The attending physician on my team and I had a good farewell chat today. He asked me for my critiques of our workflow and structure as an internal medicine team. I was pleasantly surprised to be able to open up to him about what I find remarkably troubling about the hospital (the windowless rooms, the lack of green spaces for workers and patients/families, the silo-ing of departments, the lack of time afforded to residents/interns/students to spend with patients after rounds end, the inefficiency of inter-team communications, the constant deluge of new information and feeling like it’s impossible to learn it all so quickly.) It was a good conversation. He offered me a few take-home points for my time moving forward on the IM service. Here are some notes I took:
+ Absolve yourself of self-judgement regarding how much you “must know” about the minute details regarding diseases/medications/physiology (in regard particularly to board exams). Instead, deepen your care for your patients ; then, you’ll be able to go find any nuanced, detailed information about their disease process/medications you “don’t know” when you need it. Don’t get lost in the scientific details and then forget to take time to also know your patients.
+ Healthcare systems, including our hospital, do not exist outside capitalist ideology. Doctors, nurses, social workers, and pharmacists are all workers in a very traditional, capitalist sense. I found this a refreshing reminder. Analyzing my time at the hospital with more of an anti-capitalist lens regarding the structures and functions of the workplace and how that intersects with the production of capital is helpful for me.
+ Start each day with an objective in mind. What can I learn, observe, witness, investigate each day? Take advantage of time in the hospital as something I may never have again (since it’s looking like a hospital is not my ideal future work environment…).
+ Keep dreaming big. What could hospitals look like if they centered their work around people rather than profits? Make this part of your work. There is no need to accept normative models as necessary in the future of healthcare.
+ We see people in the hospital at a breaking point in their disease process. There is value in following their disease up-stream, to the time before they emerged in the hospital, to find out the roots of illness. What can I do about up-stream causes of disease? This is a rich place of inquiry for me.
karuṇā 