Tag Archives: writing

Goodbye to Intern Year

I looked down at my iPhone as it marked mile 6…I know this is where magic happens. It’s when my legs stop hurting, when my lungs stop burning, and I am lost in the soft churn of the sunrise and the sound of the breeze.

I took up distance running during the busiest year of my residency in internal medicine. Something inside me signed up for marathons.

Maybe that something was anger – the day I heard my patient yelling at me after a 16 hour work day “I hate this hospital, and I deserve all your time!” I sat inside the facility room and cried, my dad was hospitalized and I didn’t have time to see him and just be a daughter. My dad deserves all my time.

Maybe it’s exhaustion – Obama care had brought so so many patients who had not seen a doctor in 20yrs, and in my 15min appointment, they have a list of 10 problems, and you just feel so so small and overwhelmed.

Maybe it’s the darkness – for a good 2 months of this past winter, I didn’t see the sun. My work started before the sunrise, and rolled well into the sunset. Living in darkness was isolating.

Maybe it’s the other things – that boy you loved that broke your heart but you walked bravely into another 14 hour work day, and all the friends you lost cause there’s no way they can understand why you can’t attend their wedding, their birthdays, and their worst days.

Maybe it’s grief – that day when you watch a daughter show her dad their childhood videos as he slips away. That day when a wife crawl into bed to hold her husband as he took his last breath. Or the family that finally overcame their resentment of each other, and unite at their parent’s death bed.

Maybe more times than not it’s pure joy – the day you watch someone wake up from a horrific illness, and know they’ll be alright. The day your patient made up a medical problem so they can have an appointment just to say you’re the best doctor they’ve ever had. And every single time you watch your patients leave the hospital safe and sound.

Back in high school, I ran for the races. Now I run for all the things in my life that I win and those that I can not. I run for those magical moments in time when everything feels wonderful and nothing hurts. At mile 6, I know that this run…it’s for me.

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.

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.