maybe this will launch me in that endeavor.

I always love a good opportunity to nerd out~

good medicine

Yesterday I worked on the cardiac unit. Our census was unusually low and I had only 7 patients. I'd had an extremely pleasant evening the night before and sailed into work smiling and energized. I made my way round and saw each of my patients: my new admission with a history of vertigo that suddenly had 2 days of syncope and oddly good BM's with vomiting associated; my lady with the lovely family who had a abdominal bleed as a complication from her cardiac cath when she got too much a/c over the weekend - gratefully being managed medically; my 91 y/o lady who still walks to the store with her 92 y/o sister, who now needs a pacemaker due to dysrhytmias; my 85 y/o spring chicken who had a total knee arthroplasty and was visiting us because she has a little bradycardia with some aberrant pvc's for good measure; my italian lady who's advancing dementia now comes with hallucinations that caused her to leave her house late the other night and her husband found her after a fall which she can't recall (but is ok from) and the room at the top of the hall with my two CHF'ers, one who needs an MVR and I wish they'd do it or let her go home and the other anxious lady who DID go home -novina candles all around for their safe recovery and return home.

I tend to spend a little longer than need be with each of my patients because I hate that we live in a time when clinicians spend so little time with their patients, sacrificing rapport and trust in the name of efficiency. But this morning I went beyond my usual when I came to the room of my 85 y/o spring chicken. I finished my exam quickly and had only two other patients yet to see that were both familiar to me - the day was early and I was inspired to sit. Literally, I did - perched on the foot edge of her bed, I asked a most benign but inviting question: "where are you from originally?" This set my lady off on a story of her life, the love of her husband and some of her favorite memories. I chimed in on occasion, but mostly I listened and watched as she had a willing audience for dusting off some of her favorite places and recalling anew happiness.

Ten minutes time in a hospital is an eternity. When I gently lay my hand atop hers and mentioned I needed to get back to work, she grasped mine and thanked me quite genuinely for the conversation. 'It made my day. Really. It's so nice to have a real conversation and not about medical stuff, ya know?' she said smiling as I departed.

It was a selfish impulse really. She completely reminded me of my grandmother, whom I adore. It made me feel good to open that avenue for other-than-hospital-routine for a women stuck in bed with her knee in a brace. It was selfishly good stuff I walked away with, but it went both ways. I am not saint nor angel as I have been called on occasion by my patients. I just know, with all I've yet to learn, that attention and attentiveness is good medicine.