This week I started my four-week rotation in Internal Medicine.  I am rotating with a H in north Phoenix, and I absolutely love it!  I was unsure about this rotation, as I have heard it is a hard specialty to rotate in, but so far, so good!

Starting a new rotation is always nerve-wracking.  I get really nervous about meeting my preceptor.  I never know if they will be nice and easy-going or if they will be tough and expect too much of me.  And I get really, really nervous to tell them I am breastfeeding.  It just sucks that one of the first things I have to tell a new preceptor is that I need to take breaks to pump.  I just fear that they will immediately peg me as a slacker or someone who doesn’t take rotations seriously.

Luckily, my preceptor was immediately understanding.  He directed me to some nurses who showed me where I could store my pump.  There was even a nurse who is pumping too, so she showed me the room she uses, which was really nice of her.  It definitely makes me feel better when I have everything figured out.

I am fairly sure I want to go into Internal Medicine, but I had never really thought about being a Hospitalist.  Day One on this rotation, I thought, “Nah, this isn’t for me.”  We were seeing patients the doctor had never seen before, and it just felt like we wouldn’t get to build a relationship with them, which is something I would like to do.  But the next day, we saw most of the same patients, so we started to get to know them as we followed up with them.

I was also assigned four of my own patients, so first thing the next morning I rounded on them…by myself!  I actually wasn’t as nervous as I thought I would be.  I knew the patients from the day before, and I didn’t have to take an entire history and physical.  I just needed to review their labs and orders and decide what things needed to be adjusted.  Then I wrote a progress note that my preceptor went over with me later in the day.

The thing I like most about this rotation is that we see REAL diseases.  Not to say that diabetes and hypertension, like we saw all the time in Family Medicine, aren’t real diseases, but I have always wanted to work with really sick patients, like the patients we see in the hospital.  Every patient is suffering from something different.  Just a few of the diseases we saw were Cellulitis in a heroin addict, Congestive Heart Failure, Multiple Myeloma, Pneumonia, C. diff Colitis, Ischemic Colitis, Crohn’s Disease, COPD, Diverticulitis, and Pancreatic Cancer.

I also think back to my own hospital stay a few months ago, and I remember how awful it was.  I love that I can see patients, help them feel better, and get them out of the hospital as soon as possible.  It is also rewarding to order labs and see them returned quickly.  We can change medications and see results the next day.  In family medicine, it might be weeks or months before you follow-up with a patient.

Anyway, I really love this rotation.  I love being in the hospital and working with other physicians.  I like seeing lots of patients with different diseases.  And I really like my preceptor.  I could definitely see myself being a Hospitalist, so we will see how the next three weeks go!