It’s the beginning of my fourth year of med school and I just finished my four-week sub-internship rotation in Internal Medicine. The rest of the year is filled with mostly research, random electives, applications, interviews, and unscheduled time. Thus, I’ve had an uncomfortable realization: this is it. This is essentially as mature as my medical understanding will be before I get “MD” stamped behind my name in June. Continue reading 18 weeks of practice
It started last week because we had several moribund patients, patients who we knew were imminently going to leave the hospital through the back door. Every morning, when I walked into the hospital and check my team’s patient list, this awfully morbid game played through my head.
If we’re talking in programming terms, the “_Medicine Red” list is an unsorted set of entries of patient names representing the patients we are currently managing. Names are added to the list when they are admitted through the emergency department or transferred from other teams. Names are dropped from the list when we discharge them, when we transfer them to other teams, or when they die. In simpler terms, our list of patients tells us who to treat, and changes in our list are a big deal. Continue reading A moribund game
As I’m working through my medicine sub-internship (the closest to on-the-job doctor training as we ever get in med school), I have met a handful of memorable patients that have forced me to ponder our place in medicine as doctors. Like, in a non-ironic non-philosophical way. Continue reading Doctor versatility versus obligation
I’m drafting this post in my family’s hotel room in a resort on a beach in Cancún, Mexico. Before arriving, I didn’t realize that Cancún is on the Yucatán peninsula, where 65 million years ago a big-ass meteor caused a mass extinction that nearly ended all biodiversity on the planet.
But life went on.
I’m here passing some time during my two-week winter break. It’s a welcome change of pace. I feel as if I’ve just emerged, gasping for breath, at the surface of a deep dark pool of clerkships. It’s a suitable analogy not just because I went snorkeling in brilliantly clear cenote water but because last year actually felt like a protracted dive into the depths of medicine. When you’re submerged underwater, you’re acutely aware of each second of precious oxygen escaping, but each dive is over before you realize it. And when you emerge, you might be surprised to find yourself far from where you started, pushed askew by the powerful currents underneath.
When I was busy this year, life continued on around me. Continue reading Life Goes On
A family brought a Mrs. M to the ER on the last day of her life. They shouldn’t have.
Her home hospice nurse told them not to. Mrs. M was 80, with metastatic cancer and on palliative care, resting peacefully at home when she became feverish and confused. The nurse told her four adult children that she should stay at home and made comfortable to pass in the tranquility of home surrounded by loving family. Continue reading When Full Code is Wrong
On the train back down from upstate yesterday, across from me sat a mom and her son — about 6 months old. Per the suggestion of my critical care professor and because I’m rotating with pediatric neurology right now, I observed the young boy as he cried from hunger, fed a bit, then played with his mom. I thought of the thoughts and neural connections buzzing through his brain in that moment. His curious eyes darted around studying the faces of passengers, realizing that they’re faces and we’re people. He squinted when light shone through the autumn trees whistling by outside the window. He grasped at hair and clothes and with his clumsy fingers, instinctively bringing them to his mouth. As his mom lifted him by the shoulders, he pulled his legs underneath him to strengthen his hip and knee extensors. He heard his mom’s teasing voice chanting “I’m gonna get ya! I’m gonna get ya!” and his brain captured this pattern of vibrating air molecules as samples of language for future decoding. Baby brains are outright miracles. Continue reading Bad Brains
Early this morning in the PICU (Pediatric Intensive Care Unit), I witnessed one of the most horrifying things that can happen in this world: a mother watched her 2-year-old daughter die. Continue reading To watch her daughter die
Yesterday, Monday July 11, 2016, at 8:43 am, an unfortunate young man was declared dead. Continue reading First Death.