September: Allergy/Immunology, Adventures in Research, and a Sick Day

Hey guys! This post took a really long time to write and polish, but I felt like it addressed some important issues. Sorry for the delay! October post coming up soon! 


It's late September. I'm at home taking the first sick day I can actually ever remember since middle school, and contemplating life. I've been such a go-getting, get things done person, that even on the days I feel bad, I get up and do the best I can. I don't want to inconvenience other people. I want to make sure I am getting my job done.

But this morning, as I coughed my way through eating breakfast and getting ready for the day, I realized that going to work was a really bad idea. For one, coughing hard enough to make myself dizzy and give myself nosebleeds was a really bad sign. For another, I could barely remember the phone number for our office (which usually I can rattle off the top of my head with no problem), and I just plain felt bad. It was time to stop.

 I felt absolute guilty for calling so last minute and canceling. I imagined my patients already there, waiting for me and not being able to see me. I imagined my poor coworker, having to see all of his patients and all of my patients. It would be insanity.

But I couldn't see straight enough to walk across my living room, much less walk down the stairs, drive to work, walk across the parking lot, into the building, up 5 flights of stairs, and into the madhouse that our clinic usually becomes. I just couldn't.

So, on a perfectly sunny Thursday, 15 minutes before I was supposed to start clinic, already dressed in my work clothes and white coat, I called in sick for the first time in my adult life. It was painful. It was guilt-ridden. It was glorious.

As residents, and especially as health care workers, we are told that our job is essential. We must show up to work every day, and we must do our job well. Do not be late. Do not take unnecessary time off. Do not inconvenience others. These mantras are ingrained into our minds as students, and continue for the rest of our lives. One of the popular medical blogs, KevinMD, has published several articles recounting this particular dilemma. It is inconvenient to our schedules, the patients, the medical staff, and our fellow residents and physicians if we have to call in sick. Many times, there are horror stories of physicians who were ill and were required to work as well as many examples of physicians who work through illnesses , whether their own, or those of their loved ones "by choice" as the alternative would be more inconvenient to their patients and coworkers.

In one of the above articles, the internal medicine physician whose children are ill mentions that the patient she discharged for bronchitis asked for a work note and "a few days off", and the physician was envious. I often thought the same thing when I saw my patients in the clinic, who have guaranteed vacation time, a regular 40 hour work week, and guaranteed sick days. But then again, we as medical professionals did enter into this strange dichotomy somewhat by choice. We wanted to become physicians, to help others with the knowledge and skill that we have attained after sacrificing our youth, energy, and sleep. But we are not always able to take care of ourselves.

After reading the countless horror stories of medical professionals forced to work, I am ever-so-grateful to our changing times and modern GME requirements. I am grateful to the culture of my program and the understanding program directors and GME coordinator, who all supported my decision to stay home, and called me to make sure I was okay. I was able to catch up on well-needed rest (after coughing all day), and was able to return to work the next day, still hoarse, but no longer dizzy.

Adventures in Research

To graduate from residency, I am required to complete two research projects, one of which must be a quality improvement project. As I am in the second year of the four year residency, it was time to start getting my feet wet. Our hospital, and the programs associated, are not known for its medical research culture. In fact, our first day of orientation as interns, we were advised by the grants coordinator (the closest thing we had to a research coordinator), that we were better off  "tagging on to someone else's research" than starting our own, and "just get your name on a paper" so that we could "get it done and over with." It was quite discouraging. As we are a community-based hospital, I knew that we weren't going to be in research mecca, but it would have been nice to have a little bit more guidance. Thank goodness, I am on Allergy/Immunology this month, and the program director there was starting a module-based program to educate osteopathic physicians on medical research. Thus, my afternoons and nights have been filled with watching research videos and taking copious notes, and plotting for research. It has been tedious, and difficult, and my knitting has suffered, but hopefully worth everything in the end.

Allergy and Immunology
Allergy and immunology has been the most interesting month so far. It is such a sub-specialty field that I felt quite out of my depth when I first arrived. All of the patients we were seeing were patients that I had only read about in my textbooks and told that "most likely, you will never see one of these patients in person". But Di-George, Common Variable Immunodeficiency, B-Cell Lymphoma, were patients that the fellows no longer even batted an eyelash at. They were the "run-of-the-mill" patients. It was bizarre. Gradually, though, I learned what they were looking for, and how I could contribute. The physicians were great at diagnosis, but awful at doing osteopathic exams on their patients. Every chance I had, I would treat the patients with OMT, which increased the reimbursement that the physicians could charge for.

<Knitting content>
There isn't much knitting content this month, as I was gearing up towards getting my IRB completed and because I was getting ready for my friend Liz's wedding. I did finish up some baby sweaters in preparation for my friend Laura's twins. I will be carpooling with Laura on the way to New York, so I wanted to give them something.

That's quite a bit more exposition than normal, but hopefully more knitting content next post! Spoiler: I am going to Rhinebeck!