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My First Code
Jessica Greenberg ~
“Code Blue, Interventional Radiology suite,” blare the overhead speakers.
I am a new third-year medical student, doing my first rotation in internal medicine at Yale New Haven Hospital. This morning, I’ve been rounding on patients with my medical team.
The alarm sends us lumbering down the halls, struggling to keep our clogs from falling off our feet, clutching our white jackets to our chests to keep the pockets full of stethoscopes and pens and patient lists from bouncing.
Arriving in the IR suite, I stop about twenty feet from the middle-aged woman lying in the patient bed. More than a dozen physicians and nurses crowd around her, obscuring my view.
Simple Acts
Dianne Avey ~
One night on my nursing shift in the cardiac intensive-care unit, I received a new patient from the operating room: an eighty-eight-year-old woman who had suffered a major heart attack and had just undergone emergency coronary-artery bypass surgery.
Her bed was wheeled into the room along with the usual accoutrements: six different IV drips, a ventilator, an aortic balloon pump and various other lines and monitoring devices. Her name, I saw on the chart, was Mrs. Green.
The young surgeon took me aside.
“I don’t care what it takes, just keep her alive for twenty-four hours,” he told me, clearly more worried about his surgical-outcome stats than he was about Mrs. Green’s welfare. The hospital and insurers kept
Learning Respect
David Edelbaum ~
When I finished my medical training, almost sixty years ago, I was like many new graduates: I thought I knew it all.
I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s first such specialist.)
With a wife, two children under age four, a home mortgage and an office to support, I needed to make a living. I took call at the local emergency rooms, worked nights at the VA Hospital and told my answering service to mention my availability
Who Would Want to Do This?
Kristin Beard ~
“Get the patient on the monitor.”
“How long has he been down? Someone get on the chest!”
“Keep ventilating. He’s in v-fib. Defibrillate at 200.”
“Charging, everybody clear?…Shock delivered.”
“Resume compressions. Push one of epinephrine…Hold compressions. What rhythm is he in?”
“He’s asystole, resume compressions.”
We repeat the process a hundred times over. The medic said they started coding the patient an hour ago. The family is in the consult room with the chaplain.
It Takes a Tokyo Village
Ruth Harimoto
I have lived in Japan for more than half of my life. I first came here as a nine-year-old child, the daughter of a missionary. Later, after several years of study and work in the US, I returned as an adult with my Japanese husband. You’d think that after more than thirty years here, I could almost call myself Japanese! But no. In this homogeneous country, I’m still a foreigner.
The role of a foreigner in Japan is, for the most part, a comfortable one. Japanese people are polite. They don’t expect foreigners to know Japanese, so when I do speak it (with my learned-as-a-child accent), I’m applauded and praised. This role can also be lonely, though.
As I go about
Matching Rings
Joy Liu
The room is stuffy, but the woman is shivering.
Her husband stands by her bedside. An interpreter that they’ve hired to stay with her day and night stands at the foot of the bed. And then there’s me, the doctor (I’m an intern), waiting to deliver one of many sad speeches I must give today.
Smiling wanly, she struggles into a sitting position and shakes my hand.
Even with a diagnosis of metastatic stomach cancer, she has movie-star looks. She’s only twenty-six–the same age as me. I can imagine her stepping out of a red-carpet premiere in Shanghai. Instead, having hired personal interpreters and taken a flight halfway across the world, here she is in this hospital bed, waiting
Saving Private Ryan
Gregory Rutecki
The late Eighties was the worst of times in medical education–the era when doctors in training worked a virtually unlimited number of hours each week. This unceasing and inhumane workload led residents, understandably, to view patients purely as collections of physical ailments.
Back then, I was an attending physician at a community teaching hospital. One day, as usual, I was preparing to make morning rounds and, simultaneously, to do my best to teach my team of internal-medicine residents.
Fourteen patients awaited us, every one of them quite sick. As my team and I proceeded from one bedside to the next, struggling to cram the patient interviews into ever-dwindling snippets of time, I felt a familiar sense of growing pressure; it
Just Middlin’
Alexandra Godfrey
My dad was once a physician for the coal mines in Yorkshire, England, where I grew up. It’s been decades since I accompanied him on his rounds, and fifteen years since I moved to the States and began to practice as a physician assistant in the Appalachian Mountains of North Carolina. But I still vividly recall my childhood days and the Yorkshire dialect we spoke.
Somehow, the seventy-three-year-old woman sitting in my exam room takes me back to that time.
She’s coughing violently–hacking thick yellow mucous into her tissue, spraying the floor with spittle–just as my father’s patients did.
A Doctor Confesses: I Screwed Up
Marc D. Wager
When I was in medical school, more than thirty years ago, I felt I received pretty good training on how to communicate clearly and effectively with patients and families. I even remember the name of the fictitious character we had to practice telling about his wife’s demise: “Mr. Gottrocks, I’m afraid that your wife has taken a turn for the worse; I think you should come to the ICU right now.” As a pediatrician, more recently, I’ve been trained to discuss vaccines in a nonjudgmental way with parents who, contrary to my wishes, decide not to vaccinate their children.
Despite all of this training, though, and despite many articles on the merits of doctors admitting their wrongdoing, nobody ever taught