3 Days, 34 Years, Whatever

My fellow 3rd Year NWTers (L-R): Nolan, Becky, Cody, Kif, Me, Jon, Julia & Casey

 

I've been working in Family Medicine now for 3 full days, a full day of which I have been flying mostly solo. I have learned two very important things: 1) I must broaden my gaze considerably when I'm trying to think through a problem--I miss some of the most basic things just because I have become fixated on a person's specific presentation--and 2) I need to trust my first thought, as well as what I find in the physical exam.

My preceptor, Dr. Rick, who has been practicing for 34 years, will often tell me to do something specific (i.e., "Listen to the heart then feel the carotids"), which I do, and he counters with a "What did you see?" Often I've seen or felt nothing salient, and I say so. He'll nod and follow up with, "So what does that tell you?" To which I'll respond, "That I'm probably doing it wrong." Then he'll proceed to bait me through a pathophysiologic explanation of what was present. My proficiency at describing these things or answering his questions may range anywhere from 20% to 70% correct. Once he asked me to describe to him the finer points of aortic stenosis. I proceeded to instruct him on the finer points of aortic regurgitation. Not the same. In trying to redirect me down the correct path, he stopped my explanation and asked me to explain the aortic wave in the carotids. What did I do? I gave excruciating detail on the jugular venous pulse. Again, not at all the same. DAMMIT. Almost-Dr. L FTW. Not. And that is the difference between 30+ years of practice and 3 days of practice.

Sometimes I come up with what I think is a really good question. You know, one that will spark a healthy conversation. And maybe impress him with my introspection or inquisitiveness in the process. At least that's how I keep thinking it'll go in my head. Usually what happens, though, is I'll ask the question and he'll furrow his brow, shrug, and respond with, "I don't know. How 'bout you look that up and teach me?" A useful teaching tool, for sure, but useless when it comes to making impressions.

The day I met this preceptor, something was bugging me in the back of my mind about him. He reminded me of someone, not just by how he looked but by how he sounded. But who? The next day that sensation of somehow knowing him built. During my drive home on Day 2, I figured it out. Richard Dreyfuss. Here's my proof:

Dr. Rick--OR IS IT--in the upper R

Richard Dreyfuss--incognito in Family Medicine??

The transition to Oregon has not been nearly as awful as I was expecting. Weather thus far has been cooperative, and my 20 minute commute is a pastoral wonderland. Today I drove home from my parent's place via Newberg and has clear panoramic views of the descent into the Willamette Valley, as well as glimpses of Mt. Hood and Mt. St. Helens. Breathtaking! I'd forgotten after living for two years in brown, dead, concrete-laden LA County that there are places in this country that are green and alive. Also, our hospital gave us 2 days of orientation before tossing us into the mix, and it really helped to not be flying blind when we started working. My roommates, Casey and Jon, have proven to be even more fun to live with than I suspected. It vastly helps ease the transition when you enjoy the people you're around every day.

Casey and Jon and I live in what we call The Safety Nest. When you are within the walls of The Safety Nest, you may say anything you want, unfiltered. The Safety Nest also exists in portable form within the walls of any of our cars. There is a sign on the back of our front door that admonishes us "You are now leaving The Safety Nest. Think Safety First!" So should we find ourselves in a public situation where maybe we say something we shouldn't, we can quietly admonish each other with a quick "safety nest!" to remind us to use our real-world grown-up words. It's working pretty well--I definitely say "fuck" way less now than I did two weeks ago.

We are also starting to slim down now that we have normal levels of mobility during the workday. Definite FTW.