Well, today it happened. I participated in my first code.
We were in the telemetry unit (the room where they monitor all the patients who have EKG strips) to ask about a different patient of mine only to find that a patient was coding (lost a life-sustaining heartbeat). With some coaxing from my attending, the other student and I wound our way through the around-20 people standing outside and inside of …
We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first …
“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”
I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.
The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …
The rotations on adult medicine and critical care are probably the most challenging ones for the residents doing internal medicine residency. No matter how much we try, we tend to feel overwhelmed, fatigued and swamped sometimes. As we progress into residency, we not only gain knowledge and clinical skills but also learn to tackle the challenges of a busy schedule. Below are some of the tips that might be helpful.
1. …
How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart failure, she looked at me and said, “Physicians kill patients, it’s inevitable. Has no one told you it’s part of the job?”
There is truth to this …
Based on my clinical experiences, there are ten pieces of advice I would give to any medical student starting their rotations that will maximize productivity and lead to a robust and thriving work environment (your interns will thank you).
1. Do as complete of a workup on your assigned patients as you can. Be thorough with your admission H&P. Think of all the tests, labs and imaging studies you want ordered. …
Think all the way back to your grade school years. Did you know that your personality traits were starting to be honed for the work you do today? Let me give you some examples about myself and see if you can relate.
I remember the praise and exhilaration of being the only kid in the class to get a 100 percent on an extremely difficult second-grade spelling test. My teacher told …
Why is your hospital always full? Actually, it’s more than full. You have twenty boarders in the ED. You turned your postop recovery unit into an overnight surge center. Every day administrators beg you to please, please discharge patients, if possible before 11 a.m. You’ve hired an army of case managers, dissected the discharge process, and held countless capacity management meetings, but you’re still bursting at the seams.
It wasn’t always …
Florence Nightingale was among the first nurses who started wearing a nurse’s cap.
The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.
Growing up in the 1950s …
I’m often asked to write and speak about being a woman physician. I don’t know that any of my male physician colleagues have ever been asked to talk about being a male physician. Many hospital systems have women in medicine groups, and there’s now a National Women Physicians Day. Again, don’t know of the same for male physicians. There’s a part of me that struggles with this, but I …
My story starts like most individuals who enter into medical training. I had the dream that being a physician was my life calling to bring physical healing to others. While I did gain medical knowledge and skills, I also unintentionally developed a jaded mentality. I was quickly introduced to the reality of medical culture in which public embarrassment from “pimping” (a series of difficult intentionally unanswerable questions posed to medical …
Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.
Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …
A male interventional radiologist who is active in the #HeForShe campaign recently told me that he is being pressured to stop advocating for women. My first instinct was the biggest sigh and eyeroll of my life followed by thoughts of locker room peer pressure and boys’ club type discussions.
But the criticism did not just come from men; many women are asking him to stop. That they don’t need a knight …
ADVERTISEMENT
For Apple iPhone users, the release of iOS 12 included a new feature called “Screen Time.” Although a number of productivity apps that offered a similar snapshot of phone usage were available before this update, I was never interested in quantifying my usage. Now, on a weekly basis, I get a reminder of the exact percentage breakdown of how I’m using my phone.
In true millennial fashion, a review of my …
We were in the middle of the morning routine – sign out between mouthfuls of eggs and homefries – when the call came in overhead, “Code Blue, 9 West. Code Blue, 9 West.” Just like that, our team snapped into action, the continued banter only thinly concealing a change in demeanor: backs straight, jaws set, we walked with a sense of purpose. There was a life on the line.
By the …
Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …
By now, I’m sure most of you probably have heard about the Cleveland Clinic first-year resident who was fired last September when it became known that in 2012 she had tweeted she would “purposely give all the yahood [Jews] the wrong meds …”
The website Canary Mission documented numerous tweets expressing similar thoughts. She has apologized but will likely have great difficulty finding another job as a physician.
This …
Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early rotations was in the emergency room. As a student, you have no actual authority and must be closely monitored at all times. Many times you will …
Part 3 of a series.
Patients with advanced cancer are particularly vulnerable to infection due to a compromised immune system. Moreover, the typical symptoms of serious infection, such as fever and chills, may be absent in cancer patients. If not identified and treated early, infection can lead to sepsis, a life-threatening reaction of the immune system that causes organ failure, shock, and death, as …
I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.
I left slightly broken.
Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …
Get free updates delivered free to your inbox.
