Day One

OK, so I won't post daily about what I do day in and day out, but some days require special recognition. One of these days is the first. The first day of anything is a new experience worth writing about.

I met, for the first time, the team with whom I will be working for the next four weeks, if not the next eight. There's an attending (Dr. Andreoli), an upper level resident (Dr. Morgan), two interns (first year residents whose names I can't remember), an acting intern (fourth year medical student), and four of us lowly third years - really a fairly large team. I've talked about the infamous Dr. Andreoli before, and it's all true. First of all, there was the picture perfect view of the entire team moving from patient to patient as a unit while one of the residents or the AI presented the patient's most recent findings to Andreoli. It was as one sees in any movie depicting such events, I had just never seen it in person until now. This process went on for roughly two hours. Before we even went to see patients, he noticed my choice of shirt for the day. It was a sort of dark lavender, not a stark violet, with a primarily silver tie, and he absolutely hated the shirt. In fact, his exact words were, "You should burn that shirt immediately when you get home." I won't, I like the shirt and Rachel's mom would murder me. While on my case, he decided to examine the contents of my coat's chest pocket to ensure my pens weren't labeled with some drug or pharmaceutical company. To his dismay, they weren't, and he therefore couldn't steal them from me like he did one of my colleague's, even though his pens weren't labeled; they weren't "trinkets" as Andreoli likes to call them. Because of his disdain for my shirt, he later asked me to justify my existence on this planet by giving him the top three possibilities for a differential diagnosis on a patient we saw. I knew one, but not the other two, therefore making me useless, at least to him. Of course, neither did any of the residents correctly name the other two top possibilities. However, most of his questions didn't even pertain to the care of the patient. Most of his questions were about past Nobel laureates, inventors of medical procedures or devices, culture nonsense, or about one of many famous physicians he has supposedly met or lived near to in his brilliant career.

Despite what it may sound like, Andreoli is a decent man. His bedside manner is great. He charges a dollar to any member of the team who doesn't let the female members through the doorway first. He refers to his patients as ladies and gentlemen, not merely females and males. And, all in all, he's a great educator and great with students - you just can't let his silly insults get to you. They are otherwise harmless. Tomorrow, after arriving at 7:30 AM, I will have to write progress notes on two patients after doing brief histories and physicals on them, and then I will present them to Andreoli on rounds. It will be time to be insulted again, though hopefully not about my clothing this time. By the end of the week, I should have a routine down and it will only be a matter of learning about different kinds of patients for the remainder of my stint on internal medicine at the VA. I go home at night, read some about the patients I am taking care of and their diseases, and move on. Nowhere near the volume of studying compared to the last two years. I will be working every other weekend, so I will have a couple blocks of 12 straight days of working, but oh well. Above all, I am glad I have started my rotations with internal medicine. It is the basis from which all other specialties arise, and we get to actually apply what we have learned the past two years (whereas in other rotations, our two year's worth of lecture is near meaningless). Future updates about internal medicine will likely include what seem to me to be interesting cases, so don't get too bored.