Today is Tounces' birthday. This is her, looking all sassy at the poolside, circa back-in-the-day. Could she possibly be any cuter? I think not.
Look at her. Hair all done up, likely drinking some kind of adult beverage and watching her kids splashing. She was probably feeling thankful that she'd paid for some solid swim lessons (and also dreading the mounds of kinky, chlorinated hair that she'd have to comb out later on that night.)
Mmm hmmm.
Yep. It's Mom's birthday. We've been loving on her so far and don't intend to stop. JoLai is here and that's good. This day is going to be hard for her. It already has been. But it's been good, too.
Deanna, on that same day in the pool
It's her first birthday since the new normal started, so there will be icky parts. Thinking of the perfect celebration we had for her last year has been bittersweet. Sweet because it was so full of love and special moments. Bitter because Deanna was there in person but can only be at this one in spirit. I just thought of something--there was a little video clip taken of Will and I from that night. It was a pivotal moment captured on film that Deanna thought to grab for posterity. I have always loved that it exists, but now will love it even more knowing that it was taken with her eye. Yes. We're missing her today. Especially today.
Sigh.
That said. There will be toasts. There will be hugs. Wine will be poured and just as we promised last year, we will always, always let Mom know that we love her more. More than she will ever know.
Yeah.
***
Happy Birthday, Tounces.
New to this blog since last year? Read about Mom's perfect 65th birthday and see that little video clip here. We are a very blessed family. We know that. Thanks to all of you for continuing to think of us -- and especially her. This one is for you, Tounces.
"I just looked this word up I heard y'all saying on Google."
The patient knitted her brow and had this complex expression of anger mixed with hurt when she said that. I had just come into the room with the resident and was admittedly taken aback by this being the first thing she hit us with.
"Pardon me?" I said that rather reflexively. Normally, I would have introduced myself before saying anything else. But walking in and immediately hearing something like this threw everything out of order. "Uhh, I'm sorry. My name is Dr. Manning. I'm the senior doctor working with your primary physician."
She had her phone in her hand and was still studying it. I'm not even sure if she heard my obligatory introduction. "Why do y'all have to call somebody 'morbid' obesity?"
Wait, huh?
Here's the thing. This patient was no less than three hundred fifty pounds. Her knees were being crushed under the weight and this, more than anything, was the medical problem that plagued her the most. She needed knee replacements but wasn't a good candidate for the surgery. Why? Because of her weight.
Just outside the door, the resident asked me if all patients with morbid obesity had to "just live with the pain" until they lost some substantial weight. That's when I responded by discussing the likelihood for effective healing/outcome of a newly imported weight bearing joint under so much weight.
"Y'all said I was morbid obesity." She said it matter-of-factly. "I ain't know what that meant so I looked it up."
My resident and I exchanged glances. Neither of us knew what to say.
"You know? I been fat my whole life. But nobody never called me morbid. Damn."
"That's just a medical word we use to describe. . . um. . .when somebody has . .like. . . .a lot of extra weight on them."
"I understand," she replied. "But I want y'all to know something. It ain't right to call somebody morbid. I don't give a damn how big they is."
I stared at her for a beat and then let her words sink in. My resident and I had both tossed that word around outside of her room. Loud enough for her to hear -- and then subsequently enter into a Google search.
Damn.
We had just put a remix on, with our medical jargon, something hurtful that she'd been hearing for her entire life: "You're too fat."
And yes. She'd heard us correctly. Our words could not have been clearer. You aren't just obese. You're the morbid kind of obese.
I googled that word--morbid--just like she did. And here is the first thing that pops up:
mor·bid
/ˈmôrbəd/
Adjective
Characterized
by or appealing to an abnormal and unhealthy interest in disturbing and
unpleasant subjects, esp. death and disease.
Of the nature of or indicative of disease.
Synonyms:
unhealthy - diseased - unsound - ill - sickly
Great.
So this is the medical jargon-y word that we tack on to that word obesity when describing the disabling kind to other health care providers. Not just obese. Morbidly so.
I thought about the word "morbid" and how I usually use it when not speaking to other physicians. Mostly I'm referring to something deathly, sickly or awful sounding. I imagined hearing this word being spoken about me by others and then looking it up only to find that definition. I could see why this was hurtful.
Sigh.
So what happened? Well, all that could happen, really. I told her that I was sorry for saying something that was clearly hurtful to her. I acknowledged that we often use medical terms without thinking much of how they might sound or feel to someone else. We agreed that saying the word "morbid" to describe any person's body habitus was probably not very kind. Even if it was an accepted medical term.
And the patient? She just stared ahead and mumbled that it was okay. But I could tell that her feelings were hurt.
Obesity is so, so complicated. It stands as one of our biggest barriers to health and hardest to overcome. The mind and the identity component, the emotional parts, and the social aspects. People learn to live with that part of who they are and it gets very tricky when we hit them with these overly simplistic suggestions for overhauling all of that.
The other struggle is just the whole socially acceptable practice of open discrimination to those who are very overweight. I admit that I've been there, too. Fighting against rolling my eyes when an overweight acquaintance who regularly complains of being overweight or who pays good money for a personal trainer cracks open a can of full sugar Coca Cola. Or even cringing last night while watching the "pleasantly plump" actress on HBO's GIRLS playing a game of nude ping pong during a love scene.
That actually made me write about this today. Thoughts about obesity and the flip words often tossed about in reference to it. Even the medical ones.
So, yeah. I don't have the answers. But I do know that I don't want to be a doctor who hurts patients' feelings with words that aren't absolutely necessary. I also want to be understanding, even when something deep inside fights against that.
That's all I got today.
***
Welcome to Saturday, y'all.
Now playing on the mental iPod. . . . Mr. Fats Domino.
And some old school hip hop--The Fat Boys with "Don't You Dog Me." You just gotta love the Human Beatbox!
How do you keep the music playing?
How do you make it last?
How do you keep the song from fading
too fast?
How do you lose yourself to someone
and never lose your way?
How do you not run out of new things
to say?
And since you know we're always changing
How can it be the same?
And tell me how year after year
You're sure your heart will fall apart
Each time you hear his name?
I know the way I feel for you is now or never
The more I love, the more that I'm afraid
That in your eyes I may not see forever. . . .forever. . .
If we can be the best of lovers
Yet be the best of friends
If we can try with every day to make it better as it grows
With any luck then I suppose
The music never ends.
~ lyrics by LeGrand/Bergman
___________________________
Not because it's Valentine's Day, but in spite of it. I need the world to know that on days other than this one, there are folks trying with every day to make it better and to keep the music playing. Not just on Hallmark holidays, but all year round.
I love my husband. I love him for loving me right in front of my boys every single day. I love him for the fighting chance he is giving them at feeling whole and deserving of love. I love him for rushing home today from a busy, busy day at his newest business venture--not because he thought I so much needed it, but because he thinks it's important for him "to show his sons how to treat the person they love." So that meant coming home and giving them flowers and balloons to give Mommy.
Just like he does every year.
"You have to make sure she feels special every day. But on certain days, you can make it even more special, okay?"
That's what he says and they believe it. In fact, they believe just about every word that comes out of his mouth. So I'm also glad that he's got common sense and isn't a damn fool.
Yeah, I said it.
Hindsight is 20/20. When I was waiting for the BHE, I was so tired of it. I wanted it now. I wanted to plan my wedding and have my babies. I was furious with fate for having me graduate medical school and finish residency as a single woman. In fact, I was more than furious. I was exhausted.
I'd go places and spend time with people who didn't really deserve my time. Listen to their blah-blah-blah and try to force myself to feel what wasn't there. And that sucked.
Finally, I got exhausted enough to say, "I'm just going to do me." Which meant, even if I was going to ride this life out on a solo mission, I refused--absolutely REFUSED--to be:
a. miserable.
b. dealing with somebody who didn't deserve my time.
c. fretful.
d. that woman who is constantly wah-wah-waaaah-ing about singlehood over thirty.
And that's what I did. Did me. And prayed some, too.
Shortly after that I met Harry. And let me tell you something -- I knew that I had CAME UP (no, not come up, I meant to say CAME UP) on something really, really good from that first moment we met. I promise myself every single day that I won't forget it or take one second of our time together for granted.
And I don't. Ever, not never.
Me? I got a testimony. I am patting my chest and walking through a crowd of angry, tired, jaded people. And standing up for love. Pointing my finger in their faces and saying that no, we ain't perfect, but dammit we are trying with every day to keep our music playing. Sometimes our record skips, but we are trying, man. With every day. And I just have to believe that there are others out there doing the same.
There's also somebody, somewhere wishing someone exactly like you would be the other part to their two part harmony, too. YES. Somebody who wants to treat you nice. All the time. And call you back consistently and not just after ten P.M. And who truly likes your company. In private and in public. YES. And who doesn't mind that you are WIDE open about how much your heart falls apart each time you hear his or her name.
And if they AREN'T all of these things, tell them to KICK ROCKS. And DO YOU until that person shows up. And if the person is kind of this way but not all the way ready, tell them to KICK ROCKS and still DO YOU until either the right person turns up or that person gets it together. But no Mr. or Ms. In-between. NUH-NO.
And.
If you DO have somebody? Man. Fight. Fight to keep your music playing. Keep the climate cozy and warm. I believe that good people can do bad things when they don't have basic needs met. So pay attention. Keep the thermostat in the right place and check it often. That way nobody goes looking for an extra fan or a little space heater on the side.
Mmm hmmm.
Uggh. I'm rambling.
Damn. Do I sound preachy? I don't mean to. I just feel like love needs defense sometimes. So that's what I'm doing. Defending love, man. And encouraging somebody because I know I've said it twelve trillion times, but I need to say it again. I was NOT lucky in love before I met Harry. And this lady once told me when I was crying about being single and how there was nobody out there -- she simply said that, "All you're looking for is one person." Which now I know was a good word if I ever heard one.
Yeah, it was.
Just one. And what a relief. Imagine if you needed to find like six? Or twelve? Talk about some pressure. Imagine an Easter Egg hunt where all you had to find was one egg? You wouldn't even mind if they hid them a little better, would you?
What the hell am I even talking about? I don't know. I just love my husband. That I do know. On Valentine's Day and all the random ones in between.
Yup.
That's all I got for tonight. I wish easy and authentic love to each and every one of you. More than your hands, head and heart can even hold.
And I mean that.
***
Feliz Dia de San Valentin! Now playing. . . . my favorite version of this song. . .James Ingram featuring Patti Austin. . .
February 14 is here! 100% inflation on roses and expectations for you to do things that you feel too damn tired to even wrap your minds around! Yes! It's Valentine's Day!!!
Yeah.
Hoping yours is all cherries and not the pits.
The sultry smize I gave a stranger named Harry across the room circa 2002. Ha ha. . .NOT.
Oh! And don't forget to smize. (In my experience, it leads to chocolate-covered strawberries and more. . . .even if you're old and 'flicted.)
Ha.
***
Happy Valentine's Day from a reformed Valentine's Day Hater. Or as Zachary call's it "Valen-times Day!"
Hey, y'all. Just checking in real quick for some random chit-chat over coffee on a rainy Wednesday morning.
*Yawn*
Well. I'm slightly annoyed because I've been having some ankle pain for the last several days. As I mentioned before, I've been training for a half marathon in Deanna's memory and it's been going great. Well, mostly great. A little over a week ago, I ran about five and a half miles (which, for me, was like an ultra marathon.) The following day I felt awesome so hit the pavement for another three miles. When I got home, I started feeling this nagging discomfort in my left ankle on the outer side.
Just superior to the lateral malleolus, for you nerdy medicine people who need the jargon to go with my symptoms.
So. Where was I? Oh, my ankle. So, yeah. I decided that it wasn't so bad and ran on it a couple of days later. Epic. Fail. By the following day, I was limping. And so. I gave it a solid four days of rest, ibuprofen and all the stuff WE tell our patients they need and it (mostly) felt better. I even went to a fancy, schmancy performance running store to see if I was a "pronator" or yadda yah whatever they say you are if your foot rolls in or out or something or other. Turns out I have a high arch and that I am not a pronator but instead just a normal chick who runs regular.
But.
They still convinced me to get a shoe made for a person with a high arch and a non-pronator-y foot, so I get home with it all proud of myself for (sort of) seeking medical attention. And by medical attention, I mean the dude in the Big Peach Running Store who had me run on a treadmill and who projected my bony ankles and feet on a big-A screen while analyzing my stride.
Mmm hmmm.
So I put on my new, custom fit, swanky running shoes yesterday morning. I can still feel a tiny niggle in my ankle but I decide to be bad ass and run through it. Because, I mean, it had been like five days and I was feeling myself regressing back to my baseline wanna-be runner status.
And as a sidebar, despite my medical attention from the dude in Big Peach, I also got a consult from the BHE who has done his share of running as an ex-army dude/marathoner. And his assessment of the whole situation is:
"You're forty-two babe. And you didn't rest enough."
To which I scoffed, "Dude. Are you calling me old? Are you saying my diagnosis is old-and-flicted?"
To which he replied, "That is exactly what I'm saying, baby. Old and 'flicted."
And if you don't know what 'flicted is, just know that it's short for AF-flicted and pretty much is a word to describe anything that used to work but now does not.
For example:
"I just got this umbrella and on that windy day it turned inside out on me. Now it's all 'flicted."
Or:
"Why you walking all like you 'flicted?"
"'Cause I think I hurt my ankle running."
"Did you roll it?"
"No! That's why I'm so bothered by it!"
"Oh. Maybe you're just old and 'flicted. That happens over forty."
"Uhhh, thanks. . .?"
Yeah.
So yesterday morning, in my hoity-toity runners, I went out again for three and a half miles. And today I am limping. Completely limping. Which sucks.
I'm 'flicted, people. 'Flicted, I say!
So now I guess I'm going to have to wait a solid week. And if within that week I don't feel better, I'm going to have to break down and get it imaged. The last thing I need is to hear that I have some kind of stress fracture. So yeah, I ain't even claiming that.
No, I am not.
What else? Oh. Despite my 'flicted ankle, yesterday I did a segment at HLN on this show called Raising America. I like HLN. It's a sister station to CNN and usually one channel over from it, at least here it is. They are all in the same studios in the CNN center. That was my first time doing HLN in studio. I really, really enjoyed their energy. I hope to go back. Next time I'll give you guys some notice so that you can check a sista out.
And lastly, this:
This is my friend, Shahed. She's one of my faves and is technically not a Grady doctor anymore but a VA doctor. She refers to her patients as "America's heroes" which I completely love. And she feels the way about the VA and our vets that I do about my Grady elders, so she's alright with me.
She's also hilarious. And super smart. And a major cat lover. The cat lover part is what is most hilarious. I took these pictures of Shah at the end of our Residency Leadership Committee meeting Friday as proof that she is indeed a "crazy cat lady." She states firmly that she "only has four cats" which technically doesn't make her at "crazy cat lady" status. To which I said, "No. Not crazy-hoarder-cat-lady status but crazy cat lady status nonetheless."
To which she concurred. But not before showing me her collection of photoshopped Atlanta Falcons versions of her ultra-mega-kittens (as she calls them.)
Ha.
I love my job, my ankle is 'flicted, and it's raining in Atlanta. That's what's going on with me. What's up with y'all?
Colorblind I am colorblind. Coffee black and egg white. Pull me out from inside. I am ready I am ready.
I am taffy stuck and tongue tied. Stutter shook and uptight. Pull me out from inside. I am ready I am ready. I am fine.
I am covered in skin. No one gets to come in. Pull me out from inside. I am folded and unfolded and unfolding. I am colorblind. Coffee black and egg white. Pull me out from inside. I am ready I am ready. I am fine I am fine. I am fine.
~ Counting Crows
___________________________________
I was running to this song recently and somehow it made me feel like I could fly. Like literally leap up into the air, churning my legs into the atmosphere like Elliot on that bike in E.T.
I just find this song to be so hauntingly beautiful. Kind of like. . .I don't know. . . like it puts me in a trance when I hear it. Like I could run to it forever.
Crazy, I know.
What does it mean? I don't know. But it is poetic. And like a lot of good poetry and good lyrics it means something different to me every time I hear it. You can decide what it means to you. . . . . *** Happy Monday. Now playing . . . .
His hands are steady. His feet just far enough apart. Wrists firm and arms stiffened.
Tick tock. Tick tock.
He took his practice swings and I know for certain that this is what he was saying in his head. Reminding himself to swing gently, with the control of a pendulum. Because he is cerebral. Methodical. And, as his coach describes him, "analytical."
Tick tock. Tick tock.
In went the first ball. And then the second. He missed the third and then regrouped. Regrounded himself. Refocused. Tick tock. Tick tock.
Calm eye. Feet in position. Back straight. Shoulders strong.
Tick tock. Tick tock.
In. In. In. Yes.
He looked up at me and smiled. And I smiled back because I was watching. I sure was. And so was his little brother with his own perforated grin and also holding up two thumbs high from across the room.
That warmed my heart. Because every day, I always say to them, "What do brothers do?" And in unison they say, "Stick together!" And sticking together means being for each other. Encouraging each other, supporting each other and just loving one another.
See, the little brother? He's just naturally athletic. He's a fast runner, a good catcher and is quick and agile. At most things, he's uber-competitive and is able to stick and move like he was born to do just that.
But the elder brother is less so. At least less natural at those games that require fast running and speedy hand-eye coordination. And all of it is fine. With us. With them.
Most importantly, with them.
It really is. Which makes me feel like I've done something right.
He may not run as fast. But this? This is Isaiah's thing. And watching him do this thing that celebrates his unique athleticism, his careful mind and builds his confidence at the same time is just. . . . cool.
But knowing my sons remember that no matter what, they're always on the same team? That's even cooler.
It's just that no one cares for you this way. . . (Take 'em to the clinic!)
Come here, students (Go 'head do Medicine) Come to the wards (Go 'head do Medicine) V.I.P. (Go 'head do Medicine) Loan repayment's on me (Go 'head do Medicine) Med students who ya workin' with (Go 'head do Medicine) Teach 'em right quick (Go 'head do Medicine) See ya' patients smile (Go 'head do Medicine) Come here, chile! Get your sexy up! Get your sexy uuuuuupp!
Confession: Medicine is not perceived as sexy. As much as I hate to admit it--grrrrrr---it simply is not.
Hold up. I need to clarify a couple of things. When I say "medicine" I don't mean the entire field of medicine. I mean my chosen specialty within medicine--specifically Internal Medicine. See? Just saying it sounds 'B' list and unsexy, doesn't it?
Sigh. I know.
But see, it used to be sexy, man. Like back in the day with Marcus Welby (who technically saw kids and randomly operated on folks, too, but ignore that for my point) the internists used to have SWAG. And our specialty? Man. It was . . .well. . .sexy.
Oh. The other thing I need to explain further is my use of the word "sexy." I don't mean it in the literal sense. Like, not the high-heeled stilettos and Daisy Duke shorts kind of sexy. And not the SuperBowl Calvin Klein underwear commercial "Lawdy-Lawdy-Miss-Claudie!" kind of way either.
'Cause. . . that? Just. . . whew.
No, people. I'm talking about "sexy" in the form of being . . .you know. . . chic,coveted, and on the it-list. When it comes to choosing specialties of choice as a third year in medical school, THIS is why Internal Medicine (and all primary care specialties) sometimes struggle to woo our students.
Yup. Lack of sexy.
BUT!
This is where I come in. And not just me. Me and several of my fellow Internal Medicine nerds. Buckle your seat belts, people. . . because we are determined to BRING THE SEXY BACK to Internal Medicine. Yay-yuuuuuhhhhh!!!!
*coughing spasm* Okay. At least I am.
Sure. Internists don't make as much as plastic surgeons, ophthalmologists, orthopods, or dermatologists. And no, we don't have the same cute neck ties and stickers as our pediatrician colleagues or syringes in our back pockets like the anesthesiologists. There isn't the excitement of jackknives through foreheads that our emergency physician pals tackle nor do we get to be the first introduced to slimy, amniotic fluid-covered babies like our friends the obstetrician/gynecologists.
Nope. But! We're still sexy, man. For real. Zoolander sexy, even. And if you don't believe me, then clearly--CLEARLY--you need to be made privy to:
THE TOP TEN REASONS WHY INTERNAL MEDICINE IS WAAAAYSEXIER THAN YOU REALIZE (ALSO KNOWN AS "THE DIABOLICAL PLOT TO CONQUER THE WORLD AND BRING THE SEXY BACK TO INTERNAL MEDICINETHUS-LY MAKING IT A DESTINATION SPECIALTY FOR ALL: A MUST READ PRIMER FOR MEDICAL STUDENTS AND HATERS.")
Like to hear it? Here it go!
#10 -- We can actually help somebody when someone yells out, "IS THERE A DOCTOR IN THE ROOM!?"
Adam of SG Alpha -- IM second year at Wash U. in STL.
Maaaaan. I was a resident in Cleveland, right? So check it -- true story, I promise. Me and a fellow resident were rolling down Shaker Boulevard and we see this dude laying on the sidewalk on a side street. Two cars had pulled over and a lady was on the side basically freaking out and that's it. So we pull over to see if we could be of assistance. I mean, seeing as we were resident INTERNISTS and all.
Ah hem.
So we walk up on dude with our 'scopes around our necks. ('Cause that's how real INTERNISTS get down.) But just as we do, this fifty-something-looking dude walks up and trumps us like he was Trapper John, MD.
"Please back up. I'm a doctor!" he bellows all loud and authoritative-like.
So, you know, we back up. I mean, seeing as Trapper John was all flexin' on us and everything. So THEN Trapper -- I kids you not -- puts the dorsal side of his hand to the dude's forehead. Like a pulse could be found there. His semiconscious FOREHEAD. I ain't lyin'.
So me and my friend, we give Trapper a totally hairy eyeball at this point and prepare to move in on him and see what was up with this man. My friend looks over at the freaking-out lady and says, "Ma'am, do you know this gentleman?"
And the freaking-out lady is all freaking out so it was kinda hard to understand her, but she did say she knew the dude. So my buddy asks a few more questions while I give the man a sternal (breastbone) rub to see he could be aroused. And while all of this is going on, Trapper John is kneeling over the man with his brow all furrowed and two fingers tapping his lips.
"I'm a physician," he repeated to us, "and I need you kids to call 911 and give a bit of space."
And I was all like -- Hold up. Did he just try to play us?
But by this time, my buddy had determined that the man was a diabetic and had gone for a run earlier without eating much. He'd also taken his insulin a few moments earlier. So instead of completely going off on the brow-checking PHYSICIAN for trying to PLAY us, we give this diabetic dude some candy to stick in his cheek and instructed the freaking-out lady to give the man some juice. And up he pops like that lady who passed out on Pulp Fiction after John Travolta hit her with the epinephrine.
Okay. Maybe not exactly like that, but just imagine it for the story, okay?
So, all was well that ended well. Dude woke all the way up and acknowledged that he should have eaten before he took a trillion units of insulin. And Trapper John, the PHYSICIAN turned out to be a local dermatologist. And while I am certainly NOT hating on dermatologists, I'm just saying that his checking for tactile temperature like Dr. Quinn, Medicine Woman was uuhhhh. . . .not even the move.
So I'm just saying. Internists save people. Sexy, right?
Adam would have TOTALLY known what to do.
#9 -- We get to talk about everything.
The liver. The heart. The lungs. The skin. The lady parts and the man parts. The all of it. Nothing is off limits, man. But just when the skin gets really, really gross, we call Trapper-dude for a consult. And hallelujah, we get to do the same for similar things related to the nether regions. (See Urology and Ob/Gyn for nether region specialties.) *Bleccch* #8 -- We get cool stuff not just on holidays, but on random Tuesdays, too.
Maaaan. Folks are mad grateful when you reduce their cardiovascular risk factors. For real, man, they are. I have had my fair share of delicious baked goods and even received a birthday card with my actual date of birth preprinted on it that a patient purchased for me because she remembered from the year before. Bet you nobody ever made YOU a super fancy cake like the one pictured above and gave it to you on a random Thursday, have they?
Mmmm hmmm. I didn't THINK so.
Okay. Me neither seeing as I found that image on a Google search. But that's besides the point. The point is that the ones I DO get are homemade and delicious. And sometimes even homie-made, but delicious nonetheless. Mmm hmmm. See? That's the kind of effect you have when you're in INTERNAL MEDICINE, people. YAY-YUUH!
*hand splayed in your face*
And don't EVEN start telling me about how you're an anesthesiologist or some other SWANKY HIGHER INCOME SPECIALTY and somebody did this for you (MARIA, FELLOW MEHARRIAN) because clearly the person who did so was high and delirious from your gas machine. Or just happy as hell because they got an epidural. (Yeah. I said it.) See, us internists? We get real love that isn't under the influence of opiates or benzodiazepines.
So, I'm just saying. THAT perk makes up slightly for the pay differential.
Slightly.
#7 -- We don't have to spend five hours scrubbing in to do our job.
Here's Atul Gawande, the awesome neck surgeon and writer, scrubbing into surgery. And see? If he was an INTERNIST, he could be somewhere holding his patient's hand instead of a scrub brush.
See? Yet ANOTHER perk of the illustriously sexy field of INTERNAL MEDICINE.
(And yes. I think Gawande freakin' rocks. But I am slightly annoyed with him for not choosing to be an internist.)
#6 -- We don't really have to study too hard for USMLE Step 3.
Alanna of SG Alpha, IM resident at UCSF
For the non-medical peeps, there are three rites of standardized test-taking passage for medical students and residents. The United States Medical Licensure Examination (USMLE) has three "steps" that you take before you can get licensed to ill practice. Step 1 is taken after your preclinical studies are completed. Step 2 is taken somewhere between your third and final year. Once you start your residency in a chosen field, you still have to clear the Step 3 hurdle -- one last test focusing on general clinical knowledge.
All of the uber-specialized peeps get all freaked out over Step 3 but not us nerdy internists! Bwaaah haa haaaaa! We are ALL OVER that sucker. Give us your broadest differential diagnoses from syphilis to wet beri-beri and we will DESTROY it all while the rest put the back of their hand on somebody's nearly unconscious forehead.
*Drops the mike and walks away.* #5 -- We actually know the answers to the questions people ask us at family gatherings.*
Hmmm.
Now that I think of it, this may or may not be an advantage. Nor does this do much to help the cause of bringing the sexy back to Internal Medicine.
*This may also include but is not limited to:
Your father calling you from the golf course to talk to the man standing next to the man next to him at the driving range, your fifth cousin twice removed asking you whether or not his "nature not working" has anything to do with him not being circumcised, or the lady next door to the lady around the corner from you texting you a photograph of her grandson's nanny because "it look to her like the shingles but she ain't sure."
On second thought, ignore that one. #4 -- Our white coats are the whitest ones.
Even when we're standing outside.
You know. 'Cause we're just all Marcus Welby like that. (I'm just saying.) #3 -- We don't have to worry about being portrayed as dreamy or steamy on television.
(Just a surly, drug-abusing genius. )
Sexy, right? #2 -- The medical students LOVE us (even if they usually aren't convinced they want to BE us.)
Now this part I'm not saying tongue-in-cheek. Us INTERNAL MEDICINE people? Maaan, we do a lot of teaching when it comes to medical students. Sure do.
No one will argue with me when I say that the Internal Medicine clerkship is considered the bread and butter of clinical training in medical school. Hands down. It's where students become real doctors and where the preclinical pieces get put together and applied. And my fellow I.M. nerds get racks-on-racks-on-racks of teaching awards.
Wendy A. with her racks-on-racks-on-racks
It's also a very necessary part of every other specialty. The very best surgeons, dermatologists, radiologists, anesthesiologists and neurologists have a solid knowledge of internal medicine that they apply to their patients. At least the very best ones do.
So what does that mean? As teaching internists, we have a very, very important job. Our learners take a piece of us and our field into everything they do. No matter what they do. I see that as a tremendous honor and a huge responsibility.
CdR, one of my favorite medicine nerds, in action.
Sure. Someone might find it self important to say all that but that I say, "Meh. It's my blog."
Ha ha. Seriously, though. I say that because it's true. Sure is.
We also get to build some amazing relationships with our patients. And I acknowledge that my colleagues in other fields get to do this, too. But there is something unique about educating patients about the most basic aspects of their health and focusing on the very things that are most likely to either take their lives or disable them. This is what we do. All day, e'ry day.
And that makes us happy. And happy is sexy, man.
#1 -- It's a labor of LOVE.
Let's be real. Medical school is expensive. Students go into a lot of debt to become doctors and sometimes--not all the time--how much future earning potential they have gets factored into them choosing a specialty.
Sigh.
We can't compete with incomes that are quadruple ours. Nope. But can I just say that "a lot of money" is rather relative? Can I also say that six figures is a lot of freakin' money no matter WHO you are and that most internists absolutely make that and more? Can I also say what we get in the intangible rewards is really substantial? Like really substantial. Can I say all that?
Good. Because all of that is true.
The other thing is that we are needed now more than ever. In the U.S., we know that recent legislation will open the floodgates for many people who previously couldn't get primary care. And our population is living longer, too. So now more than ever, our patients need good internists.
But see, it has to be a labor of love. Because internists often end up taking some things for the team. And, no--that part isn't always sexy but I have to say it because it's true. But the rewards? Man. They far outweigh the lumps we take. And the impact we have? On countless levels? The best.
Sure. We can be a bit nerdy at times. Sure. We sometimes sit and think about the potential explanations for one abnormal lab result or clinical finding for hours -- but you know? Somebody is better for it.
So repeat after me: "INTERNAL MEDICINE IS SEXY."
Then, look in you mirror like Derek Zoolander and say it again. But this time with a smize -- and an even sexier voice, baby. Kind of like Austin Powers.
So what if we're a little bit country. We're also a little bit rock 'n' roll, too.
Do not--I REPEAT--do not count us out because you don't think of our field as "sexy." Instead, join my crusade and stop fighting the magnetic pull you know you feel deep down in your soul to get on the Internal Medicine bandwagon. Help me help YOU. Help ME help the WORLD.
*starts pumping fist*
Together we can BRING SEXY BACK to Internal Medicine and Primary Care specialties!! You with me?! Come on! GET YOUR SEXY BACK!!!!
Yaaaaasss!!! The doors of the church specialty are now open!!
***
with Pulak P. -- F.P. extraordinaire
Disclaimer: A lot of this does apply to both Pediatrics and Family Medicine. And to some other specialties, too. And yes, I am also both trained and board certified in Pediatrics and DO fully believe in Medicine/Pediatrics combined training (like I did.) HOWEVER--this post is designed specifically to BRING THE SEXY BACK to INTERNAL MEDICINE. So don't EVEN start going off in the comments about how your cousin is a dermatologist and he saved somebody's life on an airplane and didn't just put his hand on somebody's unconscious brow. Because THAT does not help my cause. AND it does not take away from the fact that on a cold night in Cleveland, Ohio back in the late 90's, another non-internist was clueless.
(And those who aren't med students but who would do Internal Medicine if they were? Y'all can sign, too.)
And lastly, a picture of my med school classmate, BFF, and fellow internist, Lisa D. to show you that we I.M. people are bringing sexy and the SWAG back to the specialty on the weekends, too. Yeah, baby!
Of course this has been playing on the mental iPod the entire time. . . . . Go 'head, girl! Get ya' sexy up!
Honestly? I write this blog to share the human aspects of medicine + teaching + work/life balance with others and myself -- and to honor the public hospital and her patients--but never at the expense of patient privacy or dignity.
Thanks for stopping by! :)
"One writes out of one thing only--one's own experience. Everything depends of how relentlessly one forces from this experience the last drop, sweet or bitter, it can possibly give."
~ James Baldwin (1924 - 1987)
"Do it for the story." ~ Antoinette Nguyen, MD, MPH
Details, names, time frames, etc. are always changed to protect anonymity. This may or may not be an amalgamation of true,quasi-true, or completely fictional events. But the lessons? They are always real and never, ever fictional. Got that?
