The Eve of US Medicine...

(from Eric McLaughlin)

Tomorrow morning, I will start providing patient care at a regional hospital in Western Michigan.  I will only take care of hospitalized patients.  No ICU.  No procedures.  Lots of colleagues and specialists to confer with.  Good documentation.  Low patient-to-nurse ratios.  Only 15 patients to round on.  In fact, I could probably order a CT scan for every last one of my patients, and no one would balk.  You know, for kicks.

So, no reason to be nervous, right?

All of the McCropder docs except Rachel (who is 150% mom all the time) will be doing some US medicine this year, and in fact, I'm the last to start.  People have been curious to know how we feel about that, after having been in such a different environment for 2 years.  Most days in Kenya, probably 2/3 of what I did, I hadn't known how to do before I moved there, just to give a scale to the difference in environments.

I had orientation today.  It's so different.  "Reverse culture shock" has been finished for months now (if it was ever there).  But the difference is medical cultures is so much greater than the difference is everyday cultures.  Computers are everywhere.  Patients are in individual rooms (I barely saw any of them) watching flat-screen TVs.  Everyone is documenting incessantly.  Attention to detail is meticulous.  Planning a single discharge takes a whole team of people  There are a ton of narcs on the medication sheets.

The expectations of patients and their families are so different.  The 78 year old guy with metastatic liver cancer wants everything done to prolong his life.  The son says he just doesn't think he can care for his mother at home anymore.

And yet...

And yet the primary determinant of how well (or poorly) they feel treated will probably still be the care and kindness that they feel comes (or doesn't come) from their doctors and their nurses.  And yet the medical world around them is still terrifying foreign, full of concepts and information that they don't understand, and yet they know affects them gravely.  And yet, with all of the money, and the staff, and the easy access to UpToDate, I still can't save the world (though I might be more tempted to delude myself that I can).

I remain a man with a bundle of skills that can, at times, be quite handy for bringing some healing into the middle of disease, and by God's limitless grace, some hope into the middle of fear or despair.  I still have to strive to love and care for my patients in the way that God calls me to.  I remain a sheep with a good Shepherd, who restores my soul.  And not just mine.

He has led us here.  Let us trust his goodness.  May he be glorified.

Pray for your doctors.