Month: February 2016

Morning Rounds

Veronica Faller

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.

Taboo

Ralph B. Freidin

Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.

The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence in the hospital had been restricted to the cafeteria. I was twenty-three, had only examined the eyes and ears of my classmates–never a patient–and was about to perform an unsupervised cardiac exam.

Anxiously, I waited with an instructor and three classmates outside the room of our assigned patient. We had just finished eight weeks of lectures on how to perform a physical exam, with two weeks devoted exclusively to the examination of the heart.

They’ve already told us this patient has a heart murmur, I reminded myself. How difficult can this examination be?

Bliss Lomotil blum

Repose

Alan Blum

About the artist: 

Alan Blum is a professor and Gerald Leon Wallace MD Endowed Chair in family medicine at the University of Alabama School of Medicine in Tuscaloosa. A self-taught artist, he has published three books of his sketches and stories of patients, and his artworks have appeared in more than a dozen medical journals and textbooks. He is a frequent guest speaker at medical schools in courses in the humanities.

About the artwork:

“From my first year of medical school until the last day of my family medicine residency, I kept a visual diary, filling numerous notebooks with clinical vignettes, stories patients shared with me, scraps of overheard dialogue, and pasted-in sketches of my patients in ballpoint pen on index cards or prescription pads with pharmaceutical advertisements. I made this sketch on one of my visits to the patient’s home, where she had asked to be cared for instead of in the hospital. She died at age 72 less than six months after being diagnosed with an adenocarcinoma of the right lung that grew to occupy …

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Winning

Amy Odom

Like an old Atari video game I attack the folders in my inbox
Successfully devouring each power pellet placed in my path
Gulp, gulp.
Faster, faster.
Pushing to the finish line where husband and kids are waiting.
I am anxious to hear the digitalized music announce my victory.

Apparently, I am accumulating rewards for all of my clicking
            cherries for remembering to recheck labs
            stars for sending patient reminders
            extra lives for erasing the red in my registries
It seems that I am winning the game.
Perhaps on target to my all-time highest score.

2:00 am

Katie Lin

It’s 2:00 am, and the fluorescent bulbs flicker gently overhead along the quiet hallways of the intensive-care unit.

Tonight I’m the ICU resident on call, and the weight of that title sits heavily on my shoulders. My team is in charge of keeping our critically ill patients safe from harm overnight. Although the supervising physician is only a phone call away, I’m the acting team lead for any codes called during the night on patients elsewhere in the hospital who may need our life-support services. Code Blue: cardiac arrest. Code 66: anything else requiring assistance.

The metronomic beeping of the life-support machines keeps time as I blink the weariness from my eyes and share a few muted smiles with the nurses who work tirelessly alongside me while the rest of the world sleeps.

Then the call comes over the intercom: Code 66, unit 74, Highwood Building.

XmasEve

X-mas Eve

Cathleen Mahan

About the artist: 

Cathleen Mahan is a contemporary visual artist and a registered nurse specializing in critical care. “I’ve long known that my experience as a nurse informs my artwork. The same quality of touch that reassures a frightened patient becomes a creative source in the studio. Never, however, has my artwork been so directly linked to my patients as in the body of work that includes this drawing.”

About the artwork:

“One day last year while attending to the usual studio tasks, I felt compelled to draw. Inexplicably, I found myself furiously rendering the memory of a patient I cared for thirty-five years ago. Over the course of the next month a total of eighteen patients/experiences/memories beckoned me to revisit them through drawing. The process was humbling and curious. As any healthcare professional will attest, certain patients stay with us, welcome or not. These hitchhikers of memory, it seems, have a purpose after all. …

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