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Still here. - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
Still here.
Friday evening.
Grabbing dinner in the hospital cafeteria (free food) I met the Medicine chief.  We talked about my Board scores.  He leaned in and said, seriously, "You could go into ENT, you know, or Derm.  You don't have to stay in family medicine. You'd work less and make more money."  And he meant it, meant what he was saying, believed that my test scores put me above primary care and family medicine.  And nothing, O Best Beloved, could be further from the truth.
I am going to be a family doctor and I am going to heal when I can heal and know when I have reached my limits and I am going to remember that there is no such thing as one human or one profession or one specialty that is better than another.  And I will make a difference, and you cannot sign that paycheck in ink or blood or flesh, O Best Beloved, because I will deposit blood and sweat and tears and draw forth love and hope.

Sunday morning rounds.
Are  you going to practise around here? His girlfriend, from whose thumb I have just squeezed a good half-millilitre of pus and barely scratched the surface, is speaking.  Because you're going to be a wonderful doctor.  And C needs a doctor.
Social Work smiles apologetically, later.  You may just have a way with "difficult patients".  We need people like that.

Morning rounds.  Three patients, quiet, two staying only because it's a weekend and we can't transfer patients out or get Cardiolyte tests.  And C, leg looking better, now on Percocet and Dilaudid and his pain is under control for now, the surgeons are good like that.  Nykki, he greets me, awake at 8 in the morning on a Sunday, where've you been?
I took a day off.  I am unapologetic about it.  They laugh.  One of my good friends came home from Iraq.  I had to see him.  And they tell me how wonderful that must have been, and I laugh, and I agree.  Two of the folk who should be called deadbeats and a young medical student, in complete agreement.

It was more than wonderful.  There is a little piece of my heart that has spent the last more-than-a-year dying every time I hear news of violence in Iraq, in Baghdad, in the places where I know he has been.  There is a piece of my heart that has been dying for over a year, and yesterday one look at his smile and the light in his eyes and it was healed. O Best Beloved, I know my butterfly is safe.
And I love him and he promised he would come back to me and I know that we make promises and life decides we will not keep them, and I have been so terrified, in that little corner of my heart, because if he died, O Best Beloved, if he were captured or wounded or killed I would not be told unless I chanced to come across his name in a newspaper article or on a listing of the lost, I would not know.
But I saw him yesterday, and war has not changed him.  And I love you, butterfly, and I always will.

now feeling:: sleepy sleepy

16 whispers echo . o O ( ... ) O o . whisper a word
erichowens From: erichowens Date: August 9th, 2004 03:15 am (UTC) (etched in stone)
At least promise me you'll do your residency at Mass Gen or some really awesome university center!

Hey... where do you go to school at?
ayradyss From: ayradyss Date: August 9th, 2004 09:52 am (UTC) (etched in stone)
Pish, they have awful rural training.

I'm at the only medical school in Indiana :)
astridsdream From: astridsdream Date: August 9th, 2004 03:35 am (UTC) (etched in stone)
I found you from metaquotes You have a beautiful writing style. I enjoy it quite a bit. Best of luck on your path to healing, and making a difference.
ayradyss From: ayradyss Date: August 9th, 2004 09:51 am (UTC) (etched in stone)
Thank you.
I've been sitting here watching your icon go by. I love it!
Stick around, if you like.
astridsdream From: astridsdream Date: August 13th, 2004 07:20 am (UTC) (etched in stone)
I plan to. And I'm glad you like my icon. I didn't make it, but I obtained proper permission before ganking it. :-)
magwana From: magwana Date: August 9th, 2004 03:54 am (UTC) (etched in stone)
Popped on over through metaquotes and just wanted to say the Iraq thing? Almost made me cry. The love of my life is over there right now, going on month six. You summed it up perfectly.
ayradyss From: ayradyss Date: August 9th, 2004 09:55 am (UTC) (etched in stone)
You have my thoughts and my prayers...someday it'll be over, I hope.
From: altoidsaddict Date: August 9th, 2004 04:18 am (UTC) (etched in stone)
Followed you from Metaquotes...

This is so weird, because I'm originally from Ft. Wayne and my family still lives there. (My mom, harpie84, used to work at St. Joe's, and I was born there.) We're about the same age. If you're comfortable with answering, where did you go to elementary school? Are you at St. Joe's?
ayradyss From: ayradyss Date: August 9th, 2004 09:53 am (UTC) (etched in stone)
That is -so- weird...Hi!

I'm not in FW this month, though I'll be back there in a few months.

Went to Forest Park Elementary for kindergarten and first grade, then I went to Weisser/Whitney from second through fifth.
From: altoidsaddict Date: August 9th, 2004 05:12 pm (UTC) (etched in stone)
Ah. I went to Shambaugh. You had a class picture icon that looked familiar, but then again I looked like Zelda Rubinstein in kindergarten, so these things can be deceiving.
levi From: levi Date: August 9th, 2004 12:52 pm (UTC) (etched in stone)
I saw you in Metaquotes as well. I friended you, I find your writing quite interesting. Good luck with your training.
ayradyss From: ayradyss Date: August 9th, 2004 10:50 pm (UTC) (etched in stone)
Welcome :) Make yourself at home.
turnberryknkn From: turnberryknkn Date: August 9th, 2004 01:17 pm (UTC) (etched in stone)
And he meant it, meant what he was saying, believed that my test scores put me above primary care and family medicine.

Maybe he meant that; or maybe instead he was worried about the price he feared you would have to pay to choose FP. As an activist in state and national Family Practice professional circles, I know you're as intimately familiar with the same national trends that us others involved in medical activism know. I'm certain the challenges that your House discusses are the same that come up in our state and national Houses. For a lot of people those challenges and prices, the uncertainties and the difficulties, are too much to ask of themselves --or too much to ask of their spouses. Maybe that's where he was coming from.

The Lord give you strength, ayradyss, to follow where He leads. Luck.

ayradyss From: ayradyss Date: August 9th, 2004 10:36 pm (UTC) (etched in stone)
That thought gives me hope, bizarrely. The idea that anyone could be discouraging someone from a so-desperately-needed field gives me chills.

Supposedly, my butterfly is coming back to be in Kansas for good in a few months, and not back to the sandbox. But I've heard that before.
turnberryknkn From: turnberryknkn Date: August 10th, 2004 08:32 am (UTC) (etched in stone)
That thought gives me hope, bizarrely. The idea that anyone could be discouraging someone from a so-desperately-needed field gives me chills.

That's actually an interesting point --my friend resonance42 served as the medical student member of the Council on Graduate Medical Education (COGME), the HHS committee appointed by Congress to figure out how many doctors we ought to train and what kinds (via Congress' authority to fund residencies through support of Graduate Medical Education (GME). They constantly study future trends and future needs, and give advice to Congress of how many doctors they think we'll need and of what kinds every few years. Their latest report is rather thought-provoking, and I really need to get around to reading it to figure out what they were thinking.

One of the major things they've changed was revoking the long-standing recommendation that 50% of all doctors become generalists, Instead, now they say that it should be "what the market will bear". In other words, after more than a decade or two of pushing the need for more generalists, like the one you hope to become, all of a sudden they're reversing course and saying we don't need to encourage doctors to become generalists anymore.

Trends from my service on the NRMP clearly show that fewer and fewer medical students are choosing to become generalists. Fewer students are choosing "primary care" --and considering they lump inPediatrics and Internal Med, where many of those people go on, like I hope to, to specialties and not general care at all-- even fewer of those are actually going generalist. In the midst of that, COGME comes out and says that's okay.

Why the sudden change? For years, the mantra was "We need more generalist doctors. We need more generalist doctors." All of a sudden, that mantra has been abandoned, and now it's "let people decide for themselves." Why? I'm hoping to find out in the report. I have my suspicions; but as you can imagine, that's a pretty big sea change in common consensus, and COGME must have had a very good reason. It's not public yet, but will be published as COGME's 16th report, and I'll be looking at it with great interest, as I imagine everyone involved in health policy will...

turnberryknkn From: turnberryknkn Date: August 9th, 2004 01:19 pm (UTC) (etched in stone)
And I'm very glad that your friend is home safely from Iraq. I hope he gets at least a little time here before they send him back.
16 whispers echo . o O ( ... ) O o . whisper a word