Friday, June 20, 2014

Notable Quotables: A.D.

"The basics are the most important thing you will ever learn.  You will never rise to the occasion, you will always sink to the level of your training

- A.D. [Trauma Surgeon]

I had the opportunity to see a Grand Round lecture done by a prominent Trauma Surgeon who is nationally renowned.  At the start of his lecture he did a brief overview of the basic physiology that is associated with "doing the ABCs" (I'll get to that in another post but in short the first things that need to be assessed in a trauma patient are A: Airway, B: Breathing and C: circulation).  This one liner from him really struck me.  It reminded me not to cut corners in my training because this is the time to meticulously go through every single step.  In the event of a true emergency I can rely on myself and know that no matter what there is a certain algorithm that I can trust that was followed.

Thursday, June 19, 2014

The Long Call

all names used in this blog are fictional, any resemblance to real persons is purely coincidental

Tick, tick, tick.  Every call night the second hand crawls along.  I twirl slowly in my rolling office chair, from side to side.  My foot gently catching my weight and lurching me back the other direction.

I swiftly slide my phone out of my pocket and watch as the time flashes across the screen 5:48 AM and let it drop back into my pocket.

Just twelve minutes, then freedom.  The bottom dropped out of my stomach.  Another name had just popped up on the board.


Maybe if just sit here, very still, not making any noise my resident will forget I'm here.  Maybe he'll just let me leave.

The exhaustion I had been ignoring all day was slowly creeping its way down my body.  Hour number seventeen.  I wanted to scream.

A fleeting moment of solitude after I had finished my notes and patiently stood behind my resident as he painstakingly entered all the orders required for the last admission.

Request for bed.  Request for change in level of care.  Restart home meds.  Request records from outside hospital.  So many requests.

He quickly scanned his patient list, swiftly struck through a scribbled note and was once again hunched over his keyboard

To a passerby it simply looked like a messy sheet with some nebulous comments hastily jotted down.  A more seasoned eye quickly sees this single sheet of paper was the lifeblood on the medical team.

Through the tangle of notes, strikethroughs, patient stickers and various sets of numbers and letters there emerged a well crafted document that provided a tracking sheet for the entire roster of patients the resident was responsible for overlooking.

Without this sheet the team fell apart.  The senior resident meticulously keeps track of the goings on of every patient on their service, overseeing the work of theirs juniors while maintaining communication with their main attending physician while somehow making sure patients are taken care of in between.

He refreshed his list and noted the new name.  He swiftly opened up the paging software undoubtedly to inform the intern of the new admission.

Click. Scroll. Click click.  Scroll.  Click.

Quickly scanning through the patient's admission note and the scant past records already in the system.  Suddenly he was up and on his feet and halfway down the hallway before I registered that if I didn't follow I was not going to be able to find him for quite some time.