First, feeling much much better. Thanks friends. So glad to be out of pain and able to eat again!
I'm halfway through my internal medicine in Jacksonville! I got to come home for my day off, and it felt so good to sleep in my own bed! Ate sushi and saw a movie last night, watched football, and more today! I'm enjoying seeing friends and taking a break from the hospital. To say I am forcing myself through this rotation would be an understatement. Basically if the only option in medicine was internal medicine, I would not be a doctor. But it's teaching me to rely on God more to make it through the day to day. I'm really trying to remember my patients need a friendly face as motivation to keep my spirits up.
But my free time in Jacksonville has been much more enjoyable this time around! One of my closest friends from high school just moved to Jax with her husband, and we've had dinner a couple times. Last week I watched the Glee premiere with my resident from the Children's Hospital and a friend from home. Not to mention eating out as frequently as possible with my classmates :) AND I got my hair chopped off on Friday! It's a reverse bob with highlights. I'll put up pictures ASAP---just trying to avoid the picture in the mirror look. So far, I love it!
Hope you all enjoy your Sunday!
13.9.09
7.9.09
Role Reversal
I am beginning to believe empathy is hard to embody unless you have truly experienced a patient’s adventure in the medical system. Nothing compares to the feeling of helplessness, vulnerability and insecurity. On Friday night I spent 10 hours in the local ER. I had delayed going for treatment for hours. I went through the differential in my head. I hypothesized tests and treatments. I couldn’t think of anything unique the ER could do for me. Finally the pain was too substantial and a friend drove me to the hospital.
First lesson: never write “abdominal pain” as your chief complaint. This is too vague and NOT treated as emergent.
I was one of the last patients to be called and that was with connections on the inside. When I finally made it to my corner with a curtain, I could immediately tell my physician was not impressed. I actually suspected the first morphine injection to be a saline injection to test me. It was only after several more doses of morphine and residual pain that the physician began to take me seriously.
Second lesson: when a patient asks for more morphine, seriously consider giving them more morphine. It’s not as strong as you think.
Throughout my ten hours in the ER, the physician NEVER discussed a plan with me. I did not know what he was thinking or what he was testing. I was lying in a cold ER in a thin gown. I was in pain, and I was confused. I can only imagine how my patients must feel.
Third lesson: explain in as much detail as possible your plan of action. Do not draw blood without explaining why. Do not use multiple US probes in various places without explaining yourself. A patient’s body should be treated as a temple. Do not violate that temple without at least addressing them.
After several hours, still writhing in pain, I was wheeled to CT. My technician was kind and comforting. He brought me a warm blanket and explained each step to me. We actually had a decent conversation. The test went by quickly and he brought me back to the ER. After another 4 mg of morphine I finally started to doze. As soon as I fell asleep, my ER physician woke me up abruptly and started telling me his assessment and that I would be sent home. I could hardly follow him, and I actually UNDERSTAND medical terminology. I was trying to keep my eyes wide open and hear what he said. In the end, I heard………possibly early appendicitis….you may need to come back….take these pain pills……could be a colonic spasm……maybe gastroenteritis…..ok bye. He quickly rushed back out of the room. Now, I know he is busy. There were several people in the ER. But I just needed five minutes to understand. I’m still not sure exactly what we accomplished in the ER. I’m glad I went but only because I can’t imagine how much pan I would have been in without 12 mg of morphine.
Final Lesson: Do not rudely awaken patients and give them a two minute summary of their problem. If you do, come back once they’ve had a chance to digest and answer questions. Do not assume they understand even if they are familiar with the medical field.
Although ultimately it was a horrid experience, I am glad that I have a new found appreciation for what my patients will experience themselves. I hope that I will be able to maintain empathy even when I am busy and overwhelmed.
First lesson: never write “abdominal pain” as your chief complaint. This is too vague and NOT treated as emergent.
I was one of the last patients to be called and that was with connections on the inside. When I finally made it to my corner with a curtain, I could immediately tell my physician was not impressed. I actually suspected the first morphine injection to be a saline injection to test me. It was only after several more doses of morphine and residual pain that the physician began to take me seriously.
Second lesson: when a patient asks for more morphine, seriously consider giving them more morphine. It’s not as strong as you think.
Throughout my ten hours in the ER, the physician NEVER discussed a plan with me. I did not know what he was thinking or what he was testing. I was lying in a cold ER in a thin gown. I was in pain, and I was confused. I can only imagine how my patients must feel.
Third lesson: explain in as much detail as possible your plan of action. Do not draw blood without explaining why. Do not use multiple US probes in various places without explaining yourself. A patient’s body should be treated as a temple. Do not violate that temple without at least addressing them.
After several hours, still writhing in pain, I was wheeled to CT. My technician was kind and comforting. He brought me a warm blanket and explained each step to me. We actually had a decent conversation. The test went by quickly and he brought me back to the ER. After another 4 mg of morphine I finally started to doze. As soon as I fell asleep, my ER physician woke me up abruptly and started telling me his assessment and that I would be sent home. I could hardly follow him, and I actually UNDERSTAND medical terminology. I was trying to keep my eyes wide open and hear what he said. In the end, I heard………possibly early appendicitis….you may need to come back….take these pain pills……could be a colonic spasm……maybe gastroenteritis…..ok bye. He quickly rushed back out of the room. Now, I know he is busy. There were several people in the ER. But I just needed five minutes to understand. I’m still not sure exactly what we accomplished in the ER. I’m glad I went but only because I can’t imagine how much pan I would have been in without 12 mg of morphine.
Final Lesson: Do not rudely awaken patients and give them a two minute summary of their problem. If you do, come back once they’ve had a chance to digest and answer questions. Do not assume they understand even if they are familiar with the medical field.
Although ultimately it was a horrid experience, I am glad that I have a new found appreciation for what my patients will experience themselves. I hope that I will be able to maintain empathy even when I am busy and overwhelmed.
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