M4 year: the promised land?

10:59 PM

Author | Douglas Darden

Hello! As I'm sure you can tell, this is my first blog and I plan to blog the heck out of this blog.  I'll tell you a little about me first.  I'm more of a traditional medical student, in that I graduated from Lyman Briggs College at Michigan State University and went straight through to medical school.  I'm planning on going into internal medicine with an interest in cardiology. I have a younger bro who is teaching biology in Mississippi through the Mississippi Teacher Corps.  Fitness is a huge priority in my life and I still like to think I play basketball competively.

Everyone looks forward to M4 year pretty much since the first day of medical school.  Thinking you finally have some free time, get to sit around all day and play video games and sleep in until noon.  So is there really light at the end of the tunnel? So far, NO!  Let me explain...

I chose to front load my schedule, meaning that I did my two sub-internships during the first two periods -- cardiac ICU and inpatient gastroenterology.  The first week of my cardiac ICU month solidified my choice to enter internal medicine.  Patients presented with crushing substernal chest pain from a myocardial infarction were immediately relieved of the pain through cardiac catheterization and stenting, patients coming in with cardiogenic shock and heart failure and seeing the effects of all the pharmacologic pressors and diuretics we studied over the years have an immediate effect, and integrating just about every organ system into one patient's care convinced there is nothing more interesting than medicine.  As I mentioned, my second sub-internship was in gastroenterology, which was quite frustrating and discouraging at times, but still, very rewarding.  Patients with end-stage liver disease waiting for their only cure, a liver transplant, made it hard to sit back and just manage.  But when it finally comes, like during my last week on the service with a patient who spent over 40 days in the hospital, makes the long hours and hard work definitely worth it.

Also, during my GI sub-internship, we had to prep a lot of patients with GoLytely -- a notorious horrible tasting laxative that cleans out the bowel for colonoscopies.  A patient of mine had a lower GI bleed and we needed to prep him for an colonoscopy.  We tried to put an NG tube in, but he refused and was quite bitter at us afterwards.  He grabbed the GoLytely and started chugging it.  I came back 10 minutes later to see a look of disgust on his face.  He explained that it's just the nastiest thing you can possibly imagine.  I smelled it and, honestly, I thought it smelled quite tasty -- like pineapples :oP  He dared me to drink a cup of it.  I poured some in a little styrofoam cup, and my goodness, was he right.

For those who learn more visually, this is the effect of GoLytely ;o)

Now I am doing a preventive cardiology rotation, which I'll write about soon.  And in the meantime, just trying to enjoy the summer.  I played in a couple basketball tournaments, caught up with friends, and recently went to a Dave Matthews Band concert!

For those who learn more visually, this is the effect of GoLytely ;o)

So is there light at the end of tunnel?  Although I'm working harder than I did during any year of medical school right now, I couldn't imagine anything else I'd rather be doing.  Eventually, I'll have so much free time I'll probably wish I was back in the hospital.   So stay tuned for the best blog ever!

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