Tag Archives: love

What Medical School Forgot to Teach Me

My adorable grandparents, who raised me for almost a decade of my life <3

My adorable grandparents, who raised me for almost a decade of my life ❤

My 89 yr old grandpa, with a history of type 2 diabetes, very well controlled, spiked a blood sugar in the 500s (normal is in the 100s) on a Monday in February. He was a little more fatigued than usual, and my mom called me for advice. I was concerned about any infections. His primary care doctor ordered 2 doses of insulin that day.

Day 2, he appeared sicker and sugars remained high. I talked to his doctor’s office asking  very nicely for an infectious workup which includes blood work and cultures, chest xray, and urine studies. The nurse on the phone sounded younger than my sister, and did not know what hyperglycemia meant. The doctor ordered only one part of the labs that evening – a blood culture, and told his nursing home there was no need for a chest xray to assess for pneumonia.

Day 3, the results have returned and the nursing home said they were unable to reach the doctor.

Day 4 AM, my grandpa was in septic shock from aspiration pneumonia, and was admitted to the ICU. He never fully regained consciousness.

My mom called me, and I drove home to LA. The doctor’s excuse for 4 days of delay in care was “he’s old…I don’t want to be aggressive.” He offered no apologies. For the first time in my life, I cried because I was furious. I kept thinking of what my neurosurgery chief once told me “one day, you will know that your job as a good doctor is to protect your patients against the morons in the hospital” and his other advice “the worst prognosis is a nice patient with a nice family.”

I spent my time in the ICU since Valentine’s day. He became vent dependent meaning he needed a machine to breathe, he got tuberculosis (when he tested negative all his life), he got a feeding tube and then had a massive stomach bleed, and finally DIC, a condition indicating severe illness. He also assumed decerebrate posturing, indicating possible stroke, a likely complication of his severe shock. In between all these episodes were his doctors telling us to take him off of life support, a conversation they never fail to deliver when they somehow forget to discuss any other test results or procedures conducted.

My grandpa is on comfort care now, meaning there is no more treatments or blood draws. He gets a morphine drip and some IV. He is dying, paralyzed, and semi-conscious due to gross medical negligence. 

I thought of how much medical school failed to prepare and discuss with me: 

-How our treatment can hurt as much as it can save a life.

-How machines and medications and procedures can prolong not the living, but the dying process. 

-How the consequences of our inaction and negligence, ignorance and fatigue is real. 

-How not to sue another physician, a doctor who’s negligent at the end of his career at 65yrs old, who makes a very humble living as a primary care doctor in a country in gross shortage of primary care physicians. 

-How to act as a family consult with medical knowledge, and objectively decide to terminate treatment for someone I love deeply. 

-How to deal with my mistrust and anger toward members of healthcare when I myself am a physician. 

-How to advocate firmly for the correct course of care when it’s in disagreement with another physician. 

-How important it is to encourage patients and their families to be vocal, and strong advocates irregardless of how stupid it sounds. 

-How important it is for physicians to apologize in times of error, not because of policy or fear of lawsuits, but because the patient and their family deserves it. 

In 2 months, I will become a full time internal medicine doctor. I thought of all the families who have yet to come under my care, and all the things that can go wrong. I didn’t know…4 years ago…when I first began medical school, what tremendous responsibilities this lifetime was going to entail.

Advertisements

On Finding That Little Voice (for Ms.Lynne Aidikoff)

I came to America at age 9 not speaking a word of English. Liberal art classes were obviously my least favorite. All that the school system cared about was reading a passage and answering some stupid questions about main characters and plot. Needless to say, I didn’t thrive in school.

Then came the 6th grade, junior high. Ms.Lynne Aidikoff was my writing/history teacher. Somehow in all my grammatically incorrect assignments, she saw something worth reading. My dad had a meeting with her during the school year, she told him I can write (who knew?!). I received my first A in English since coming to America that year.

So I kept on writing, and reading so I can keep on writing. I wrote words that she loved which delivered my heart and my opinions. The type that was shamelessly honest and vulnerable. I wrote my way into UCLA, through upper division romantic lit classes in college, and then to medical school.

This year, during my residency interview, the program director remarked “I read 1000 essays this year, yours is the only one I remember.” I can’t help but think of Ms.Aidikoff and how her encouragements brought me here.

We’ve been in contact via facebook over the past few years. She left little comments and messages filled with proudness, joy, and always encouragement. I found out today that Ms. Aidikoff passed away recently. I wish I told her what an amazing adventure in literature, writing, and life she had sent me on. What unbelievable empowerment, release, and comfort writing has brought me in the darkest times of my life.

Looking back, I only realize now that she had given me the single greatest gift that a student can acquire in education, a voice.

My Baby Sis

My parents have shaped so much of who I am today. They’ve given me a safe home, and (like all awesome, competitive, A-type personality Asian parents) bought me some hobbies in art and music and dance. They’ve taught me the importance of education, to seize the best opportunities, and to take risks. Everyday, I become more deeply grateful that I come from a beautiful home. But, if there was one thing that I am the most grateful for, it’s the fact that my lovely parents gave me siblings.

Up until age 9, I seriously thought the world revolved around me. I had the full love and attention of everyone in the family..24/7. I would shed a tear, and the next moment, I would get whatever I screamed for. My grandpa once cooked 3 separate dishes for me…cause I wasn’t willing to eat any of them. I was…spoiled (ya think?!)

Then came my sister, a rotund 9lbs of boneless chub. My parents and grandparents busied themselves with the everyday activities of a newborn. When she cried, I got in trouble. When she learned to walk, she started keeping my stuff. When there was something yummy, she always got the last piece. And yet… I came to love her so so…so so much.

Because in the midst of the annoying crying, nagging, intrusion of privacy, unwanted touching and attention she brought to my life, my sister taught me to love more than anyone else in this world. She shaped the way I loved at the time in my life where everyday I was molding my heart and mind to the person I would become.

16129_10151582420979377_287619543_n

From the sharing of things I didn’t want to share, she taught me about generosity and how I can give without expectations of anything in return. From those stubborn fights, she showed me that apologies aren’t here to prove who’s right, but to show us that relationships and forgiveness matter more than what we want to agree on. In exerting her carefree, social butterfly, “whatever” – personality, she taught me to accept and appreciate people simply for who they are despite how different our dreams, priorities, and lifestyle may be. From those hours of parental attention I did not receive, I learned to be introspective and to rely on myself to learn from my mistakes. Trying to live up to the unrealistic and incomprehensible amount of admiration she carried for me, I hold myself to a higher standard in everything that I do. This fall, when my “baby” sister went to college, and started partying, I learned what it feels like to wear my heart outside of my body.

Lizzy taught me so much about love, the type of love that I always hoped to give to the people I care about. When I see all the wonderful things that my parents have given me, I am most thankful for my darling baby sis. Because whether she knows it or not, she taught me how to deliver the single greatest experience of our human existence…unselfish love.

For Mrs.S

 

I appreciate your candor and thoughtfulness…and lastly, I hope you’ll find a life of happiness.” 

Mrs.S passed away last night, and her family handed me a small white card with cherry blossoms (my absolute favorite), and those were her last words to me.

Mrs.S came in 2wks ago screaming in pain from metastatic ovarian cancer that she fought brilliantly for 10 years of her life, beating all the odds and statistics we love to throw at our patients. Her CT scan showed that more concerning than her shoulder pain, was her entire right chest was crushed by a gigantic tumor mass. The pulmonary doctor chuckled to me “she’s all yours, that’s the worst lung I’ve ever seen.” Mrs.S had almost no lung left. She went to Mexico to receive dendritic cell treatment, which did not work. It was clear on that night, she did not have much time on her side.

Over the next 2 weeks of my internal medicine rotation, I sat with her. There was no cure, there was no particular medical miracle I can offer her except pain control. She began to tell me the stories of her life. she met her husband at age 26, when he was 19. They spent a lifetime touring together as musicians, and they have no children. Some winters in Michigan, they would spend months indoors next to the fire together because it was painfully cold outside. They told stories and read novels to each other to pass time. They spent their 25th anniversary in the hospital over a liquid diet. She spoils her niece like crazy. She hated Spy Kids movies…we laughed over all these details of her life.

Then one day, sitting in the green armchair of the hospital room, she got serious. She looked at me and said she was afraid, not of death, but of leaving the love of her life all alone.

I looked at this woman who is more than a lifetime ahead of me in experience and age, standing less than a week from dying, being afraid for the pain this would cause her husband. As she spoke these words, her husband, working intently on his computer at the other corner of the room, came over. He told her that he had a lifetime of “happiness and love”, and he’ll be okay.

There are defining moments of our lives where everything we do just makes sense. As I watched a loving husband comfort the fears of his dying wife, I fell in love with internal medicine. There was no where else in the world I would rather be, nothing else I would rather do despite the months of indecision over my specialty options for residency applications this year.

And dear Mrs.S,

Your husband is busy driving across the country to take that trans-America trip you wished for. That’s how he chose that morning to celebrate your life.

As for me…I too, hope I’ll find a lifetime of happiness.

An Angel in the Clouds…

622272_10101856948512116_612857538_o

I enjoyed a beautiful afternoon at the beach yesterday. Although my life is infinitely blessed, I still felt my share of inadequacies and insecurities lately. As I watched the sunset over the horizon, I felt embraced by the love of the infinite designer. I took a picture of the sunset, it wasn’t until afterwards my friends and I found the angel in the sun, complete with its halo. I realized that the reminders of this loving God is all around us, sometimes all it takes is a moment of reflection outside of our own circumstances to see the grandiosity and beauty of His creations.