I may not do medicine

I might've been alarmed if someone told me three years ago that 2 months into my 3rd year of medical school, I would decide that I don't want to do medicine. However, that's the direction I'm leaning right now, and it doesn't bother me at all. Healthcare is so specialized these days that "medicine" is just one specialty among many. "Medicine" refers to general medicine, which can either be a practice in itself or a launching board into things like cardiology and oncology. However, "medicine", with all of the subspecialties it entails, encompasses just one of many alternative categories that a medical student can go into, the others being surgery, pediatrics, neurology, psychiatry, and OB/Gyn.

For my first two months of 3rd year, I worked on inpatient medicine wards at two different hospitals. Generally, the patients we took care of were extremely sick and required quite a bit of care. I have a lot of respect for the doctors that work in inpatient medicine for a living, "hospitalists", as they are now called. It's a tiring job in which you see quite a high turnover in patients, with the end goal of improving patients' quality of life just enough so that they can make it through the acute condition that brought them to the hospital and then leave and hopefully be followed up by their primary care doctors or specialists on an outpatient basis. Hospitalists deal with the sickest of the sick, and their knowledge must be broad because they see any and all conditions that meet inpatient criteria. They have to know how to treat all these things, and, equally as important, they have to know their limits and when to refer to other services within the hospital.

The thing that struck me most about the hospitalists I worked with is that they truly care for the patients they see. Other services would briefly consult one of our patients, and follow up once a day perhaps, but the hospitalists took care of each patient as if he/she was their last. While a specialist sees a patient as a particular problem - kidney doctors fix the renal failure in Mr. B, while liver docs fix Mr. B's liver failure - the hospitalists sees the patient as a person. Mr. B is a 39yo male who is unemployed, trying to quit drinking alcohol, and currently having a hard time dealing with pneumonia on top of his kidney and liver failure. It may seem like a subtle difference, but it's one I've begun to appreciate in the past 2 months, and it's the one reason why I haven't ruled out internal medicine as a career. I'd like to view my patients as people, not problems. However, I can also see myself getting burnt out very quickly working on an inpatient hospital ward because it requires such intense care.

We'll see how the year goes. I'm currently doing a month of outpatient medicine with a community physician and really enjoying it. He's a doctor who's been in practice for about 12 years, and has been seeing many of his patients throughout that entire time. He knows their histories, their families, and their struggles. It makes for a really rewarding experience.

Here's one of the first pictures I took with my camera, probably about 7-8 years ago. It's at the Huntington Library in Pasadena.