… is the one that begins with a patient crashing and burning. You’re confused because this patient was supposed to go home today. And now they are being intubated as you watch, and you eventually realize you are supposed to be attending a mandatory lecture.
You stay with the patient. It’s not a hard choice. You’re the only person in the room they know. The patient is looking at you, bewildered. You squeeze their hand while they’re sedated and paralyzed. You are leaving for a new rotation, so you will probably never find out what went wrong. Or if it’ll really be as okay as you’re promising.
You get an e-mail reprimanding you for not attending the mandatory lecture. You now have to write an essay about your thoughts on the subject of the lecture:
The High Rate of Suicide in The Medical Profession.
You look up the statistics.
You read a depressing article.
You pour yourself a drink.
You decide this essay is a random decision that will never be checked by anyone of any importance, you say “screw it”, and you go to bed at 7.
That’s a rather ironic lecture topic given how your day went otherwise. Unfortunately, we all have days like those in medicine, and the fact that you’re bothered by bad patient outcomes is a sign that you’re going to be a good doctor. Hope future days go better for you.
What Solitary Diner said.
It’s the med students who don’t give a shit about bad outcomes, OR who choose the bullshit lecture over the patient, who shouldn’t be here.
Yesterday I told a beautiful 20 year old girl, in her 2nd year of college, that she had a cranial sarcoma. It has a terrible prognosis. I didn’t sleep all night.
I’m so sorry about your patient.
I’m a nurse. It’s doctors like you we need. Not doctors who walk in say “you’ve got x” & then walk out, leaving nurses to deal with the questions (which legally we usually can’t answer). You made the right choice. The first few arrests/intubations are so scary to watch. It does get easier, but it never gets easy. I work with children; I thought I was comfortable in an arrest setting. Then I moved to paediatrics emergency.
Don’t be afraid to follow up & see how a patient’s doing. I never did it until I was in a coma last year & one of the paramedics who kept me alive until I was intubated followed up with me when I woke up in ICU. We had a chat. I’ve not heard from her again, nor do I expect to, but it was closure for her & for me, it was just nice that out of the many patients she sees everyday, I was one she thought of. I’ve since followed up on difficult cases. On cases which have touched me. Because in medicine it’s profoundly intimate; we touch patients- sometimes without even knowing their names. We take parts of them & put things into them & we’re humans, not robots. SOMETIMES there are things we see that have an impact on us on a personal level & that’s ok. It’s also ok to follow up. Even if you just drop into the ward or call the ward & explain who you are & your involvement. Usually the NUM will usually at least give a condition report.
I found your blog through a friend of mine & I’m enchanted. You’re an amazing writer. x