Reflection on Family Medicine, Rotation 2

In Uncategorized on August 22, 2012 by David

Just as my internal medicine block showed me how much I really enjoy medicine,  of taking care of people, and understanding how things work, family medicine reminded me that there is more to life than just medicine. The last eight weeks have been amazingly fulfilling in an entirely different way. Reconnecting with old friends, hanging out with new friends, and working on side projects, there are so many things that I enjoy in addition to great medicine.

To be fair, there was great medicine on family medicine. Some really interesting pathologies, really nice patients, and learning extremely useful skills in dealing with the kind of illnesses, malaise, and disease that affect most individuals, including me and my family. But if I had to be honest, the most memorable part of the last eight weeks was what I did outside of medicine.

For the first two weeks of block 2, I took vacation to work on a side project with Aron. We took over and squatted in a conference room in Mission Bay for the entire two weeks, and proceeded to work. For almost every day during that time period, our routine would be to drive to Mission Bay about 9AM, review what work we need to get done, work until 7-8PM (with lunch mixed in the late afternoon), summarize what we did that day, and then go home and grab food. Since it was Aron’s first time in San Francisco, we checked out a few of my favorite food places in San Francisco – I almost got Aron to do the pho challenge at Pho Garden. Haha. It was a learning experience in how to deal with people, as we had to deal with working to find a new mobile developer and close things out with our old mobile developer. It was also eye opening on how unpredictable and challenging work can be – some of the things that we imagined would take the least time in fact took the most time, and our initial goals for the two weeks turned out to be quite optimistic. Regardless, it was an amazingly fun experience, to be able to work hard on things that I was passionate about with people who share similar goals and similar work ethics. The tail end of the second week was also July 4th and Grace came to visit Aron, and it was fun showing them around the bay area. Hopefully I can convince more friends to move over here. Haha.

The next six weeks was my actual Family Medicine rotation. On Mondays, I was at Palo Alto Medical Foundation in PA. It was actually quite enjoyable to drive down the 280 early in the morning, listening to the radio and getting lost in my thoughts. Since it was a far drive, and I don’t often have the opportunity to visit south bay, I took full advantage of my time and went to see lots of people. I hung out with Brian, Irene, and Michael a few times – intern year is surprisingly chill relaxed for them. I guess without evaluations looming overhead, it is really just an opportunity to learn, immerse yourself in the medicine, and enjoy the time. I stayed overnight with Brohaus a few times, it was good to see all of them again. Even after 5 years now, some things never change. Haha.

On Tuesdays, I had my longitudinal clinic in Radiation Oncology/Head and Neck Cancer at Mt. Zion in the afternoon. The pathology is really amazing, and it continuously reminds me how much more there is for me to learn. I stand around awkwardly without the answers when patients ask me questions. Thursdays and Fridays were General Family Medicine at Lakeshore, here in San Francisco. That was a great experience, as I really felt like I had autonomy and able to do more for my patients. I learned a lot about the general aches and groans that all people face, things that I face – from knee pain after running to slightly elevated cholesterol with a poor diet. Deep down, I still feel like a little boy, but I feel both honored and surprised that people take my recommendations seriously. Seriously, what does David know? 😛

Wednesdays was didactics and geriatrics home visits. Seeing geriatric medicine really reminds me how precious life is, as we grapple with the challenges of end of life care, goals of care discussion, how to minimize the symptoms of neurodegenerative disease, and how to cope with the inevitable frailty and loss of reserve. After seeing elderly patients and seeing the natural, although sometimes not graceful, decline we all face, I am skeptical by how some people view the future and longevity. Calling it a singularity, or the idea that exponentially increasing knowledge will somehow naturally result in miracle cures for a longer, healthier life, these ideas are just our generation’s reframing of the fountain of youth. Idealistic but unrealistic. It is perhaps telling that no one with rigorous medical or biology training champion this idea of singularity, but is rooted in the optimism of electronics and software development where rapid change in the rule. The discussions on Quora always start with Moore’s law – that there is accelerating innovation in electronics and hardware, and with sufficient handwaving, that can be translated to medicine and health.  I think there are physical laws of nature that naturally dictate how long we can give, and better nutrition or supplementation will only result in diminishing returns. Immortality is just a dream of the young. Enjoy the time we have here.

For the next six weeks, I am on Pediatrics! With kids! Maybe I will be more optimistic about long life there! 😛 Hopefully I don’t get sick! Haha. Cheers to a good time at Parnassus.


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