For my internal-medicine rotation as a third-year medical student, I was placed at Boston Medical Center, a large urban hospital that serves patients from all walks of life. My team included an attending, a pharmacist, a resident, two interns, two of my classmates and me.
Here is a snapshot of morning rounds with some of the patients I met, and of the emotions I experienced during my first weeks on the general-medicine ward. I refer to the patients by their illnesses not only for confidentiality but also to show how we sometimes identified them, despite our best intentions.
My First Patient: She comes in with altered mental status–confusion, sleepiness and memory loss–and she does not speak English. My resident tells me that she meets the criteria for systemic inflammatory response syndrome, but at this moment, I can’t remember what that means. My intern speculates about bacterial meningitis. My attending is concerned about viral encephalitis. They turn to me and ask me what I think. I can only contribute that she’s constipated.