I saw eight patients in clinic today, and I didn't care about any of them.
I know it's terrible to say that, but it's true. I don't know if I was unusually tired, or these patients were unusually awful, or I'm just a bad person, but they came in, I listened to their problems, I prescribed some medication, made some referrals, wrote some notes, and really didn't care about any of it. Just wanted to be done with it and come home... come home to nothing, really. The Braves-Giants playoff game on TV, I guess. Me and some Kraft Macaroni and Cheese, the Braves-Giants game, an empty e-mail inbox, and very few thoughts about these patients I saw today.
I know I complain about inpatient rotations when I'm on them, and I say I want to do outpatient work, but, man, outpatient work sucks if you don't have a life. If you have a life, it seems pretty great. You go to work, you have appointments, you come home, you make pretty good money and get to live the rest of your life. You're on call sometimes, sure, but you can own the time you're not working, and the time you're working isn't so terrible, it's pretty chill to see clinic patients, you see the same five problems, you refer the rest. But if you have nothing to come home to...
At least the insane hospital schedule lets me forget I don't have a life. How can anyone have a life working eighty hours a week, overnight every x nights, weekends, 16 hour shifts, on your feet, running codes, watching people die. You can't. You can get wrapped up in the work-- you have no choice but to get wrapped up in the work-- you can't have a life even if you want one.
But then I'm on outpatient and all of a sudden there's time to breathe, the days don't run into each other in quite the same way, I have weekends... and I have nothing to do and I realize that this can be my life if I don't do something about it. Go to work, come home, watch TV, go to sleep, do it again, and have absolutely nothing change, ever.
That's the thing about this job. Other jobs change over time. You have business trips, you work on new projects, you have things to look forward to, things to plan for. This job, you see patients. And then you see more patients. And then you see more patients. You see patients, you get paid. You sit on your couch, you don't get paid. There are no special days, there are no new projects, there are no new challenges. There are just patients and whatever they're sick with. And if I'm bored 16 months into residency, what's going to happen in five years?
Doctors don't blog. I can't quite figure out why. There is no community. There's Kevin MD and a few others, but there's not much with any real traction, at least not that I've found. Doctors write books, a few of them, Atul Gawande, Jerome Groopman, but for the most part doctors are not telling their stories. No one at work even remembers their patients from one day to the next. I feel like a lot of my co-residents wipe their memory clean every day. They barely remember each other-- or at least they barely remember me. No one reads the newspaper, no one sees movies, no one else is probably even watching this Giants-Braves game. It was like that in medical school but the excuse was medical school is insane. Now there's less of an excuse. Doctors are boring. I'm boring. Life is boring. This blog is boring. My patients are boring. Two flu shots, a urinary tract infection, bronchitis, and two referrals. Boring.