Residency is hard... I am currently in the middle of a string of 20 days without a day off. Obviously it’s not ideal... Most of the time, it’s not even all that fun. I mean, I spend the bulk of my time doing paperwork, entering orders in the computer, reading/preparing to get “pimped” about anything from skin cancer to drug interactions to home health arrangements. A lot of times, I feel like the guys in this picture... However, there is a brightside to all of this (and it certainly isn't the money)...
To prove it, I submit the following stories. We’ll mark them Exhibits A and B.
Exhibit A. As an intern I don’t operate much So when I do get to the OR it’s very, very exciting. Last month, I met a patient with an occlusion in the artery to the leg. The patient came in with a lot of leg pain, and the patient's first morning in the hospital I listened closely and changed the patient's pain medicines (super small decision... but ended up making a big difference to the patient). When it became clear that the patient wouldn’t respond to medical therapy we decided to amputate the occluded leg... After talking to the patient about the procedure the patient still seemed unsure of the procedure but said, “I don’t care if that tall blonde guy is the worst surgeon in the hospital... I want him to do it...” I of course responded with, “Ummm, my hair is NOT blonde...” And we took the patient to the operating room.
It’s a simple procedure, we didn’t have any complications and I got to do a lot (which basically means it was the blinding brilliant light from heaven on an otherwise craptastic day). We finish, and as we’re leaving the operating room I had the following exchange with my chief resident:
Chief: Alright I’ll take the patient (PS we don't refer to everyone as the patient... it's just my way of keeping the patient's story private... see there I go again) to recovery, can you go talk to the family?...
Me (never one to allow complete ignorance or lack of skill to stop me from doing something), Sure.... yeah.... ummmm... anything in particular you want me to talk to them about?
Chief (quizzically): Why don’t you start with the surgery and see where that takes you?
Me: Oh... right...
I walked up stairs to the waiting room, and nonchalantly asked the patient's family to step out into the hallway (good or bad news I feel like it should be private)... Because I wasn’t sure where to begin, I started with, “Well we finished the surgery
To prove it, I submit the following stories. We’ll mark them Exhibits A and B.
Exhibit A. As an intern I don’t operate much So when I do get to the OR it’s very, very exciting. Last month, I met a patient with an occlusion in the artery to the leg. The patient came in with a lot of leg pain, and the patient's first morning in the hospital I listened closely and changed the patient's pain medicines (super small decision... but ended up making a big difference to the patient). When it became clear that the patient wouldn’t respond to medical therapy we decided to amputate the occluded leg... After talking to the patient about the procedure the patient still seemed unsure of the procedure but said, “I don’t care if that tall blonde guy is the worst surgeon in the hospital... I want him to do it...” I of course responded with, “Ummm, my hair is NOT blonde...” And we took the patient to the operating room.
It’s a simple procedure, we didn’t have any complications and I got to do a lot (which basically means it was the blinding brilliant light from heaven on an otherwise craptastic day). We finish, and as we’re leaving the operating room I had the following exchange with my chief resident:
Chief: Alright I’ll take the patient (PS we don't refer to everyone as the patient... it's just my way of keeping the patient's story private... see there I go again) to recovery, can you go talk to the family?...
Me (never one to allow complete ignorance or lack of skill to stop me from doing something), Sure.... yeah.... ummmm... anything in particular you want me to talk to them about?
Chief (quizzically): Why don’t you start with the surgery and see where that takes you?
Me: Oh... right...
I walked up stairs to the waiting room, and nonchalantly asked the patient's family to step out into the hallway (good or bad news I feel like it should be private)... Because I wasn’t sure where to begin, I started with, “Well we finished the surgery
and everything went well.” Thinking that would be a sufficient explanation of a relatively routine procedure, I opened a huge can of worms with, “Do you have any other question?” They in fact had exactly one million questions about how the procedure was carried out, what exactly we did, and how the patient tolerated the procedure... It only took about 5 minutes, but the calming influence seen on their faces while hearing an explanation of a relatively routine procedure is really why I do this.
Exhibit B. One night on call I was covering the burn unit (usually not a lot of big issues... more just little things throughout the night), but occasionally you have to “admit” someone. Meaning you go see them, get the history and examine them. This can be more or less involved depending on the degree of the injury. While on call an elderly patient was transferred in from an outside hospital following a really bad burn. It became apparent right away that the patient would not live through the night. The doctor in charge spoke with the family over the phone, and they quickly realized that nothing could be done. They said they would be on their way and hoped their relative would make it until they arrived....
The patient’s family arrived, and the patient passed shortly after. In the midst of an insane night on call, I had to go to the intensive care unit and pronounce the patient’s death. The exam itself isn’t hard, but explaining the procedure to the family, asking them to step out of the room, examining her and then speaking with them about the pronouncement was definitely something that makes you pause and think. I won’t get into everything it makes you think about, but it certainly makes you miss the family and friends you have at home. It also makes you grateful that even on those busy nights, when you don’t think you have time to breath, you still get to come into people’s lives at a moment they’ll never forget and be a positive influence. So I guess if I’m going to be stuck somewhere doing something... it might as well be something that gives me opportunities like this every day...
Exhibit B. One night on call I was covering the burn unit (usually not a lot of big issues... more just little things throughout the night), but occasionally you have to “admit” someone. Meaning you go see them, get the history and examine them. This can be more or less involved depending on the degree of the injury. While on call an elderly patient was transferred in from an outside hospital following a really bad burn. It became apparent right away that the patient would not live through the night. The doctor in charge spoke with the family over the phone, and they quickly realized that nothing could be done. They said they would be on their way and hoped their relative would make it until they arrived....
The patient’s family arrived, and the patient passed shortly after. In the midst of an insane night on call, I had to go to the intensive care unit and pronounce the patient’s death. The exam itself isn’t hard, but explaining the procedure to the family, asking them to step out of the room, examining her and then speaking with them about the pronouncement was definitely something that makes you pause and think. I won’t get into everything it makes you think about, but it certainly makes you miss the family and friends you have at home. It also makes you grateful that even on those busy nights, when you don’t think you have time to breath, you still get to come into people’s lives at a moment they’ll never forget and be a positive influence. So I guess if I’m going to be stuck somewhere doing something... it might as well be something that gives me opportunities like this every day...
1 comment:
Are the shower incidences similar in prison & your residency.
See I do read your blog.
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