Sunday, January 18, 2009

The Descent Continues

My medication change, my talk with the Site Director, my realization that if I just kept getting up in the morning, going to the hospital, coming home, taking Ambien, going to sleep, and getting up again, I could go on indefinitely. And that's what I did- I slogged back and forth between the student housing and the hospital. I ate, I slept, I did all the things and ordinary human being is supposed to do during his or her time on earth. And I fell into an equilibrium.

Realizing that things were better, but not great, I again called Dean Stewart to ask about taking time off. “Now that you’re psychiatrically stabilized, I don’t see that there’s any benefit to you taking time off…” I wanted her to understand that while I felt my feet were becoming more firmly planted beneath me, that things weren’t right. I was functioning in the hospital, puttering about, writing notes, presenting on topics; and while I wasn’t excelling, I was now certainly up to standards. She advocated self care, telling me that perhaps I should take a day off on the weekends as opposed to voluntarily going in to the hospital to see my patients.

I eventually finished my 5 weeks of internal medicine at Glendale and returned to my home hospital at [] medical school for the final five weeks of the rotation. When I arrived I’d been branded as a “student in trouble,” a distinction which awarded me “extra help” in the form of constant suggestions during my presentations. Were I not to have been branded, I believe, a lot of those little mistakes would have gone unnoticed, or would have appeared in my evaluation as qualifications to my otherwise stellar performance. But instead, my preceptor, desiring to “help” me decided to do so by bringing our preceptor sessions to a screeching halt when he sensed that I did not understand something. The other 3 people in the sessions politely waited as my presentations were drawn out and picked apart. Did I understand the difference between infection, and vasculitis? Yes, I stammered, turning red; the preceptor was doubtful that my response reflected true understanding and launched into a long explanation.