My final reflections as I graduate from medical school on fear, courage, and doing right by patients.
In just under two months, I will be making two big transitions as I begin life as a resident. The first and obvious change is from student to doctor.
The patient was hacking sputum into a tissue when the resident and I entered his room. "How long have you had that cough?" "Oh this? As long as I can remember." "But it's been worse lately?" "Yeah." "Worse how?" "More stuff coming out each time.
"Stick to your guns." "Put your nickel down." "Stand your ground." If you're a medical student, there is an excellent chance you have heard one of these in the course of your training.
Last year, I was honored to receive an invitation to address the Medical Student Section of the American Medical Association (AMA) on writing about medicine.
I was glad she never asked if I had done this before. My first nasogastric tube was placed on an elderly woman with chronic liver disease. As her illness worsened, it gradually turned her skin yellow, her abdomen swollen, and her mind foggy.
The life cycle of a medical advance usually goes something like this: from discovery at the research bench and replication of findings, to translational research and clinical trials, to implementation.
He was known to the hospital as someone who would try to manipulate his caregivers. And I fell for it anyway. Frequently admitted for pain crises associated with a chronic illness, he spent most of his hospital course avoiding eye contact with the team.
“You wanna talk? Let’s talk.” The 42-year-old man sits up straighter in the hospital bed and grins a toothless grin.
"So, is this the sickest list you've ever had?" the resident asked me at 2 AM, after I finally finished checking off all my boxes for the night.
"We pass through the present with our eyes blindfolded. We are permitted merely to sense and guess at what we are actually experiencing. Only later when the cloth is untied can we glance at the past and find out what we have experienced and what meaning it has." - Milan Kundera Two weeks ago, I [...]
The page comes from the psychiatry intern on call. "There's a situation with patient RB on the unit. Please advise." We gather in the hall outside the patient's room.
Read the full piece here Hospital bullies: they’re a minority, but they’re sizable enough that they can unfortunately set the tone for everyone else.
“Ms. M,” the resident says, “I saw in your chart that the last time you had surgery you had a pulmonary embolism.” She nods with recognition: “I felt like I couldn’t breathe.
Had I met her anywhere but the hospital, I would have gone to her side. I would have asked her what was wrong. I would have offered to help.
You may not remember me, but when I asked how you were you said “Alive.” A few weeks earlier you were afraid of going under anesthesia and not waking up.
“This is not normal for him.” A tearful mother pointed to her six-year-old son, lying in the hospital bed. Fevers had been intermittent. He was withdrawn, but not uncommunicative until a few minutes earlier.
I’ll start with this: it’s great to be back. I’ve been on hiatus from blogging for the past few months because of the exam I took last week: the medical boards, or Step 1, an eight hour test that covers all of the first two years of medical school to prepare us for the hospital wards.
In 1977, a group of doctors began a campaign to change the name of an inflammatory arthritis after discovering it was named after a Nazi doctor who planned and performed gruesome forced human experimentation that killed thousands.
On Tuesday, Massachusetts voters will face the Death with Dignity Act and decide whether they are comfortable with the idea of a physician being able to provide medication that a terminally ill patient can self-administer to end his or her life.