The echoes of my steps resonated within the expanse of the hospital garage. As I made my way to the end of the aisle to my stall, a couple caught my eye.
A tall man, his hair only beginning to turn grey, faced a woman of similar age, dressed in a beautiful white summer dress. Next to them a car, its trunk agape, half packed with a box of personal belongings and a white plastic bag full of clothes sat waiting. Still, they stood, pausing, ruminating.
They stared longingly into each other’s eyes, a deep seeded pain overwhelming them as tears trickled down their delicate features. A warm embrace as they held each other tightly and wept.
I wondered what terrible tragedy had befell them. Did a loved one’s health take a turn for the worst? Did a loved one just pass away? Did their mother, father, daughter, or son, just perish from this earth? I could not help but wonder.
But it was not my place to ask.
I watched helplessly as they buried their heads in each other’s shoulders and comforted one other.
I continued walking.
I saw a patient on the ward on call recently where the patient’s complaint was some mild shortness of breath. Upon reviewing the progress notes, one of the issues low down on issues list was titled PE.
My heart skipped a beat.
Pulmonary embolus. My thoughts raced at the possibility that this patient had a recurrence. I quickly went back to see the patient but found that his story and physical exam did not quite add up to what I had imagined. I decided to go back and read the chart notes carefully again.
The more I read the notes in its reverse chronology, the less this PE sounded like a pulmonary embolus until I finally found the source, some ten pages back, buried in the middle of their already thinned chart.
Over time, a relatively benign finding had been unintentionally shortened to a grave and emergent issue by the student writer. I breathed a sigh of relief.
It was yet another reminder of how shorthands and acronyms can cause miscommunication.
I rushed home today after finishing call to log on to my computer. It is my first pay day, and I was anxious to know if my payroll application had gone through. It did.
While the electronic transfer only takes into account a week’s worth of pay due to delayed processing, the amount transferred was still more money than I had ever received on a single pay stub.
On call again. Half way through my shift, my pager has started to flash its low battery warning. No. Not now. Not when I still have follow ups that need to page me.
It is yet another issue to deal with, keeping me on edge, preventing me from sleeping.
Please do not die on me tonight.
My friend, old and passing, said,
“There is more to life than staying alive.
Don’t rescue me too much.”
On his farm, twelve miles out
by rough gravel roads, he is done
with plowing, spraying, harvesting.
But he is not done watching the sun
sink below the windbreak or listening
to the nighthawks above his fields.
Don’t make him move to town.
There is more to tragedy
A Note to His Doctor by Kevin Hadduck.
Poetry and Medicine, JAMA July 2, 2014, Vol 312, No. 1
Today marks the end of my first week as a doctor. To say the least it has been exciting, interesting, but above all, scary.
I have hit the ground running here, starting my first rotation in internal medicine. The days thus far have been long, hard, and busy. Everything feels more real, more high stakes; after all, I am now the one who needs to make the decision overnight.
However, every resident feel like this when they begin practice. What I would like to share instead are some of my other experiences:
There are still two years ahead of me in this residency and much to learn, see, and do. Expect more thoughts on this transition in the future.
Being off service for three months has made me more rusty than I thought. There was no greater wake up call than realizing I had forgotten how to approach some simple problems on the ward.
While it is July 1st and most all of the seniors and attendings expect a bit of an adjustment back to clinical work, my performance today was disappointing.
Back to the books.