The Art of Medicine

Today was kinda the same ol' shtick. But you know how some days just aren't quite on key, today was one of those days. For example, we're standing next to a baby's room talking about what's going on with him. We're discussing that we've had to increase oxygen during feeds, the baby is growing more edematous (fancy word for swollen with water), and the lasix (a drug that makes you pee off that water) isn't doing the trick at the moment. My plan today was to get an X-ray of her chest today and consider changing or increasing his diuretics (lasix). I said my plan, which immediately was shot down (nicely of course) by the attending. Basically he said, "Lets give the lasix a bit longer to work and see how she is doing then. The X-ray won't change our plan of management."

Damn! Why didn't I think of that!

When to act, when not to act. That's one of those things that fall under "THE ART" of medicine. Going through medical school you gain the medical "language" and their way of thinking, enough so that you can see a problem when it's coming on most times. You even know enough to intervene in the "right" fashion to correct that particular problem and if you don't know, looking it up is quick and easy (usually). However, it's the experience and skill in the art of medicine that tells you when to act on what you are seeing and even if what you are seeing is "important" in the first place.
The art of medicine is where those phrases come from like "the enemy of good is better", "sometimes doing nothing is the best treatment of all", and (my favorite) "treat the patient, not the numbers". Most times I falter because I want to fix every little thing I see, "Oh! The baby's sodium is down a couple of points maybe we should supplement." My best advice, to myself, is to chill out (I constantly forget to). I find I do best when I'm loose and in the moment. It reminds me of hitting a golf ball, if you're squeezing the hell out of the club and you try to hit it with all your might, you'll shank it, which, if you are like me, you do more often than what you are trying to accomplish, which is a long drive straight down the fairway. However, there are those rare times in golf and in medicine (for me) when I hold the club just on the firm side of "loose" and instead of focusing just on the ball, you see the big picture and boy is it pretty when you see that ball fly right where you want it.
When I'm uptight and treating numbers and small signs of problems, that's when I get to putting a band aid on every little scrape I see. You become that annoying person who is always raising his/her hand in class asking pointless, insignificant questions - it's a complete waist of energy and time. (Most times patients will get better on their own if you let them - another "Art" quote) Sadly, today I was more of that person than I would like.
I know I've said this but sometimes the amount of things I need to know, the height my skill level has to reach (and where I'm currently at), it's daunting. Today I was a little depressed. If one day a person is reading this, thinking of joining the doctor ranks, I would think long and hard about it. Up to this point it has daily tested my pride, my knowledge, mental endurance, and optimism...it's something that when I'm doing well I love and when I'm doing sub par it gets me supremely discouraged. But tomorrows another day, I'll sleep, I'll wake up, and I'll try again till I get it.