Student Perspective: INTENSIVE CARE

Matriculating into medical school, I had the same idealistic and stereotypical goals most medical students do. I wanted to help people by volunteering my time and talents for the betterment of my community and the underserved. What held me true to those beliefs was the time spent Friday nights downtown. Not what first comes to mind with nights out on the town, but rather with Tampa Bay Street Medicine (TBSM). In hindsight, TBSM has been the driving force for why I want to go into Primary Care and treat the whole human.

On the very first day of 3rd year rotations, I saw a homeless man in the ICU. He was admitted for uncontrolled hypothyroidism and risk of myxedema coma. The teams’ sole priority was treating his disease and discharging him as quickly as possible. Unfortunately, the medical treatment outweighed the personal treatment. He had struggled with his hypothyroidism for years because he was unable to coordinate follow up lab work after his hospitalizations and afford his levothyroxine. A simple outpatient provider could have saved the hospital thousands of dollars on his multiple admission. None of his systematic disparities in medicine were addressed during his hospitalizations or discharges.

I’ve gotten to know this patient closer over the last 6 months through TBSM. He was “adopted” by someone who arranged his mailing address to be her office, transported him to get his Hillsborough county health care plan, and even a shave/haircut on her day off. He has now been receiving treatment through TBSM for his hypothyroidism. Every week when I see him he remarks at his increased motivation and energy. I can see the effects beyond the trimmed hair/beard or 65lb weight loss; his eyes have such a vitality and light. I don’t know if that is a side effect of the medication or the medical care and attention he is receiving now.

I’m not here to reflect on the state of American healthcare, but I feel that the “intensive care” portion of the intensive care unit should address all aspects of the patient. I hope to bring this type of intensive care into my daily practice.