Yet another pearl from the humble doctor! Much respect from eastern Europe. I can almost hear the song playing in the back..."My momma told me there'll be days like this".
When I think about my expected date of retirement, I'm often reminded that I tell my residents that we have the greatest "Job" in the world. If garbage collecting paid superbly and doctoring was just getting by, which would you choose. What will I do next??
I love your Friday reflections: they're honest, thoughtful, and insightful.
But I'd be interested to hear about your day after you've been up all night fielding phone calls, only one of which was really an emergency and that one kept you from falling asleep after 4AM worrying if you made the right the decision.
Then you got to the office to find the staff double booked you for two new patients, one of whom has a chronically leaking cystotsomy and requires 2 staff to get her into an exam room, and the other is aphasic and arrives with 4 family members hoping you can sort out a recent 2 month hospitalization elsewhere.
Then Dr. Smith calls you up and asks if you can see his wife today, she's been having atypical chest pain for 2 weeks. (Your first patient showed up 20 minutes late, so you've been running late all day.)
Finally, your daughter has a dance recital at 5, and you promised everyone you wouldn't miss it this time.
I suspect you've had more of these than I, and also suspect you handled them better than I.
Thank you! You make my mind wax nostalgic on my years in the Air Force and as a Paramedic, and my 20 years of teaching human physiology and my ultimate decision to follow my mind and heart into Christian pastoral ministry….now a physician of the soul, I give thanks as I read your inspirational take on a “day in the life” of a physician of the body. Well done!
I wish all medical people would read this. What a wonderful essay on what its all about. As a Pharmacist that believed in interacting with patients. I am retired now but I was in a chain where I had to talk to 200 to 300 a day (12 hr shift). Now the Pharmacist is so busy that you have to ask the tech if you can talk to the pharmacist if you have a question. Based on my experience before I retired I did a count and over 90 % of the patients signed off counseling. Too bad.
I love this so so much! Thank you for sharing these peeks into your day and your professional and personal insights and experiences, Dr. Cifu! I feel so blessed to be a part of this substack! Have a blessed Friday and a wonderful weekend, too!
Very well written. Reminds me of a quote from a doctor that used to be on the Society of General Internal Medicine (SGIM) website: " If you love what you're doing, you will never work a day in your life". Too often one focuses only on the negatives: 12 admissions last night, angry family of one of the patients, intern on service acting up, UM is bugging you to discharge a patient you feel still needs care, etc. etc. Better to focus on the wonder of medicine and the enrichment our patients give us.
The other thing I would add to this great story as a patient came in wearing a hat that said World War 11. 93 year-old, I knew him as a man with a circumflex lesion that often caused bradycardia. I stopped and asked about the hat and sat there with my mouth open as he explained he was there +3.. He was in the 29th infantry and they went 25-50 YARDS a day fighting to get to Berlin. His unit made it . Once home they were kept in a camp in the states isolated for 90 days until their PTSD settle down to make them safe to integrate into the population.. I didn't know about that did you?
My first day has the cardiologist not as an interior, not as a resident, not as a fellow, but as a cardiologist, I was in charge of the CCU team in a very large military medical Center. I card flipped with the resident who is now a rheumatologist in Alabama and the other is an internist in Austin. And then went down to our offices, and I flipped with the chief of the department!! This is after how many years of training? Most important thing I learned is to have humility. Your patients lives depends on it.
A decade ago I read "Of Leaves, Trees and Primary Care" ( by Dr Cifu for those who have not read it--you must!!!!!!) (Ann IM 2014160806-plrase indulge yourselves)- I have used it ever since as a touch stone for discussing with students' other trainees how mindfulness/self reflection of the moment affects both are care and our caring.... I just put a copy on my daughter's desk who has never read it
Timing, as Dr. Nicholson described. On the day before Thanksgiving when my daughter and I were cooking, we took a break and sat in the family room. I had recently moved things around and decorated. She looked at a new set of shelves with my nursing caps on top. I had washed and starched them and then reapplied my stripes. The one on the left is my senior cap from my last year in nursing school and the one on the right is my graduation cap. I also have my original license there. She said that they looked nice in this room. I smiled, ear to ear, and told her other than my family - deceased husband, 2 grown children, 3 grandchildren, being a nurse had been my goal my entire young life and I am very, very proud to have this career. There would be no other for me. I'm proud of myself for graduating nursing school, passing my boards the first time, and having that white cap with the black stripe.
Thank you for sharing the sunlight in a sometimes dreary period. I've never regretted my career choice but there have been times where the going has been rough. After the dust settled from those times I realized it made me a better nurse.
Yet another pearl from the humble doctor! Much respect from eastern Europe. I can almost hear the song playing in the back..."My momma told me there'll be days like this".
Wonderful to read. Wish I could see you as a patient!
How do we select for medical students who appreciate these feelings.
When I think about my expected date of retirement, I'm often reminded that I tell my residents that we have the greatest "Job" in the world. If garbage collecting paid superbly and doctoring was just getting by, which would you choose. What will I do next??
I love your Friday reflections: they're honest, thoughtful, and insightful.
But I'd be interested to hear about your day after you've been up all night fielding phone calls, only one of which was really an emergency and that one kept you from falling asleep after 4AM worrying if you made the right the decision.
Then you got to the office to find the staff double booked you for two new patients, one of whom has a chronically leaking cystotsomy and requires 2 staff to get her into an exam room, and the other is aphasic and arrives with 4 family members hoping you can sort out a recent 2 month hospitalization elsewhere.
Then Dr. Smith calls you up and asks if you can see his wife today, she's been having atypical chest pain for 2 weeks. (Your first patient showed up 20 minutes late, so you've been running late all day.)
Finally, your daughter has a dance recital at 5, and you promised everyone you wouldn't miss it this time.
I suspect you've had more of these than I, and also suspect you handled them better than I.
Love it. Thanks for the prompt for a future post.
Thank you! You make my mind wax nostalgic on my years in the Air Force and as a Paramedic, and my 20 years of teaching human physiology and my ultimate decision to follow my mind and heart into Christian pastoral ministry….now a physician of the soul, I give thanks as I read your inspirational take on a “day in the life” of a physician of the body. Well done!
🙏
I wish all medical people would read this. What a wonderful essay on what its all about. As a Pharmacist that believed in interacting with patients. I am retired now but I was in a chain where I had to talk to 200 to 300 a day (12 hr shift). Now the Pharmacist is so busy that you have to ask the tech if you can talk to the pharmacist if you have a question. Based on my experience before I retired I did a count and over 90 % of the patients signed off counseling. Too bad.
Of all your posts I love this one the best as you walk us through your dedication and emotional involvement. As a retired nurse I can relate .
As another retired RN, I also agree and can relate.
I love this so so much! Thank you for sharing these peeks into your day and your professional and personal insights and experiences, Dr. Cifu! I feel so blessed to be a part of this substack! Have a blessed Friday and a wonderful weekend, too!
Thank you. Best to you too.
Sounds like a great day to me!
Very well written. Reminds me of a quote from a doctor that used to be on the Society of General Internal Medicine (SGIM) website: " If you love what you're doing, you will never work a day in your life". Too often one focuses only on the negatives: 12 admissions last night, angry family of one of the patients, intern on service acting up, UM is bugging you to discharge a patient you feel still needs care, etc. etc. Better to focus on the wonder of medicine and the enrichment our patients give us.
Amen.
The other thing I would add to this great story as a patient came in wearing a hat that said World War 11. 93 year-old, I knew him as a man with a circumflex lesion that often caused bradycardia. I stopped and asked about the hat and sat there with my mouth open as he explained he was there +3.. He was in the 29th infantry and they went 25-50 YARDS a day fighting to get to Berlin. His unit made it . Once home they were kept in a camp in the states isolated for 90 days until their PTSD settle down to make them safe to integrate into the population.. I didn't know about that did you?
Wow. What a story.
Dictated sorry for typos
My first day has the cardiologist not as an interior, not as a resident, not as a fellow, but as a cardiologist, I was in charge of the CCU team in a very large military medical Center. I card flipped with the resident who is now a rheumatologist in Alabama and the other is an internist in Austin. And then went down to our offices, and I flipped with the chief of the department!! This is after how many years of training? Most important thing I learned is to have humility. Your patients lives depends on it.
Hard to lose humility in this job, right?
Bravissimo!
Adam - sounds like a Forest Day !?
A decade ago I read "Of Leaves, Trees and Primary Care" ( by Dr Cifu for those who have not read it--you must!!!!!!) (Ann IM 2014160806-plrase indulge yourselves)- I have used it ever since as a touch stone for discussing with students' other trainees how mindfulness/self reflection of the moment affects both are care and our caring.... I just put a copy on my daughter's desk who has never read it
Well, this just made my day. Thanks so much. Here’s the “Sensible Medicine version” of the article. https://www.sensible-med.com/p/friday-reflection-4-days-of-leaves
Timing, as Dr. Nicholson described. On the day before Thanksgiving when my daughter and I were cooking, we took a break and sat in the family room. I had recently moved things around and decorated. She looked at a new set of shelves with my nursing caps on top. I had washed and starched them and then reapplied my stripes. The one on the left is my senior cap from my last year in nursing school and the one on the right is my graduation cap. I also have my original license there. She said that they looked nice in this room. I smiled, ear to ear, and told her other than my family - deceased husband, 2 grown children, 3 grandchildren, being a nurse had been my goal my entire young life and I am very, very proud to have this career. There would be no other for me. I'm proud of myself for graduating nursing school, passing my boards the first time, and having that white cap with the black stripe.
Thank you for sharing the sunlight in a sometimes dreary period. I've never regretted my career choice but there have been times where the going has been rough. After the dust settled from those times I realized it made me a better nurse.
Beautiful. I read sitting in the kitchen with a not warm sun shining on me.