We asked a number of our residents to describe what a typical day looks like. We are grateful to share their stories in this series of diaries.
As the trees start to change colors in the fall, I reflect on how far I have come in just a few months of internal medicine residency. As an ex-general surgery resident, my life has come full circle to a second intern year. I ranked the University of Iowa Hospitals and Clinics #1 for internal medicine because of the strongly positive culture that I witnessed here on my interview day; one of respect, camaraderie, and warmth. Even as the temperature drops and winter grows near, this warmth carries me through each day at the hospital.
A typical day at UIHC is fast-paced and immersive. I have found myself managing unique challenges on a regular basis. I love the thrill of the unknown; how will I have to apply myself today? My cell phone ‘clock tower’ themed alarm goes off at 5:45 AM, timed 15-minutes before my back-up alarm clock. Every morning I like to have 5-minutes of mindfulness meditation, where I reflect on gratitude and my quest for intrinsic fulfillment. Centering myself in this way brings serenity to the start of my day. I pick which color of Figs’ scrubs I’ll wear and get ready to head over to the inpatient hematology-oncology unit on 4JP.
As I arrive to the team work-room at 6:45 AM, my friend and co-intern greets me happily. He’s been on call with cross-cover overnight, and is looking forward to giving me sign-out about my patients. Seeing a familiar face brightens both of our mornings, and we go through our hand-off meticulously. As I begin my routine of EPIC chart checking, I make note of important information like vitals, labs, consultant notes, and plan my pre-rounding system. I enjoy spending cherished moments of quality time with my patients in the mornings, discussing how they feel and what they’ll have for breakfast. Cancer patients’ clinical course can be tenuous, and pivotal conversations like these can affect their mood and outlook. At 8:00 AM, my attending comes in and we prepare to round as a team. As we discuss each case thoroughly, I share my ideas about the treatment plan. I’m often wrong, but that helps me learn!
Rounding as a team is always fun, involving some great conversations and perspectives from the attending and senior. Listening to their stories gives me insight into what my future will look like. After rounds, I often need to have heavy goals of care discussions with my patients, their family members, and the palliative care team. This rotation is particularly challenging in this regard, but it helps me to refine my communication style. I am always trying to enhance my active listening skills, deepen my empathy, and be there for my patients in an emotionally intelligent, perceptive way. Sometimes simply being there, not as a doctor, but as a friend, goes a long way. As I ponder, a piece I heard in a resident orientation lecture pops into my mind: “being worthy to serve the suffering.”
After placing consults, writing orders, finishing notes, and triple-checking my to-do list, it’s time for noon conference! Lunch is always provided and is very tasty, I get to see all my friends and listen to a thought-provoking lecture about an interesting clinical topic. My pager is covered by the administration during this hour so that I can truly connect to my education. Noon conference usually brings me another five minutes of mindfulness as I pause the day just to reflect. Often times I remind myself of how lucky I am to get to do what I truly love on a daily basis.
At 1 PM I head back to the wards, and usually take a new admit or two. Sometimes, even three or four! Placing admit orders, writing the history and physical, and seeing new patients is always exciting because it gets my mind rolling about the new treatment plan. If there aren’t any new admits, I like to spend the afternoon talking to my patients in further detail, and getting to know them more personally. Connecting with my patients in a way that they benefit from on a mental, emotional, psychological, and humane level is of utmost importance to me. I often have my patients pinky promise me that they will follow through on an element of their care, like taking their medications properly or prioritizing their mental health by doing something that’s good for their soul regularly. I have found that putting energy into creating such a heartwarming bond is where fulfillment lies, which is something I often think about. I carry a journal and write my thoughts down throughout the day whenever I pause to reflect about my existential questions regarding meaning and purpose as a physician, and my place in the universe.
By the time sign-out at 5 PM rolls around, the day has been rewarding in more ways than one. I hand-off my patients and rest assured that they are in good hands for the night. As I drive home, I reflect on how different my life was in surgery and feel a rush of gratitude. The evening flows into tranquility with my rose-scented candles and black-leather diary; after I cook some ravioli while losing myself in an instrumental piece by Debussy, I step outside to my starlit balcony and breathe a sigh of relief. It is finally true: I have found my place, my people, and my purpose.