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It Doesn’t Work That Way

Jenni Levy July 5, 2016 1 Comment

My second month of residency. My first solo thoracentesis–a procedure to remove fluid around the lung. The supervising physician I’d just met watches over my shoulder as I carefully count and percuss the rib, fasten the drape in place, gown, glove, and cleaned off the skin.

Infiltrate with lidocaine…good. Thread the catheter into the trochar…good. Attach the stopcock…good. Make sure it’s open in the right direction. Puncture the skin, pull back on the syringe, fill the syringe with fluid. A sigh of relief–it’s in the right place. Turn the stopcock, remove the syringe…. The supervising physician makes an inarticulate noise. I look at the stopcock and freeze. It’s turned the wrong way. I have just introduced air into the area around the lung–a major mistake.

Blindsided

Alice Y. Kim July 1, 2016 9 Comments

Alice Y. Kim

When Teresa showed up forty-five minutes late for her appointment, I sighed. I knew this would disrupt our clinic’s afternoon schedule.

That was nothing unusual, though. The clinic treats large numbers of patients who are undocumented, homeless and uninsured, and many must walk or take public transportation to get here. After seven weeks on rotation here as a third-year medical student, I knew that appointment times were flexible.

As I read Teresa’s notes and recent lab results, the nurse came in.

“Teresa’s blood pressure is 210/122,” she told Dr. Fuentes, the attending physician.

White Coat Ceremony

Mary McCarthy June 13, 2016 No Comments

What do you think medicine’s most powerful diagnostic tool is? A CAT scan, perhaps? An MRI?

No. Look at your hands. These will be the most important tools of your chosen profession.

A Lifeline of Yarn

Tullika Garg June 9, 2016 No Comments

During my internship in general surgery, I had few opportunities to go into the operating room, yet I was itching to put my hands to work. I heard around the hospital that a transplant surgeon I admired was a talented knitter. So I signed up for a basic knitting class at Michaels craft store, learned my knits and purls, and began constructing lopsided scarves using inexpensive, scratchy acrylic Red Heart yarn. I was quickly addicted to my new hobby.

The Abdominal Exam

D. Micah Milgraum June 5, 2016 No Comments

“Your fingers are your eyes to see beneath the skin,” my stepfather says to me. “When you examine your patients, close your eyes and imagine what is beneath the surface.”

He and I–an experienced physician and a nascent medical student, respectively–are sitting on our living-room couch next to a twenty-year-old neighbor who’s asked for advice, after explaining that he’s had a sore throat, fever, and fatigue for the past two weeks.

Clapping Hands

Sheila Pinchin June 3, 2016 No Comments

“May I present to you the graduating class of meds…”

The uproarious burst of applause that always follows this statement is a wonderful sound–one that I’ve heard echoing through nine years now of medical graduation ceremonies. It’s the sound of the clapping hands of proud parents, exultant students, happy faculty and supportive staff who are all so glad to see this moment come.

Morning Rounds

Veronica Faller February 26, 2016 12 Comments

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

Taboo

Ralph B. Freidin February 19, 2016 7 Comments

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.

A Routine Transgender Visit

Nat Fondell January 8, 2016 6 Comments

Nat Fondell

“Hey, Rick. They warned you about me, I hope?”

My routine med-student opening line elicits a slight smile from my balding forty-two-year-old patient and the patient’s wife. As we shake hands, I continue the script.

“I’m Nat–the medical student. What brings you in today?”

“Well, I’d like to transfer my care to this clinic. We’ve brought my medical records.”

Together, they heave stacks of papers onto the desk. Rick’s hands slide back into the pockets of well-worn work jeans.

“Can you tell me a bit about yourself?” Classic open-ended question.

“Well, I’ve been seeing specialists for years about my headaches. That explains most of the paperwork. High blood pressure and high cholesterol. Plus my family has

Denial

Kendra Peterson October 9, 2015 8 Comments

Kendra Peterson

July first Fellow,
a pager blares announcing
my initiating consult, a 29-year-old
(just my age)
malignant melanoma
and a first-time seizure
while receiving an infusion
of experimental treatment.

When I arrive
she’s already gotten
two milligrams of ativan
dilantin load is hanging
and I examine
a somnolent young woman
now coming ’round,
could be my friend, my sister, me,

Say It Ain’t So

Dominic Donato June 12, 2015 8 Comments

Dominic Donato

I am in my twenties.

I am a student in dental school. My seven classmates and I have gathered, notebooks and pens in hand, for the first day of our ten-day rotation at the Veteran’s Hospital oncology department.

Dr. Steele, a published expert in oral cancer, instructs us to follow him to the outpatient clinic. Some of those he’ll examine are initial consultations; others are follow-up exams. All are U.S. veterans. Many are homeless alcoholics, whose lifestyle, we’re told, predisposes them to oral cancers.

“I want each of you to take a look at this lesion on the right lateral border ventral side of the tongue,” says Dr. Steele in resonant tones. We bob our heads to find the

Pimped

Anne Whetzel May 29, 2015 25 Comments

Anne Whetzel

It’s two months into my second year of medical school, and I’m at the clinic, preparing to shadow Dr. Neiland, a primary-care physician.

I didn’t want to come here this morning.

Yesterday, one of my preceptors decided that it was my turn to be “pimped.” Pimping, in medical education, is when the preceptor asks you questions until you get one wrong. Then he asks more questions, highlighting your ignorance. Theoretically, this ensures that once he tells you the correct answer, you’ll never forget it. This works for some students, but not for me. I get defensive, and the right answer, whatever it is, goes in one ear and out the other.

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Tag: medical training

It Doesn’t Work That Way

Blindsided

White Coat Ceremony

A Lifeline of Yarn

The Abdominal Exam

Clapping Hands

Morning Rounds

Taboo

A Routine Transgender Visit

Denial

Say It Ain’t So

Pimped

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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Tag: medical training

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