One of those days

Yesterday morning was one of those days where everything just clicked.  I saw three patients in clinic, and they were all interesting and different and had something (or multiple somethings) going on beyond the typical check-up.  The first was an early-teenage boy with high blood pressure, weight problems, and who was still occasionally having trouble with bedwetting (surprising fact:  as many as 1% of 15 year old boys still wet the bed and--medically--it's totally normal.  They just grow out of it later than most.).   The cool thing about him was that I knew what to do for each of his problems and it felt like I knew how to manage this complicated patient pretty much by myself (although part of it was easy--convincing his mother to actually give him all of his BP meds before his heart explodes on him).  Second kid was a 1 year old in for a check-up, mom was great, kid had an ear infection and cold, which I successfully diagnosed and knew how to manage.  Third was a very young teenage girl whose mom wanted her on birth control because mom was sure she was having sex and not telling anyone.  Turns out, she was (frightening)--and I felt really accomplished because we ended up having a very candid conversation about being up front with mom and up front with us so we could keep her safe, what she needed to do to protect herself, etc.  I think we may have actually gotten through to her on some level.  

I think I paid for the awesome morning with the afternoon, because my second patient (at about 2 or 2:30) was a 17 year old female with lower abdominal pain.  Those in the medical community will know that this complaint on this person is a recipe for a headache for any physician/resident/student/nurse/bum on the street, mainly because there are approximately 8 Trillion things that could be wrong and you have to work up for all of them because they're all BAD.  PID, ectopic pregnancy, appendicitis, STDs, gastroenteritis, colon cancer, the list goes on and on and on and on and on...you get the idea.  Luckily for us, we were able to narrow it down and ended up treating her in the office--but with all of the workups we had to do it took FOREVER.  By the time I saw my last patient (at 4:00), the mom was so cranky from waiting so long that I thought her eyes would shoot daggers at me when I introduced myself as the medical student.   

Days like this make me love my job.