MATTERS OF THE HEART

Well, it's back to the grind now. No more vacay :( But that's okay, I had a fantastic month off and am very grateful to be rested and ready to go. First up for this year is cardiology. I was stressing about this rotation for a few reasons. First, the heart is one of my weaker subjects. There is so much to remember, and it all gets inter-twined. I'm hard of hearing, so hearing murmurs can be very difficult. Second, there are so many contributing factors that make this less of a action/reaction, direct effect, instant gratification specialty. I like to see a problem and fix it, which is harder in cardiology than it is in other specialties. Third, my next rotation will be vascular in nature, so this whole heart thing is going to be a big deal then, too, so I'd better be paying attention! And lastly, I've been on vacation for a month. Going from doing whatever I dang well please all day every day straight to keeping someone else's schedule and explaining my every move is not an easy transition.

With all that said, I have honestly really enjoyed my rotation so far. I wanted independence, and I got a big dose of it! I'm rounding on my own at the hospitals, so I see lots of patients with a variety of ailments. The best part is that while I'm mainly concerned about cardiology-related issues, I'm treating a whole patient and have to consider the whole picture, so it really keeps me interested. I can look up stuff I have questions on, and I can always call my preceptor with more questions or concerns.

This has been a whole new experience in another aspect-most of my patients are in ICU or long term care facilities. That means that their situations are very fragile and can literally change by the day. This is the first time I've ever had to convey that to a family. I don't think I've ever chosen my words so carefully. I also have to watch for the subtlest signs or changes in lab values each day. It has made me realize, again, how important it is for EVERY person to discuss with their loved ones what their wishes are if they become incapacitated. Please keep in mind that from my view, incapacitated doesn't always mean dying...it has a variety of implications, including severe dementia, dehabilitating infection, changes in psyche, and otherwise. And it's not always a permanent situation. It's important to discuss resuscitation, intubation, "life support," restraints, medications, etc...don't leave some subjects unbreached because it makes for an uncomfortable discussion. It breaks my heart to see families in distress over what their loved one would want in a time that already brings about such emotion. It breaks my heart even more to see families go into denial regarding very real situations, and watch them simply leave family members behind at the hospital. Would you want your family to leave you in a hospital bed for an undetermined amount of time and come visit once a month for 15 minutes because it makes THEM uncomfortable to think about it? It's never an easy conversation, but being in the heat of the moment won't make the decisions any easier or any more clear. I'm sorry to bum yall out on a beautiful Sunday morning, but this really weighs heavily on my heart today, and I saw it way too often in just one week. On a happier note, I also saw true love this week. I saw spouses come sit bedside all day, every day. They knew what their loved one wanted, and did everything possible to uphold that. They would read, make sure favorite TV shows were playing, talk, and even hold hands. And sometimes, I saw the patient respond to such love with a squeeze of the hand, a head nod, or even as subtle as blinking-once for no, twice for yes.

Realizing how fragile life as you know it can be, I think I learned from my patients that it's probably better if we all take it just one day at time, and never pass up an opportunity to show love or have meaningful conversation with our loved ones. Thank you, week one of an intimidating rotation, for teaching me such a valuable lesson.