Geriatrics (Part 3/3, RETROSPECTIVE POST)

I was trying to gain as much Experience as possible prior to my Semester 12 Rotations and (deferred) Internship with regards to Paperwork and Physical Exams (Visual Acuity, UL & LL Exam, also Ankle-Brachial Pressure Index), and was very proactive in asking the Interns and Residents for Things I could assist in. Part of me wonders if my Motivation to do all this was also to please and be liked by Colleagues? I didn’t want to be known as a People-Pleaser, but having been through my horrible Childhood, wanting to gain Approval was quite tempting. Is this low Self-Esteem or Insecurity speaking? The more things I did for them, the happier they seemingly became, and I became even more motivated to help them. It was like a Positive Feedback Loop. It was almost as if I was doing the Extra Work not because I wanted to bend over my back to help the Patient, but because I wanted to help the Doctors, to do something important and be valued by them.

It was during this Elective in which I frequently came to the Hospital on the Weekends to work on the Draft Discharge Summaries. The Nurse Unit Manager was so impressed by my Diligence that she even bought me a little Cake the following Monday, which I wasn’t able to eat coz I was at a Medical Appointment IIRC. On the final Day of the Elective though, the Registrar actually told me that whilst she appreciated my Efforts to be helpful, I needed to look after myself as well, and that it was important to rest on the Weekends when off-duty for the purposes of sustaining yourself.

Doctors are Human after all, they’re not G-ds or Machines, and they also need to have their Physical Needs satisfied, so they’re more likely to perform at an appropriate Level when at Work. Interestingly she also said that there wasn’t much Point in doing all these Discharge Summaries for Internship Preparation coz she believed I was going to forget all of that Knowledge, and would be better off learning it soon before/after Internship started. She believed that I was taking a long time to complete the Discharge Summaries coz I wasn’t the main Doctor looking after them, and thus wouldn’t be able to recall the Patient’s “Story” quickly off the top of my Head. That may be true, but I was also concerned that it was also due to my intuitively reduced Ability to see the “Big Picture” and instead process all the Medical Issues and Management as little Details, thus bogging me down. I’ve identified a possible weak point and will explore this later on.

She also said it was a common Phenomenon for new Interns to go through a Phase where they get paranoid about the Medication they’re prescribing, that it might accidentally harm the Patient, eg “Panadol causing Acute Liver Failure” even though people buy it Over-the-Counter at Pharmacies and use it all the time. It was comforting in that I wasn’t alone. My Experiences during this Elective really hit me, that if uncontrolled, I could easily go overboard with Work, which is facilitated by the Aspie Hyperfocus Tendencies, and let Medicine take over my Life. I will need to actively recognize and set Boundaries in order to maintain a Work-Life Balance…

I was extremely satisfied from my Geriatrics Elective, not only from the Patient Aspect (as with Paediatrics), but from the Staff who I interacted with. My Impression is that how much you enjoy a Rotation can also be influenced by the Staff (Doctors and Nurses) you meet from that Specialty. I appreciated that the Staff made the Effort to help the Patients each Day even though the Recovery Process frequently seemed rather slow. In Fact, a Handful of Patients I met at the start of the Elective were STILL at the Hospital when I was nearing the End!!!

From an Academic Perspective, I’d strongly recommend a Geriatrics Elective for Medical Students who aren’t sure what Specialty to do an Elective in, given the high prevalence of elderly Patients in Hospitals, or want to gain some Generalist Experience in “General / Internal Medicine” but with a “Twist”. It’s very eye-opening and heart-breaking at Times, but one could learn a LOT, both Medically and Socio-Emotionally.