Wednesday, July 07, 2010

Raring to go!

How do you spell "raring" anyway? I guess since spellcheck didn't flag it, I must have done it correctly.
Okay, I know I ought to be studying right now. I have the stack of notebooks/binders, study guide, etc sitting next to me at the dining table. The pile of stuff is like a pathetic, ignored dog. "Read us, whimper whimper." Eh. Maybe later.
I'm trying to justify my current study avoidance by at least doing other productive things, like renewing my passport, completing my application for permanent medical licensure in the state of Missouri (a TOTAL pain in the arse), working on other "official" doctorly documentation stuff.
BUT what I really want to do is get on with my life as a hospice and palliative medicine fellow!
Last week I was so excited to get to start the very beginning of the journey. Sort of.
Background check: I took a nice long maternity leave, utilizing the "gift" that is FMLA. I took 12 weeks of time out of residency. Now I have to pay back the time. So, technically, I've done the graduation stuff, but officially am still a resident until September 30.
Back to the story.
Last week on July 1 and 2, the hospice and palliative med (heretofore referred to as HPM) had our orientation days. We went over the perfunctory stuff: schedules, policies, goals of fellowship. And then we got to do some fun stuff: LECTURES!
Yep, I'm a total nerd. I was so pumped about getting to sit through a couple of days of lectures. See, finally I'm getting to a point in my education/training/career where I get to focus so much on what I'm actually, genuinely, truly interested in learning! No more sitting through an hour long lecture about the cell receptors involved in organ transplantation rejection and what some scientist is doing to trick those receptors. Now, I get to listen to people I professionally and personally admire discuss topics that apply to our shared field of interest: HPM. So exciting. I was riveted.
What was so exciting, you ask?
Well, we had a talk about management of nausea/vomiting and constipation. Way more exciting than you'd think. Except, these are symptoms that have huge effects on people's quality of life - not the most glamorous - but probably among the most important.
We talked about management of pain, calculating doses of pain medication, changing medications and therefore adjusting doses. A fun little math game, really, in that "word problem" sense. For example:
Your patient, Ms. B, has taken 6 doses of oxycodone over the past day, totalling 30mg. You wish to change her medication from oxycodone to oral morphine. If 20 mg of oxycodone is equivalent to 30 mg of morphine and you plan to allow doses every 6 hours, how much should each dose be?
I have always loved word problems.
There was a brief discussion about the use of social media in raising awareness of the field of HPM and getting word out to the public.
Hello, I'm obsessed with facebook and I have 2 blogs - okay maybe they aren't always that current - but, of course I'm interested in social media!
We also covered applied ethics and its role in HPM. So cool.
We covered communication skills - probably one of the key skills needed for HPM. How we figure out what someone is saying when they can't find the right words or right way to say it. How to tell them what they are ready to hear, and what they need to hear. So many little nuances and so much to learn here.
Then there was the lecture on prognostication (I hate even using the word "lecture" because these are so not lecture-y). Meaning, how do we arrive at our best estimates on the trajectory of disease and the effect it will have on the quality and duration of a life? Phew. Talk about tough.
And, importantly, we talked about the role of self care in the life of the HPM physician. How do we maintain our sanity when we are working daily in a world with so much stress, emotion, chaos, morbidity?
Can you guess how I might choose to help deal with these? Any takers?
And this is my point today: I'm a writer.
I'm not saying I'm a Writer. I'm saying, when it comes to dealing with my inner world, or how my inner world reacts to the rest of the world, or how the rest of he world looks to be functioning, the way I deal is to write.
For the past few months I have been trying to make myself sit down more often and just write. Just do a blog. You might notice after reading my entries that sometimes it takes me a while (a few sentences to a few paragraphs) to get to the meat of the story. It's because I just sit down and start typing. The story eventually comes through. Yes, there is often some back story to trudge through, but eventually, we get there, don't we? Usually?
It's not always exciting. Or gut wrenching. It has up to now been an effort at discipline.
As part of my self care, I am going to renew my efforts. I want to blog more. I would very much like to say I'll blog a little bit every day - but then I just know I'm setting myself up for failure.
I'm going to try, though.
This may actually require splitting my blog (again). There are some things I wrote that I don't care if everyone sees. At times, though, the line between personal and professional needs to be a bit more distinct. One of my hopes would be that if I am able to blog more regularly (goal = 3 times weekly) throughout my fellowship and maybe beyond, that it can be a record and a guide for those who may want to learn and do more in HPM.
SO: if you come to this blog and find it seems a bit different that's why.
Once I make the final split, I'll figure out how to let people know.
Okay, now I guess I ought to pay attention to some of these books over there...

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