Transition

Today was my last day at the VA. In a way I am ready to move on to something else, and in a way I am going to miss it. I got my last two patients on Sunday, one was an 87 year old man with abdominal pain. Turns out he has some small bowel obstruction, but no one knows why. The most common cause is a side effect of surgery, but he has never had abdominal surgery. We discharged him today and he will follow-up with GI as an outpatient. The other patient was a 75 year old man with COPD, coronary artery disease, and a newly diagnosed recurrence of squamous cell carcinoma in the right middle lobe of the lung. He was scheduled to have a triple bypass and tumor removal on Friday, but came in with a severe exacerbation of his COPD. We started him on steroids which helped him a lot, in fact he is being discharged today, but he won’t be able to have the surgery. My attending thinks he shouldn’t ever get the surgery since his risk is so high, and he could definitely be right.

This morning I rounded and wrote notes on my patients for the last time. I had evaluations with my attending, who said I did a good job and brought up the suggestion that my personality is probably more compatible with internal medicine than surgery, though he didn’t want to dissuade me from surgery if that is what I want to do. This isn’t really a surprise, I’ve known for a long time that most students interested in surgery are a lot more out-going than I am, and I definitely do not fit the stereotype of the typical surgeon. He could be right, maybe when I do the surgical rotation I won’t like it, but he could be wrong too—I’ve met easy-going surgeons. Should be interesting.

Tomorrow morning I have my shelf exam, then I have the afternoon off. The Christian Medical Association chapter at my school is having its welcome picnic for the new first years in the evening, and then my Bible study group will meet afterwards. Then Friday morning I will start surgery at my school’s main hospital. I’m hoping that I get at least one day off this weekend.