Geriatrics

Time is flying... I only have two weeks left here in Seattle. The more time I spend working in geriatrics the more I enjoy it. Once again my expectations about clinical year are completely wrong. I thought womens health was what I would find most inspiring, and although I enjoyed it, I am really loving geriatrics. I look forward to working through charts to determine what we can change, I enjoy chatting with patients and I enjoy the challenge patients provide simply because most have several chronic conditions that must also be considered in the event of an acute problem. On Wednesday,  Dr. Addison and I had been working all day, it was 6:00 pm and we were trying to wrap up charting so we could sit in Seattle traffic to get home, but we had one more patient to see. He was a new admit and had several problems. I was trying to rapidly review his chart to determine what active problems he needed attention to, but his medical records were a mess, they weren't sequential and I was struggling a bit to move quickly. At that moment I looked up and saw two residents/patients that I truly enjoy because they are both always smiling and positive, they were eating dinner together in the common room where we were working, I could hear a woman down the hall hacking to get something out of her lungs over and over again, and I could hear someone speaking loudly (most likely because they can't hear) asking where all the chairs had gone ( I have no idea what this person was asking about). It hit me again, I am loving geriatrics and I couldn't help but giggle. I find some patients to be particularly grumpy when I ask them if I can sit and chat with them about their health, I take this as a challenge and hope that they will at least tolerate me for a bit, and they usually do. Patients with dementia can be challenging for several reasons, often times they dont even understand what I am trying to ask. For example I was asking a patient yesterday if he had diarrhea or constipation and his answer was "yea I pee and poop in there (point to the bathroom), you can go look at the toilet." This same patient wouldn't let me examine him because he had pain and didn't understand that I was trying to help him not hurt him.  Although emotionally challenging, I have found counseling families about end of life issues to be rewarding.

"You know you're in love when you cant fall asleep because reality is finally better than your dreams."
        -Dr. Seuss

Although I have no problems sleeping, my dreams are coming true and they are far better than I ever imagined.