Grindin’ With Appreciation

You know, having to be on the wards this morning wasn’t that bad at all. Yes, it was weird having to go to sleep around 9PM on a Saturday night and having to work at the hospital today all the while reminding myself that tomorrow was actually Monday and not Tuesday…

 robert downey jr iron man eye roll the avengers tony stark GIF

But having to work a weekend day wasn’t bad at all! It was actually relatively chill, or as “chill” as being on the Renal unit can be I guess. I have absolutely no complaints and I absolutely enjoyed the more intimate atmosphere that I had with the smaller team that I was working with for the day. The interns I worked with this morning even let me go home quite early. However, my concept of a weekend is now a bit discombobulated lol. It now feels like I have “hospital-time” and “free-time” during the week as opposed to “a work-week” and “a weekend”. Thank God I’m actually having a great time while at the hospital and am not dreading spending my days there! The fact that time just continues to fly by while working just proves to me how much I’m loving my experience in third-year so far, even if I’m exhausted by 7:30 PM just about every day and have zero willpower to continue studying. Overall, I just feel very lucky and blessed to be able to love what I’m learning and doing enough to be perfectly okay with going in to work on the weekend.

This past week on the Renal service has really been an interesting one. (I know I’ve probably said that about the last two weeks already but darn it, all of third-year has been interesting so far!) During my second-year, I learned about how renal patients tend to have multiple co-morbidities and how the ones with end-stage renal disease have to rely on dialysis to keep themselves relatively healthy. But it’s one thing to learn about it from PowerPoint slides and another thing to witness these real-life patients with your own eyes. These patients are truly sick with multiple conditions and dialysis is required for many of them to survive. I felt really bad for the patients that I interacted with this past week, but I also got a sense of the strength that these patients possessed in order to battle the multiple conditions that they were afflicted with. I’ve also felt the deep appreciation from a patient who was just grateful that I came in to listen to her talk for an hour. That experience reminded me just how lonely being a patient in the hospital can be and just how appreciative some patients are when someone comes in to spend more than a few minutes with them. With another week in this unit, I’ll be granted the opportunity to continue processing the difficult lives that these patients live as well as the complex care that is necessary to adequately care for this patient population.

Along with learning more about this patient population, I also had the opportunity to observe and perform a few procedures! Yeah, I said it. You read that right. I PERFORMED SOME PROCEDURES! (With supervision of course.) I wasn’t doing brain surgery or anything, but I had a direct, physical impact on patient care for the first time since I started medical school! Well that is if you don’t count physical exam manuevers, because I guess that also qualifies as having a physical impact on patient care. But that ain’t as direct as pulling out vascular catheters from the necks of patients or placing an IV line into someone’s arm! Yeahhh that’s pretty lit, ain’t it? I did pretty well with removing the catheters, but I could use some more practice on placing IV lines though 😅. I also was able to observe a couple of blood draws and a procedure called a thoracentesis, where a doctor works to remove excess fluid from the pleural space surrounding the lungs. Wild, huh?

Alright, I gotta get back to studying/tackling my to-do list now that I have a bit of free time to do so, especially since I’m getting ready to attend an Internal Medicine Clerkship dinner in a couple of hours where I’ll be socializing with other students, faculty and residents working in Internal Medicine. Should be a good time!

Make sure to have a spectacular week!

“You may encounter many defeats, but you must not be defeated. Please remember that your difficulties do not define you. They simply strengthen your ability to overcome.” – Maya Angelou

– Black Man, M.D.

P.S. – I’m trying not to let the ridiculousness currently taking place in the government kill my mood on a daily basis, but it’s getting REALLY hard to helplessly go on about my day while our country is being actively driven to the ground. There’s only so much phone calls can do, especially when your “so-called” representative isn’t even listening to what you have to say.

The Joy of Resilience

It’s been about a week since we started the Renal block, and I believe it’s safe to say that the physiology of the kidneys is complex as hell. I’ve been hammering away at it all week and I still am far from comfortable with how the kidneys work…and we have an exam on the physiology this Friday.

GIPHY Originals reaction annoyed whatever frustrated

However, the more I’ve studied it, the more it’s starting to click for me. Go figure. Contrary to the opinions of many, I’m finding that I actually don’t hate Renal physiology. As a matter of fact, I see it all as a very intricate puzzle that needs to be put together. The many ions and transporters that are involved in concentrating urine and keeping the body in homeostasis can get confusing, but it’s also very intriguing. It’s especially intriguing given the fact that many things that happen in the kidneys relate to other organ systems I’ve learned about already like the heart, brain, liver, GI system, etc. Overall, I’ve been slaving at understanding this material, but I haven’t been necessarily suffering. I just need to get it all together before Friday.

Then I’ll be on Winter Break ya bishhhhh!!!

Nick At Nite dance happy dancing celebration

Gotta stay focused tho. I have five whole days of work until then.

In this block, we’ve all been assigned to meet with a patient on dialysis treatment at a local dialysis center. My assigned day happened to be last Wednesday, so I went ahead and drove up to the dialysis center that I was assigned to that day in order to learn more about life as a dialysis patient. When I got to the unit where all the patients were, I was randomly given someone to talk to, who happened to be a black male who looked to be somewhere in his early 60s or so. We introduced ourselves to each other and began to talk about where we came from. A couple of minutes into the convo, he mentioned that he was a Kappa, which completely took me by surprise. When I told him I was one too, boooyyy did his face light up! He started grinning from ear to ear and then proceeded to spill his whole life story in pure excitement. He spoke with me about how he had been a teacher for 34 years, in which he taught middle and high school students and how strict he was as an educator. He also talked about how strong his marriage has been throughout his time on dialysis, how his college days helped shape him up to be the man he is today, how tough being on dialysis is and how important a positive attitude and unwavering faith is. I’ve been aware of how often patients on dialysis need to go to a center in order to get treatment, but just hearing it come out of the mouth of someone I was talking one-on-one with really made it real. He has to go to a dialysis center three days a week, and the treatment takes about four hours each time. That’s a LOT of time just sitting around being hooked onto a machine. He described to me how he’s met a good number of people from all walks of life in the center and how grateful he is to be at the dialysis center at Wake due to its state-of-the-art care and facility. We (He) ended up talking for almost an hour and a half, which I felt flew by really quickly. He was really grateful to have been able to talk with me, and I felt the same about being able to gain some knowledge of his perspective of life as a dialysis patient. It was a wonderful experience overall, and it helped put a face to the material I’m learning in the Renal block.

Apart from school, I’ve had a pretty eventful weekend which included fellowshipping at two different houses that belonged to physicians, visiting the elementary school that I’m helping to start a mentorship program at, attending the annual medical school holiday party, wrapping and delivering Christmas gifts as Santa to kids afflicted with sickle cell anemia, and going out to Chapel Hill to mingle with some SNMA medical students at Duke and UNC. Now that I just typed that, I’m looking at it and am saying to myself how crazy it is that I actually did all that in the past couple of days. Everything I did this weekend was pretty fun though, especially being able to dress up as Santa Claus and watching the faces of the resilient kids light up as they received their gifts!

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The costume had me looking absolutely ridiculous though 😂😂😂. I didn’t have a white beard, and my pants were extremely short…so my red Nike socks were in plain sight along with my Lebron’s. Someone told me I looked like the Santa from Friday After Next. Lol, I was also being hella extra in my costume and just having a good time with it overall. My friends that were helping pass out gifts to the kids thought it was all so funny. Even the older ladies in charge of the event were in tears as I came out in my highwaters! I think it’s safe to say my friends and I helped bring some joy that morning to everyone in attendance!

Okay, time to crank out this last week of study before winter break.

Y’all have a stellar week!

“Your attitude, not your aptitude, will determine your altitude.” – Zig Ziglar

– Black Man, M.D.

P.S. – I had my last medical ethics class and my last Health Systems & Policy class last Monday! No more long Monday afternoons!!

What A Week

Aiiiiiight…..so this material for Neuroscience Exam #2 is starting to stack up on a youngin’.

We’ve had three weeks of lectures (23 lectures to be exact), and we have another 10 coming up this week. And our test is next Monday. We’re gonna be tested on material that encompasses all 33 lectures.

So with all that said the real question is how did I end up back in Miami this weekend? Lol I can’t seem to stay away from this place…plus my girlfriend and I are doing what we can to make this long-distance thing work. In order to be down here however, I had to grind hella hard last week and make sure I was on top of my studies at all times…which meant locking myself in my apartment and enjoying the company of general anesthesia, traumatic brain injuries, epilepsy, movement disorders, anticonvulsants, yeah you get the idea. So I’m happy to say that I’m all caught up in terms of lecture material, but I’m by no means comfortable for this test yet. ESPECIALLY after the fiasco that was last exam a.k.a. the first test on the brain that I tested my brain on. Ever since then, I’ve been searching for ways to study smarter while at the same time studying harder (Idk how much harder I can study 😩) and have also been making sure to look at the things that the professors told us not to worry about because as you are well aware, we “didn’t have to worry” about drugs for last test….aaaannnd we all know what happened with that. 😐 Gotta keep my guard up. At the end of the day though, if I’m passing then I’m passing. Being able to comfortably apply the material that I’m learning to the USMLE Step 1 exam and to patient encounters in the future is more important to me than getting a high score on these exams in front of me today.

I know I said I locked myself in my apartment this past week to stay caught up, but I also had to leave at times for my mandatory afternoon class sessions. We also had a mandatory lecture one morning where we not only learned from a neurologist about what different movement disorders looked like, but also witnessed what the terrible condition of Huntington’s disease looked like in real-life. One of the neurologist’s patients came in to talk to us about what life was like with the condition and showed us what she could and couldn’t do because of her affliction. Fortunately, she’s still in the early stages of it so she’s able to drive when it’s not raining and she can still do daily activities by herself, but she’s had a very hard life ever since being diagnosed with Huntington’s. Because the disease is genetic, she was forced to witness her mother succumb to it…so sadly, she has the dreadful knowledge of what’s next to come for her. But through it all she’s been trying to maintain a positive attitude about life, which was evident with her interaction with us. She was joking around and making light of her condition, but also strongly desired to be saved from her suffering. Huntington’s is a terrible, terrible disease man.

In my clinical skills class, we’ve been learning how to conduct a neurological exam. It consists of the set of maneuvers your doctor makes you do whenever you go to a checkup. You know, where you follow his/her finger, resist his/her force, walk in a straight line, etc. After practicing the maneuvers with classmates, it’s been confirmed that I don’t have a patellar reflex…😅. That’s where your leg is supposed to kick out after being tapped on the patellar tendon at the knee. Both my class facilitator and another doctor didn’t believe me and banged on my knee endlessly to make it work, but they got nothing. So if any of you out there happen to not have a patellar reflex, don’t worry. We’re in this together. In the same class, we talked about how different it is to talk to older patients as opposed to middle-aged and younger patients. We had a discussion about how ageism is subconsciously reinforced throughout the healthcare setting due to the fact that most of the elderly people we encounter are typically frail or sick in some way, shape or form. Because of that, healthcare professionals and students make the assumption that an elderly patient will need to be accommodated in some shape or form, so they either dread interacting with them or end up treating the elderly patient like a kid that doesn’t understand certain things. Adding to that, the healthcare professional or student will typically consult one of the patient’s family members or friends instead of directly interviewing the elderly patient. All of this leads to a good amount of frustration from a number of elderly patients and thus negatively impacts the doctor-patient relationship between them as a whole. I believe it’s important to not only interact with elderly patients the same way you interact with other patients but also to realize that older patients have lived lives full of experiences up to the point that you met them. Disregarding them as old, frail people that are hard of hearing and are lost in their own world is just wrong. Some elderly people may even be in much better physical and/or mental shape then the younger doctors that treat them. Funny huh?

And last but not least, we discussed the topic of allocating health resources to certain patients that need them in my medical ethics class this past week and the agonizing decision-making that goes into allocating these resources. As a matter of fact, we took it a step further and actually played a game called “Who gets to live?” where my small-group class served as an allocating committee and chose which three out of five patients would receive dialysis. Our choices were based on various factors of the patients’ lives that were given to us one at a time. We were given the patients’ marital status, age and # of children at first and were forced to make a decision on who would receive dialysis and who would die. After that initial decision, we were then slowly exposed to their salary/insured status, occupation, comorbidities and race/ethnicity and we had to make decisions each time we were given a new factor of their life. It was agonizing man. I literally felt like I was allowing people to live while sentencing others to death based on my judgment of their life….which is exactly what I was doing. While playing this “game”, I felt like each of us were creating some kind of “value” or “worth” for the patients we were deciding on, whether it be social worth, economic worth, etc. It had me thinking seriously about how this actually used to occur in real life before funding was passed to allow dialysis for anyone that needed it. I couldn’t imagine having to be on a committee that decided who would perish simply because there weren’t enough resources to go around. When it came to race/ethnicity, my group unanimously agreed that race shouldn’t be a factor in choosing who got to live. But then one of our facilitators brought up the point of “restorative justice”, describing that one could argue that race/ethnicity should be considered when you take into account that some people in certain groups (ex. African-Americans) were simply born into the condition they were in due to social injustices and the environment they grew up in that reflects those said injustices. The foods these people eat and the habits they pick up would be a direct reflection of how they were raised/the environment they grew up in, which in turn could influence their long-term health. She really knows how to keep us thinking man. This session was, without a doubt, the most fun/interactive one we’ve had all year. If each ethics session was structured in a similar way this one was, I feel like it would be a MUCH more popular class.

I sure left you with a good amount to read this time around lol. Definitely made up for last week’s post…

Hope you have an extraordinary week!

Pressure can burst pipes and create diamonds. Only you can decide what it will do to you.

– Black Man, M.D.