Sunday, May 1, 2011

The mother of all updates

It's May!

This past month, I've been on the pulmonary consult service, a welcome respite from back-to-back critical care, then wards ... then wards again, starting next week. Life on the pulmonary consult service is relaxed, for the simple reason that the commonest breathing problems in the hospital are readily handled by generalists (pneumonia, asthma exacerbation, COPD exacerbation) or are so severe that they require mechanical ventilation in the ICU, in which case, the attending physician is generally a pulmonologist anyway. So we don't see too many consults on the intpatient pulmonary consult service, and the cases we do see have been fascinating esoterica. Lung inflammation caused by chemotherapy, or rheumatioid arthritis, or amiodarone. New lung nodules in a immunosuppressed woman already on serious anti-fungal therapy. Shortness of breath in a pregnant woman with a rare clotting disorder. Massive and disseminated tuberculosis infection that initially presented with an esophageal ulcer. In other words, fun!

Which leads me to: I have a humbling confession. After years of generally cursing myself for choosing to go to medical school, ranting to basically anyone who would listen about the mess that is contemporary American health care, griping about my hours and my patients and my paycheck ... I actually like my job. And not for any reason that I clung to as a pre-medical student; not for any reason that featured prominently in my various personal statements over the years. Helping people? Ha. Science? Whatever. Fair compensation for the my time and efforts? Hilarious. No, what I like -- what I am coming to treasure -- about my job is something much more pedestrian. As a physician, I have a truly unusual opportunity every single day to be kind to someone who needs kindness. I don't have to seek them out; they come to me. It's an honor, this job, and a blessing to recognize it, however belatedly.

In other news, we've had a number of occasions and celebrations since I last posted. Sam's third birthday was back in March.















And because I can't stop myself, a few more:









In other-other news, I am pregnant, due in late October. I feel well and the baby appears to be healthy and growing. Brian and I are elated and Sam is absorbing the news in his own way. Which is to say, intuitively and incompletely and sweetly.

Easter pictures soon!