two years

This week marks two years since I began at my current place of work, so I cannot help but reflect on my time there. I don’t mean to be a broken record, but I really do love my job. I love the community I serve. I so appreciate the flexibility my boss has allowed me, as she smiles and nods as I essentially dictate to her my work schedule. I am grateful for the autonomy I have and the knowledge I have gained. Above all, I am so very grateful for the relationships I have built with my coworkers and patients.

As I have reflected on these past two years, I have made some observations:

I look young. Every so often, a parent will refer to me as “darlin”. Every time I hear, “hey there darlin, so Jimmy has this here rash,” I pause and wonder if this is actually appropriate. And then I realize that I look 15 and probably deserve it.

I absolutely love teenagers. Whether it is a positive pregnancy test or a stab wound or finally passing the ninth grade, I feel privileged to walk beside these kids during some of the most vulnerable times in their lives.

I have a thing for fat babies. In my mind, the fatter the better. Intellectually though, I know I must have the foresight to warn mamas that two year olds should not weigh 84 (!) pounds and they might want to lay off of the tortillas.

My huge Hispanic patient base has stolen my heart. I have fallen head over heels in love with Mexican and South American culture. While my ability to communicate in Spanish still lags far behind what I would like it to be, my understanding of the language has increased substantially. It has been a struggle for me to remain “culturally competent” in my practice while still teaching best health practices (i.e. your child’s runny nose is not caused by parasites or “bad blood” and no, the antibiotics you bought at the “Mexican pharmacy” will not cure it). However, I feel as though I have gained the respect of many of these patients and have to frequently fight the urge to take one of their sweet little children home with me.

My job can be hard. All too often, I find myself awake on a Saturday night wondering if Patient X’s fever has subsided or if the CBC on Patient Y was normal. I wonder if I made the correct diagnosis or should have tried a different approach to treatment. I also can get bogged down with the negative things we see. Horrifying cases of abuse. Fatherless foster kids. Pregnant teens. Poverty. Occasionally death. As difficult as some days can be, I refuse to become hardened by them. I believe I am a far better provider when I allow myself to truly feel and sympathize.

If I want to appeal to the male big, burly male high school athlete, I simply have to stay on top of my knowledge of sports. I have a special fondness for high school football players but probably annoy them to no end as I become all “motherly” on them. Stay hydrated. Stretch. Stop playing when you’re hurt. And for heaven’s sakes, quit the cigarettes!

One of my best methods of assessing a child- regardless of the age- is to ask them what they want to be when they grow up. I have found that kids in this community unconsciously feel “stuck”. Granddad picked tobacco, dad picks tobacco, I’ll pick tobacco. Mom and dad are addicts, so I’m going to shoot up too. Call me idealistic (I am), but I truly believe that if I can get them to dream and think outside the box, many of their health and developmental problems fix themselves.

As I look over this list, it is glaringly obvious that my biggest lessons these past two years have not been in pharmacology or epidemiology. Rather, it has been the process of learning to treat the whole person rather than a disease process- a family rather than an individual. Now, I just need to be taught how to do all of this most effectively in the 10 minute time slots I am allowed…