This was a short week because of Thanksgiving, but a lot was packed into it. On Monday after geriatrics rounds, I went around with the chaplain and the Hospice nurse practitioner to visit the Hospice patients. Two of them wound up dying within half an hour of one another. Somehow, it didn't seem as bad as some of the other patient deaths I have seen. I think a lot of it was that they were comfortable and the families were there. Also, they all had time to prepare. It was sad, but not depressing.
Tuesday I had my own consult, and it was a tough one. The patient has stage 4 lung cancer with metastasis to the brain, which has caused seizures and dementia. So he really doesn't understand what is going on. But I did my best to explain what Hospice was to him, and he agreed to have a Hospice nurse come out to his home. Wednesday we had a patient who didn't speak much English, but fortunately his family was there to translate. They decided to take him home to his native country to die, which seemed sensible to me. Dying in a hospital is so undignified, especially if it's in the ICU.
The Hospice nurse wrote me an incredibly nice evaluation for my portfolio. She was really upset though when I told her that I didn't want to do medicine and was thinking of doing something with less patient contact. She told me it would be a waste of my talent at working with patients. Considering how much I hated my medicine rotation, it always surprises me when someone says this to me. It makes me doubt myself a little. But I keep thinking about how only five weeks of inpatient medicine made me so miserable, and how the residents were so miserable, and I just don't think I can do it for three years.
I was off on Thursday for Thanksgiving. Friday was a holiday for the UP students, but not for us. So I was the only student who showed up, and I was running around frantically trying to help the nurse practitioner cover the other students' patients. She wanted me to stay in the afternoon too. But I told her that I had to leave at lunchtime because we have classes on Friday afternoons. That is usually true, but we didn't actually have class today because it was our free Friday afternoon. (We get one free Friday afternoon each month.) I was annoyed that she expected me to stay in the afternoon. It made me feel like she was taking advantage of me. I had already come in for the morning even though I could have easily gotten away with not coming in at all. It was enough. I care deeply about doing the right thing, but that doesn't mean there are no limits to what people can ask of me.
I forgot to describe the VA "Stairmaster" last week. The hospital is six floors tall, and the Stairmaster is actually one of the stairwells. The walls in that stairwell have been painted with motivational exercise statements and pictures. There are also colorful charts telling you how many calories you burn doing various activities, depending on your weight. One of the UP fourth years who had rotated at the VA before had told me that they play music in this stairwell sometimes, but I hadn't heard it before. Well, on Monday, they had turned on the music. Since the Hospice patients are on more than one floor, I had several opportunities to go up and down the VA Stairmaster. They played all kinds of things, from country to pop to jazz. Every time I went into the stairwell it was a completely different genre. I was thinking last week that the VA Stairmaster was kind of silly, but now that I've been in there with the music playing, I like the idea. They should post a schedule for what they plan to play when, though. I have decided that I really don't like climbing stairs to jazz!