Nearly done

I’m awake.

It’s early.

I don’t have to be awake, but I can’t sleep. You see, this is my last day of service.

Not my last day of work – no, I have that tomorrow – but for whatever reason my mind is aglow with whirling transient nodes of thought (Blazing Saddles reference for you) and I can’t get back to sleep. I’ve just caught up with some outstanding dictations (outstanding in that they are late, not that they are in any way good) and so I thought I’d reflect a bit.

I’ve been at Upstate for the past 7 1/2 years. I showed up here as a medical student, post-PhD, not yet done with my medical training and not yet certain about even doing Pediatrics as a career. I had set up a month-long elective in Pediatric Infectious Disease because (A) my one and only US medical contact was a Peds ID faculty member and, er, that was it. I figured I should brown-nose a bit.

No seriously, that was it.

At the end of that month I had somehow got the next 7 years all planned out… This guy hired me to work for him doing research and clinical trials for a year. I took my USMLE exams. I applied for residency (Upstate was the only place I applied to). It was taken for granted that I would transition into the ID Fellowship, which I did, so I have just been part of the furniture here for all that time.

I'm second in from the left, back row...

I have seen the new Children’s Hospital grow from a mythical idea to scaffolding to wonderful newly equipped spacious rooms. I have supervised medical students, watched them grow as Residents and young people, and seen them graduate and start work as Faculty. I have made mistakes, learned a lot, learned that I have a lot still to learn, and I like to think that somewhere along the way I saved a few lives. I’m not sure I’ve actually achieved anything quite so grand – but I’m pretty sure I had a positive impact on an awful lot of kids.

I certainly can’t claim to be the world’s best resident – I have had plenty of peers and colleagues who were better doctors than me: more knowledgeable, more intuitive, harder working, better at getting IV’s started…but I have found that I am good at what I do. I am good with patients and families, I actively practice patient-centered care, I can teach effectively and I can do research. Give me a database and a few hours to code and I can churn out some cool stuff.

It’s a weird feeling to move on – to a job where there are things to get done, where I won’t have the kind of supervisory backup that I’ve enjoyed as a trainee, but where I’ll also have the freedom to practice medicine and work more along my own path. The light at the end of the tunnel has turned out to be an oncoming express train…and I don’t think it truly hit me (pardon the expression) until the past few days. My last 2 weeks of service have been too busy to think about it! Now suddenly, here I am, wrapping up my last dictations and preparing my last lecture. I need to bring boxes to my office to empty it: how weird is that? There are an awful lot of really, really cool people I’m going to miss at Upstate. Nurses, lab techs, pharmacists, Docs – so many people who I’ve worked with over the past few years and got to know. They shaped how I practice medicine. I think that may be the most intimidating thing about having to move – having to re-learn all the ways and intricacies of a new system, a new place. I’ll be flying blind for a bit. I figure it’s worth it.

The thing to remember, and this is a crucial thing for any aspiring doctors to realize, is that I really enjoy what I do. Whatever fluke of fate brought me to Upstate and Peds ID, I can truly say that I don’t think I’d be happier doing something else. Pediatrics wins over any adult care for me, every time. And Infectious Disease…? There’s just something about finding a cause for a disease and killing it. You can’t do that for hypertension, or asthma, or obesity, or diabetes – “You’ve got the bugs, we’ve got the drugs” became my catchphrase.

Confucius said “If you love your job, you’ll never work a day in your life.” He was right.

  1. #1 by Sandra on September 5, 2011 - 08:02

    What a wonderful post Nick! I have worked in medicine for 20 years and worked with many different people. I like to think I have learned something from each of them. You must be an awesome positive influence on everyone you treat and work with!

    Good luck on your new adventure!

  2. #2 by Aaron Stupple on September 5, 2011 - 16:23

    Wow, really enjoyed reading this! (I didn’t know you were here that long!)

    Best of luck next year. You’ve definitely been an inspirational force, Connecticut is lucky.


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