Mile 5998: Fritos & Coffee

Above: Roadside stands like these are available all thoughout Georgia. I get my load of honey-roasted pecans each time I pass here.

EVEN WHEN ITS ONLY FIFTY-DEGREES OUTSIDE,
MY WINDOWS ARE DOWN.

Every minute seems to blur into another, as the weeks pass by faster and faster. We're already in our third week (about to start our fourth), and it was only yesterday that I remember we were getting into the realm of things. The one thing I like about the internal medicine (IM) rotation I currently am at is that it satisfies the standards that I had set at Mile Zero on my journey very well. Doing this rotation actually makes me rather excited about IM. Our work on the floors has the quality of intensity, something I have been desiring for some time.

The following is a normal itinerary for me on a weekday.

6:00 AM - I leave home early. In Chicago, traffic accumulates with every minute lost in the morning, so this is the absolute goal for departure. Although I don't have to be at the hospital until 7:30, I'd rather do some reading in the resident's lounge than waste more time stuck in traffic. I usually get to the hospital about 6:30 AM, and when I get there, I'm loading up patient data from the computers and visiting the patients I'm following before my intern arrives.

7:30 AM - My intern arrives. The first thing he does is make coffee at the maker in the resident's lounge. On the table in front of the maker is an aluminum tray with a few juice cups and bags of snacks that the hospital delivers for the on-call team for the night. He usually isn't able to grab breakfast in the morning, so he grabs a bag of chips and opens it up for breakfast. Not leaving my resident alone with the morning ritual (even though I already had my Frosted Wheat Puffs and Ovaltine earlier this morning), I usually pull up a bag of Fritos (or Cheetos, as a viable alternate) and get a cup of coffee.

This is a superb example of a resident-recommended diet.

8:00 AM - I round with my intern, releasing the data from the labs I pull in the morning and the data I pulled on the history of the patients I'm following. These rounds are walking-intensive (involving going up and down several floors and down several wings) and can slow down whenever patient demands in the ICU or on the floor come up. I usually find myself walking around in "shadow mode" sometimes, leading myself to walk exactly in the footsteps of my intern (which could have me backing up into walls or other health care staff).

10:00 AM or thereabout - On some days, we have what they call "teaching rounds," with a senior attending physician along with our group of interns and students (about 8 in total), which involves a component of lectures, bedside patient presentations, and resident/student presentations. This is one of the lecture components provided. I believe that lectures are good to recap what's going on in the hospital. Getting lost in the demands that the rotation/residency provides is easy; we can't forget we have to learn every step of the way.

12:00 PM - We have another didactic lecture over lunch, on a hot health topic. This usually takes place in the lecture hall and makes our day more efficient, by giving us a good time to combine eating while our learning. Time management and efficiency is critical to operating and being successful in residency.

1:00 PM - I sit down and write progress notes on patients I'm following. The afternoon is usually left to admitting new patients, taking their histories/doing physical examinations, running actions/plans past my intern, and reading up on their cases. Medical education is very reliant on real cases, and that's a good thing. It's not the same reading about a topic in a book. Each medical case encompasses critical thinking skills and problem solving. Memorization won't get a physician anywhere.

5:00 PM - By this time I'm ready to leave the hospital if I did everything right. Sometimes there are exceptions, either late (or multiple) admissions, falling behind on notes, and the occasional assisting the intern, so he can get stuff done earlier. But in the end, I don't see the way I work with my intern as senior-junior, but in many ways it ends up as a team. I think that's just really cool, because that team combo has enhanced my learning experiences in medicine.

6:00 PM - After some time in traffic, I stop by one of the nearby Caribou Coffees or Starbucks and pick up a good iced coffee that powers me for the rest of the day. That night, I read up on primary literature for my cases and lectures, and I finally get to bed by about 11:00 PM.

And with that (and some occasional changes day-by-day), it's simply rinse and repeat for the next day at work. Weekends are a tad shorter (ending by 3:30 PM), but the same routine above follows. I'll be shooting out more specifics on what goes on during my internal medicine rotation, so stay tuned.

The Iced Coffee Property

Above: A motivational graphic provided courtesy, Dr. James F. Catroppo, Ross University.

Becoming a doctor requires a lot of sacrifices... time... effort... but the most significant sacrifice of all was brought up by a late New York Times article...

"... A TEMPORARY LOSS
OF THE SENSE OF SELF."

We'll get to that in a second.

Saturday. I need to take breaks. Some of the latest research has said that taking breaks is actually quintessential to remembering and organizing material (the brain does some subconscious file-sorting thing). Or, sometimes I could just be using a break to push back studying the next 70 psych drugs I need to memorize. So, I have one of three choices:

1) Stand up, grab some random book on the shelf that looks interesting, and read it.
2) Sit at my computer and Facebook and Gchat away.
3) Stare at a nearby window and start daydreaming about being outside.

On Saturday Night, I was at one of my local Starbucks, so #1 really isn't an option, and #3 was already next to me (the Starbucks next to me has some amazingly giganormous windows), so #2 was up my alley. After strumming along, I notice that my friend Cathy posted up an article from the New York Times, with the following title: Taking Time for the Self on the Path to Becoming a Doctor.

I started to read, getting the main gist of the article about the sacrifice and how us medical students embrace that sacrifice to have this sense of disconnect between our professional and our personal lives. Let's back it up a step, and put it in less technical terms. The article acknowledges through a John Hopkins University School of Medicine research study that although medicine is a time and resource demanding job, finding that appropriate time to spend with family, enjoying hobbies, and enjoying time with self, will lead to less burnout in the future.

(The article put it dramatically with the sacrifice as stated above... LOSING MYSELF? I CAN'T LOSE MYSELF!)

I learned that disconnect between was a horrible thing back in Undergrad. My friend Neal taught me that I need to be in touch with my personal self, by doing a lot of the things the Johns Hopkins' study provided and by spending that quality time with me. However, through the Illinois Leadership Center, I also learned that introducing personality and embracing a job as a "hobby" of one's own allows for a gratifying crossover between the two seemingly separate worlds. I think that both are critical for maintaining my morale.

When I was done, I looked up and there was a perfect example of how to accomplish some of this... right in front of me.

Sunday Night. I go to many coffeehouses in my area. There's some with free wi-fi, some with comfy leather chairs, others that serve time-saving lunch and dinner, and even some with all of the above. Like I said before, I can't study at home. However, this one Starbucks near my house has one characteristic that all the other coffeehouses, even other Starbucks, didn't have.

I'm observing one of the baristas, Adam, and how he interacts daily with customers, such as myself:

"Hey, how you doing today?"
"Great! How are you doing?"
"Doing well. What can I get you started with today?"
[Insert customized Starbucks order here]
"What are you guys up to tonight?"

And through this, he started a conversation learning a few things about what people get to do on a staurday night, and all with a genuine smile that says, I'm enjoying my job. I've seen him have a great dialogue on race and the suburbs with several people who just walked in, and even talk about computers with a guy who set up his own office in the corner of the shop. And on Sunday night, he came and talked to me about medical school. As I kept watching, I felt that same aura of the rewards he was reaping through simply talking; it was that enjoyment of getting to know people.

Don't get me wrong though, he was still getting his job done (and well, may I say), cleaning up floors at appropriate intervals, taking customers up as they were walking in the door (even mid-conversation), and even putting bags of coffee on the shelf appropriately. His interactions with his co-workers were also noteworthy (with Adam and Chaz at the counter, it can get quite entertaining).

You know, he could easly be a Barista who:

1) Did his job, day in and day out, not caring about the interactions with his customer. (Burnout in the forseeable future, no?)
2) Talked and talked, but never did anything for his job. (Just a talker, not a doer.)

But he was neither. He did something what many doctors can't do (combine doing their job while enjoying learning from their customers)... in a coffeeshop. And thus, with this, I name the following The Iced Coffee Property.*

"To live every day of my life with medicine, a day I don't learn just more about the science itself, but to also enjoy learning from the people who I take care of everyday, not just about medicine, but about the fulfilling lives they live. And to encourage them to live their life to their fullest, through encouragement and through allowing my personality to penetrate the job."

And there, folks, is my hobby, my way of envisioning crossing my personal and my professional life... a way to make sure that I live my love for medicine, while satisfying my thirst for always learning something new. For those of you who struggle with the idea that medicine is a burnout field, go grab some iced coffee. Then you'll see.

Source: The New York Times.

*Named after my regular item on the menu: A grande iced coffee with nonfat milk, and sugar-free vanilla sweetner. I have to watch my calories you know.