What (little) I've learned: medicine edition

​The practice of medicine has been part of my life for 15+ years now. The lessons keep coming. Just when I think I've got a great handle on things, new information comes out or I see something I've never seen before. 

Here's what I've learned so far in medicine.

1) The learning doesn't stop at med school, residency or fellowship. That just scratches the surface. God, I was such a little punk then. Clueless.

2) Most of what is learned doesn't come from a book. It comes from experience, or it comes from instinct (a fancy word for experience + gut feeling). And it comes from trial and error.

3) Dr. House is right. Patients lie. All the time. Unless you can get them to trust you and tell you the whole ugly truth. Sometimes this will happen. But usually not when it involves controlled substance prescriptions.

4) There is humor in anything, even the process of dying. Sounds sick, right? Many patients have told me that they appreciate feeling "human" when I can still make (appropriate of course) jokes with them, even as they enter hospice. Everyone deserves to be treated like a human, not a collection or organs.

5) Emotional separation is necessary and possibly career-preserving for the physician. It's possible to care but not absorb all of the pain and suffering. Not having this ability to separate from the situation leads to depression and burnout. (been there)

6) No way will I ever meet every single person's needs. Ever. I get hateful messages when I take a week off. Or, a patient yells at the staff to get them their prescription rightth is minute and the patient doesn't particularly care that I'm out of the office on an emergency to save a mother/baby.

7) Good nurses save my ass. And sometimes cover it. This is why I kiss theirs.

8) Calculating dosages of medication at 3am is not safe for anyone involved.

9) I would have made much more money and had much less debt and much better work hours if I'd gotten an MBA. But holding a new baby is way better than holding a spreadsheet. Any. Day. Of. The. Week.  

10) It's better to be lucky than good. Being both is nirvana.

Bonus) Spending two hours of suturing a massive injury ("I don't know how the chainsaw got away from me, doc.") is still one of the most relaxing activities around. Satisfying, too. And fun, especially when the patient regales me with tales of how the injury occurred. Sometimes these tales are even true.