The first real patient of my medical career was a 60-year-old man in the surgical intensive care unit. I met him on the first day of the third year of medical school, when students join teams of doctors doing inpatient medicine.
The surgical team met at 7:00 am–a ludicrously early hour, I thought. There were nearly ten of us–four students, a couple of interns and senior residents and a chief resident.
As the team gathered around the patient’s bed, we students hung back, looking at the form before us. A pale, fleshy foot poked out from under his hospital gown. The room smelled funny.
The patient was comatose. Had he been awake and alert, he might not have been heartened by our team’s assessment, which was swift and automatic. In a telegraphic blur a resident recounted this poor man’s dismal hospital course, which included postoperative complications, and rattled off lab results. An intern picked up a clipboard from the edge of the bed and recited vital signs. A senior resident palpated the man’s abdomen.
The chief resident looked in our direction. “Listen to the lungs!” he barked. Startled, we jumped and began fumbling with our stethoscopes.
With his …