I will tell you that being on inpatient internal medicine wards is just tough—it’s one of the tougher months during residency. Typically, patients are very sick. I’m at the VA, so many of them are much older and/or at the end of their life. And let me tell you, that is HARD! Besides the incredibly early mornings and very long days (which I am not a fan of), the hardest part is watching my patients pass.
Here lately, it feels we keep getting the sickest of the sick. Some are lonely and just pass without anyone present. Others have so much support from their families. That is just tough. I’m definitely not meant to be a palliative care physician. I don’t think I could even be a hospitalist or geriatrician. It’s so difficult to watch.
I know you can play an integral role in helping the patient and in helping the family heal, but it is just so hard sometimes. I’m an emotional person. You can always read it all over my face. We have one patient on our service who is nearing the end. He is breathing 8 times per minute with max oxygen. It’s sad. Seeing his daughter and his son try to hold it together as we update them—it’s all just so sad.
I watched them hold onto him as they wept. I had to step out. It was just so difficult. I wish this patient and his family the best. Medicine can be difficult, but it can also be very rewarding. I realize there are times where I’m the patient’s only advocate. Medicine is not for everyone, but I’ll tell you this—I’d do it all over again.
Thoughts from a psychiatry resident physician,
Dr. AKP
