External Medicine: A Career In Internal Medicine

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The motivation to pursue Medicine as a career is frequently presented as a few typical clichés. Some say “I’ve always known that Medicine was the career for me.” While others tout “I was often sick as a child” thus “the hospital was an integral part of my life” while others use the typical “Dr. _______ changed my life and I always wanted to be just like him/ her”. While some these things ring true of my own life experience, there were numerous, sometimes unrelated factors, that have influenced my decision and fueled my desire to pursue Medicine. However, I am particularly drawn to Internal Medicine because of its complex problem solving opportunities, emphasis on team centered care, and the never-ending learning opportunities it affords.…show more content…
Though not for the faint of heart, Internal Medicine allows for a daily dose of these complex diagnostic and treatment problems. During my Internal Medicine rotation, one of my most memorable cases was a 44-year-old who presented with shortness of breath, cough, night sweats, fever, focal neurological deficits, and 45-pound weight loss in 4 months. Subsequent history revealed that he had a kidney transplant and was on immunosuppressive therapy. Imaging showed multiple lung and brain lesions highly suspicious of metastatic cancer. He was told the diagnosis would need to be confirmed by biopsy. Before the biopsy, I decided to do a “head to toe” exam and found two nodules on his scalp (hidden by his hair), a nodule in his axilla, groin, a tiny one on his forearm, and one on his foot. I proposed a diagnosis of Disseminated Nocardiosis, but was told “…when you hear hoof beats, think horses, not zebras.” The biopsy later confirmed that I had found my zebra. Yes, some puzzles are easy and many could figure it out with adequate H&P, the “bread and butter” of Internal Medicine. But then there are puzzles that I love to sit and think about. The ostensible “idiopathic” puzzles some people write off as too hard to attempt to solve. Internal Medicine allows me to become acquainted with these puzzles and presents the welcomed challenge of identifying unique, scientifically grounded ways to approach their…show more content…
I would play Point Guard, as the position suited my personality and skill. However, if at any point there was someone better suited for the position, I’d happily play Shooting Guard and do my best to help the Point do a great job. If it was best for the team, it was best to me; although not always best for me. Moreover, recognizing the value and importance of teamwork, I excel clinically because I know (from experience) what it means to be a team player. While I worked as a Registered Nurse, I quickly learned that caring for patients should be a team activity. In the hospital, Internists play Point. Whether it’s getting a Neurology consult on a difficult stroke patient or rallying the Nurses and Residents through a tough patient, an adept Internist can effectively manage their team for the benefit of the
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