I find my job a delight
Even when working at night
On this I won’t budge,
I’m a doc, not a judge,
And there’s always something to write.
I have decided to reopen my blog after a year’s absence. I miss writing, and I miss the immediacy that comes to my life when I go through my day thinking about my post. I’ve been at my new job a year now.
My workplace runs on teamwork; I’ve never been any place where people seek out so many opportunities to help their coworkers.
Our patients have few resources; 50% have no insurance, 35% have Medicare or Medicaid, and 15% have commercial health insurance.
I see a lot of schizophrenics, people whom our society has failed badly. I’m sure if they could push a button and come to a closer contact with reality, they would. As it is, they hear voices when they don’t take their meds and sometimes even when they do. An extraordinary number also carry a diagnosis of bipolar. Almost all smoke, and, given enough time, almost all develop insulin dependent diabetes.
I find it easy to avoid judging the schizophrenics; they did not ask for their problems. The less I judge my patients, the more energy I have at the end of the day.
We have so many patients from Ethiopia and Somalia that we have Oromo, Amharic, and Somali translators, and I’ve learned to say Hello, How are you, and Thank you. Mostly hardworking, family oriented people, they came here after unspeakable horrors.
Many of the people who come to my clinic have been behind bars. I don’t ask them why. After all, I did not train as a judge. Those folks have done their time and my job, as I see it, demands that I focus on what can be done in the future, not what has already passed.
I start Mondays with hospital rounds till noon, then clinic till 8:00PM. I’m on call 35 Tuesdays per year. Most call nights I work straight through till after 9:00 PM. I start Wednesdays at 7:00AM and finish around 6:00PM.
I have Thursday off, along with Friday, Saturday and Sunday if I don’t have call. I still put in 48 hours weekly.
Yet I worked no more than two days a week in the last six weeks, which I found unfulfilling. I arrive at work Monday mornings cheerful and happy to be back, and I go home on Wednesdays ready for the weekend.
Saturday/Sunday call a year ago ran to fewer than 10 patients between two hospitals, but practice growth led to mission creep, and now a hospital census can run upwards of three dozen. At any one time, we usually have three patients in liver failure, and three in active alcohol withdrawal. A surprising number of non-alcoholics end up with cirrhosis. About half our hospital patients also show up on the dialysis service. Mental health census averages 5.
Our patients get sicker younger than any patient population I’ve seen before, which surprisingly, gives me more hope.
Tags: alcohol withdrawal, alcoholic, Amharic, bipolar, call, cirrhosis, commercial health insurance, diabetes, dialysis, Ethiopia, liver failure, Medicaid, Medicare, on call, Oromo, prison, schizophrenic, Somali