pieces

i am a loosely assembled, poorly glued, pile of pieces. each moment, i feel like i am actually holding myself a bit tight, in hopes of not completely falling apart. not in a psychological way - no, no time for that luxury. just in general, in a practical, daily-living, passing-rotation, not killing my patients, kind of way.

yeah.

my living room floor consists of piles of mail (one for each day) that i dump and ignore as soon as i close the front door behind me, as well as piles of books i meant to use, piles of papers and articles i bring in from the hospital hoping to put to some sort of use. my kitchen is comprised of stacks of dirty cups and dishes, my bathroom is relatively benign, my bedroom has turned into my walk-in closet.

medicine has exhausting hours, remarkable demands. i have never learned so much in so little time.

wednesday was my 30 hour call day. this time i wasn't as sick, just a honking cough i sometimes slipped into mid-sentence. i got two patients, both complicated, though one remarkably more than the other. i worked on them most of the day and late into the night and began to write my notes up around 1am. at 5am, i rounded on them again, and began progress notes. we rounded, i got home at noon. ran errands, got into bed by 5pm. slept and slept until waking up this morning at 5am, exhausted, to rush to work. today flew by again, and now i am here, overwhelmed by the amount of work i still have to do tonight -juggling three unrealistic hypothetical scenerios of the things i will accomplish before bedtime - and it will be back to the grind tomorrow at 6.

i realized today, that unlike any other type of medicine, internal medicine is about working with the sickest of the sick. people whose bodies have fallen apart, in multiple ways, usually clinging onto days, weeks, months, or sometimes years. we try to make them feel better and occasionally, remind them it's ok to die.

anyway. scattered. tired. overwhelmded. i think i'm happy. but i don't really have time or energy to think about that. (and anyway, as we say in medicine: why order such a test? what would you do with the results when you got them?)

am learning a lot. meeting amazing people. meeting amazingly sick people. learning how to put put their broken pieces back together, at least for a while.