Still, long days or not, easy or not, I love my job.
A number of things plague my mind tonight.
One of my patients informed me today that she was dying.
Not knowing how to reply, I did the only thing I do know. I was honest.
I told her, "We're all dying. It's just a matter of how and when."
And then I said, "No matter what happens though, my job is to take care of you and make sure that your time here, however long, is as comfortable as it can be."
Thankfully, she smiled and replied, "Good answer."
~~~
One of my Palliative Care patients was in dire straits yesterday, but following our treatment regime, she has improved markedly, and I've been very, very happy with this.
However, despite having COPD and a chest infection, she still continues to smoke.
Rightly or wrongly, it feels like we are fighting to give her a better quality of life (however long she's got), and she's fighting against all our efforts.
It's against my nature to give up on my patients. Palliative Care or not, she's still alive now, and I firmly believe that her life CAN be better. If her lung function improves, her appetite may as well, and really, that's the only thing that's holding her back.
She has not got a terminal illness as far as her records show (no more than the rest of us, anyway - Life is a terminal illness, after all), she's just got really crappy lungs. But that's not killing her - the smoking is. Slowly, but surely, and most certainly torturously.
I know I'm new and inexperienced, but I just think that if she were managed better, she COULD come out of this, despite her many near-death episodes.
Unfortunately, my opinion in this case means nothing because as things stand, I have more faith in her potential recovery than she does, but she's the one calling the shots.
~~~
A young man showed up today after having his first episode of generalised tonic clonic seizure.
He is my first patient of this variety, and I couldn't help but recall the words of my Neurology mentor.
"Before referring to Neurology, ALWAYS check the tongue."
And I did. And sure enough, he had bite marks on his tongue; an observation I included in his notes as any conscientious medical student would.
Naturally, I did feel proud when the admitting physician said that my notes were "perfect".
In medicine, it's those kinds of moments that get you through the day.
We spend so much time swimming against the tide, fighting the odds, and being thrown around by waves of uncertainty and by so many factors beyond our control that we will pretty much take any victory that comes our way.
Even if it comes in the form of perfected paperwork.
I have now come to the end of my day, and I'm exhausted.
Every patient I see is unique and important and I care for them in different ways.
In a way, they've all had a piece of me today. And today, I'm feeling it.
The stretch, the weight, the tension...
Regardless, I wouldn't give up my job for anything.
It's what I'm here for. It's my role.
It's my purpose.
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