Talk about continuity!

You probably remember my excitement at being able to provide continuity of care on my Ob/Gyn rotation to a woman (OK, girl) who I saw at my clinic, then saw again in labor and delivery. Well, Dr. HWong14's continuity of care just got bigger and better. This week, we had a little 4-month-old baby with RSV bronchiolitis, and on morning rounds I could not stop staring at his mom. I noticed that she had really thin, stringy hair and looked "older than her stated age" (though not by much). Then I had a really strong sense of deja vu, which isn't unusual for me, but this time I realized it was real! I had seen her before! And thought the same thing about her hair! But where? In clinic? On surgery? No -- on Ob/Gyn! I asked mom where she delivered, and she said at University. I checked the baby's birthdate on his chart -- July 24. I was at private practice then, so I couldn't have delivered her. It took another day, but I finally figured it out -- when I was manning L&D triage, she came back in a week after her C-section to have her staples removed, and I removed her staples. I saw that little baby when he was just a week old, and now I was taking care of him four months later. So cool!

I've had another sort-of continuity experience as well -- at the beginning of last week, we rounded with the other half of our team, and when we entered this little boy Jacob's room, I knew I had seen him before. And the woman with him looked very familiar, too. All of a sudden, it hit us at the same time and we interrupted rounds to exclaim that we had seen each other just two weeks prior in outpatient clinic! She was Jacob's grandmother, who took care of him and his sister because his mom had been diagnosed with a brain tumor right after the daughter was born earlier this year. It's a really sad story, but that family is so amazing. Well, Jacob was diagnosed with adenovirus pneumonia, and by the end of the week, his sister was admitted for RSV. Talk about social stressors. It was nice to see Jacob again (I had seen him in clinic for a well-child checkup) even though it was under such difficult circumstances. Plus, he was absolutely the cutest boy in the entire world.

So I guess since I get excited by continuity, that I'm more cut out for primary care than I thought. Plus, it turns out I HATE hospital medicine. I hate rounding every day. I hate the "wait and see" of long-term illnesses. Especially when there are no more labs or radiology tests to perform on a daily basis. You mean we just have to wait for the patient to get well enough to go home?? It drives me crazy! And rounding is so boring -- walking around to every patient's room every morning takes hours! I don't get to actually start on the day's work until after lunch! I mentioned this to Eric the other day and he asked what I would rather be doing during the time we spend rounding. My answer? "Cutting people open." Yeah, I know, I have problems.

Surgery isn't the only thing I like. I like clinic better than outpatient medicine because there's an immediate goal: discharging the patient. I see the patient, figure out what's wrong, figure out what I'm going to do about it, and send the patient on his or her way. Sure, some things need referrals and further workup, but I resolve the issue at hand and grab the next chart. Keep the line moving, get everyone seen. No wonder I've always been drawn to emergency medicine, too. If only emergency medicine wasn't, as one anesthesiology resident put it, "clinic for crackheads."