My alarm goes off and I delightedly look at the clock, 8:15am. I slowly get out of bed and get ready. The kitchen already has a cup of coffee waiting for me, and I sit down and slowly drink it while trying to really enjoy each sip. I head out, walking down the ancient stone streets of Salamanca, Spain, passing countless tapas bars and stores as I head to my class at the Spanish immersion school. I was on my elective, that glorious block of time where residents can choose what they want for 3-4 weeks out of the year, and I decided to improve my Spanish to more effectively communicate with my patients.
Let’s be honest: there has never been another time in residency when I woke up at 8:15am. Most days, the time passes so fast there isn’t a chance to stop and ponder what just happened. Instead, you move on to the next task or check in on the next patient. But, on my elective, I had nothing but time to ruminate, because the majority of topics in our Spanish class involved describing our life when we were not in Spain. I didn’t realize how different my day was until everyone’s reaction to my morning routine: get up around 5:30 or 6, in time to get to the hospital to round on all of the patients before the day’s surgeries, which start at 7am. Rounding, I struggled to describe in Spanish, meant talking with them, examining them, and seeing what happened overnight, and what they needed that day in order to continue to heal. I don’t like eating breakfast in the morning, because I am rarely hungry at 5:30 when I first get up. It was unclear what offended my professors more: skipping breakfast or wake up before 7am.
My class quickly moved on to other topics, such as when we eat lunch. My class was a mix of ages, some college-students, some retired businessmen. Most felt that eating at the same time every day was very good for the body, because your body could adjust to this schedule. It also mirrored our schedule in Spain: everyone ate with the host family from 2-3pm. All other activities worked around this schedule, including the shops, pharmacies, and markets. Lunch hour is taken very seriously here.
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When my turn came, I said, “I eat when I can”, which is not very eloquent but I was in a beginner Spanish class so it was difficult to discuss more nuanced or complicated topics. Unfortunately, there was no way for me to describe how amazing it is to walk your patient to the OR, reassuring her that after the surgery to take her uterus out, she will no longer have to be afraid to leave the house during her periods because she bleeds so heavily she has to wear diapers and change them every 1-2 hours. Or, to meet the patient trying to become pregnant and share her hope that the surgery will improve her chances of conceiving. Lunchtime passes without a thought as I try and navigate through challenging anatomy or working on improving my robotic skills. Sometimes, in the afternoon I will go to clinic. I see women six weeks post-partum, trying to briefly address all of their concerns within 20 minutes: are you breastfeeding? Do you feel sad or overwhelmed? Isolated? Have you attempted sex yet? After an exam I discuss how to get back to normal activities post-pregnancy. I see women who are interested in birth control, for their annual check-up, or for their pap smear. I see pregnant women and talk about what to expect before their next visit with me. After clinic, I have to run back to the hospital and check up on the patients still in-house. Did they get all of their medications? Are they progressing appropriately after the surgery?
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All of these thoughts swirl around in my head, but unspoken, limited by my novice status in the foreign language. But, if I could express myself properly, I would talk about how I get to take care of women during some of the most exciting and happy times, but also the saddest. All within a days work I can go from delivering a healthy baby, to telling someone that their current pregnancy is high risk and they need to be hospitalized for at least 10 weeks, or that their pap smear was not normal and they need more tests to make sure it is not cancer. It is a field full of clinic visits with procedures, the ability to follow the same patients for years, and oftentimes surgery to completely alleviate their problem. Every day is completely different, so it is impossible to describe an average day – which is one of the reasons why I love it. No matter what time lunch is.