Saturday, August 22, 2015

Week 39: That didn't go as planned...... at all!

Well that didn't go as planned.

This past week went everything but how I had thought it would. Monday was the most normal day out of all of them.

I came back to the hospital after the great wedding weekend motivated to work. Especially considering it was my last week in hematology and oncology and I had finally gotten to the point where I really, really liked working with my two colleagues.

Monday was a bit crazy as always. I spent the afternoon admitting patients and completing the usual long lists of examinations with them. The last patient of the day was a lady I had seen with the chief two weeks earlier in consultations. Since the chief is on vacation, I was the only one in the department who had an idea who this woman was. She has end stage pancreas cancer and let's just say her and her husband either don't want to accept the disease and acknowledge the scope of it or they really don't understand. She couldn't have the next round of chemo right away since she had elevated infection lab values. In their mind, once she gets the next chemo, the cancer will be stopped and she can live her life as it was before the cancer. The doctor and I tried to clarify some of the circumstances surrounding the disease but the two just kept being fixated on the chemo and that it'll be the cure. It isn't easy talking with them. I have no idea how I would be if I was in their position and every person is different and deals with such situations differently but the doctor and I just feel like we can't really help them grasp the scope of what is coming up for them.

During the Monday tumor board conference, I was flagged over by the chief of thoracic surgery. With a lot of brown nosing, he asked if I would be willing to assist in operations the next two days. I was sitting right next to my hem/onc doctor, he wasn't amused about giving me up for the days but sort of had to agree due to hierarchy.

The next morning, I got up earlier in order to make myself an omelet for breakfast. Not having been in an OR for a few months, I wasn't going to risk fainting. Since I had no idea when the operation would start (and not having access to the OR schedule since I'm in the internal medicine department), I snacked in between tasks and drank two cups of coffee being prepared for whenever the call came. It came at 10:30. I chugged a high energy drink and went to get scrubbed in. I most likely took in way more calories than necessary, had an overdose of caffeine and water in me but I wasn't taking any chances. (It proved to be a good amount of everything because I didn't feel fainty at any point during the 3.5 hour operation). I wasn't binge eating/caffeine drinking during my surgery rotation but my system was trained for long days in the OR. Not having operated in a while, I had to make sure I wouldn't feel sleepy or have low blood pressure (caffeine), wouldn't be hungry (high caloric drink, breakfast, KIND bar, chocolate bar) or thirsty (a liter of water) and made sure to empty my bladder just before entering the OR area. 
I think I ate about 11 of these throughout the week

I assisted in a partial removal of the right lung. It was a fun operation. Aside from the technical aspect of it all, the conversations we had while working were fun. The chief told that he didn't like the idea of me going back to the States. He offered me a job in his department. He proceeded to offer me a husband and house as well! He told me that his wife's brother is a really great guy, tall, good looking, works in media/broadcasting at a major German television station and would be moving to Hannover in October. The chief said he'd make sure I got a house in a nice part of town. He assured me the guy liked traveling and would love kids. In theory, it all sounded great. I threatened the chief with the prospect of having to deal with me a lot more if that all happened. He said he wouldn't mind. Oh man. This is just one of many situations I've had the last few months as my departure from Germany comes closer. Relatives are making me offers in hopes of keeping me around; “Vik, I have two private practices you could work in, the doctors there will be retiring in a few years and it can be yours!” I truly appreciate the love and effort and if I could live parallel lives, I would. If the States would accept my German residency I'd even consider it all. But the circumstances don't allow it if I ever want to work in the states and not redo my residency. I approach my return to the states with big time mixed feelings.

Wednesday, I took the elective student with me into the ER because she had never been and was supposed to assist the second operation. This time, we were supposed to go to the ER first thing in the morning. Again, I made eggs for breakfast, snacked along the way, chugged a coffee and a high caloric drink before entering the OR. Again, we took out a part of a lung. I was allowed to do a bit more this time around. Parallel, we all helped the elective student adapt to the new environment. She was lucky to have had such a great team as her first. It can sometimes be pretty ugly in the OR. Especially when everyone is stressed and gets snappy. That wasn't the case in the thoracic surgery OR however.

So after a quick rendevous with surgery, I thought the rest of the week would go as planned. That wishful bubble quickly burst when I woke up to a text message from my uncle (who at the time was on vacation in Italy) that my grandma had fallen the night before and was in the hospital. I called him, although it was 6AM. He told me that my grandma had fallen about 5 feet down. The miracle of the whole thing is that she supposedly didn't break a single bone. I called the hospital at 7AM, very well knowing that I wouldn't be able to talk to a doctor. The nurses told me that she had gotten through the night just fine and that nothing was broken but that they couldn't tell me more than that (something I totally understood due to confidentiality). They said it would be good if I stopped by to bring her some things. I partly laughed and told them that “stopping by” wasn't quite as easily done as said. It would take me 4 hours by train to even get there, not to mention I still had to go to work.

I had packed most of my things for my planned Munich weekend the night before, I threw in a few missing things (still missing things in the process as I noticed later) and took the train to work as usual. When I got there, I told my doctors what had happened and that I wanted to leave work as soon as possible and would be taking a vacation day for Friday. Nonetheless, I wanted to complete the intern tasks and not bother anyone else with them. I participated in rounds which seemed to drag on before leaving. I was bummed. I had looked forward to two fun days with the guys and those had to be cut way short. Obviously, fallen grandma trumps fun at work. I'm in the fortunate position as an intern to just take a vacation day without much notice (notice is appreciated but not mandatory).

I had to take the train to my home town first to drop off some things I had planned to drop off after work but had to be taken care of that day (otherwise I would have taken a train immediately to my grandma and not take the detour back to my hometown). I felt under extreme stress the whole first half of the day with all the running around and catching trains. Once I got to my grandma's town, it was a series of taxi rides to get to and fro from the house and get the key for my grandma's car from her at the hospital.

She is doing alright. Her back and ribs hurt understandably. Again, it is a miracle that my 85 year old grandma didn't break a single bone in that fall/tumble/stop. I was there too late to talk to a doctor. I already knew they'd be done for the day and the on call doctor wouldn't have been much help.

It is weird being so close to being a doctor myself and then having to be the patient's relative. I walked a fine line between doctor and relative, not trying to step on anyones toes but also fulfilling the tasks my uncle and dad had given me. I was especially considerate of the nurses knowing how annoying it can be to have a patient's relative constantly wanting to know something and even better, try to change something about the course of treatment.

This morning, I finally got to talk to the doctor. Again, I took steps to assure that I wasn't trying to hijack my grandma's treatment plan and that I respect and trust their work but that I had to be the messenger for a few of my dad's and uncle's questions/requests. I tried to avoid all the annoying things I've come to experience over the years of working in the hospital. I think I did an ok job and none of them dislike me....or at least I hope.

So although nothing this week really went as planned, one thing didn't change, the fact that I will be spending some days in Munich visiting friends and family. I might head back a day early and back up to Grandma if need be but otherwise I'll be back up in that corner of the country next weekend anyways.

Without further ado, I hope you all have a healthy and fun weekend!


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