Columnist
Icahn School of Medicine at Mount Sinai
Katie is a Class of 2016 student at the Icahn School of Medicine at Mount Sinai, in New York City.
Pleural Space
Pleural Space looks at the experiential curriculum of medical school, the many things that are taught and learned that aren’t listed in a syllabus.
On the first day of my surgery clerkship, our chief resident gave us a few instructions for our next two months together. We had to carry certain types of gauze and tape in our soon-to-be overflowing white coat pockets, create a clear and confident daily plan for each patient we followed, and be ready for rounds at 6 a.m. the next morning.
Just last month, the Supreme Court issued a ruling declaring bans on same-sex marriage illegal. While many hail this as a major step in the quest for equality, equity in health outcomes is still lacking in the lesbian, gay, bisexual, and transgender community. Many clinicians and prospective clinicians do not receive significant training in how to address the unique needs of members of the LGBT population.
Inpatient neurology at UAB is a busy service, accepting a variety of calls every day from the ED, inpatient consults, and transfer patients throughout the state. On a particularly hectic Wednesday afternoon during my second week of rotation, our team received a page from the psychiatric ward that one of their patients, Mr. S, was being transferred to our floor after a possible seizure. The residents were busy checking out patients to the night team, so I was sent to see the patient first.
“Medicine is a team sport,” said one of many administrators who spoke to my class during medical school orientation. This utterance rang true to me, as I have always believed that medicine relies on people working together in a cooperative and respectful manner. Yet, what I never imagined is just how challenging it is to work in a group when you are the most passive person in a room. I came into medical school shy and feeling a little out of place.
“Look, you’re not out on a four-year picnic at that medical school, so stop talking like a disappointed lover. You signed up for a spell of training and they’re dishing it out to you, and all you can do is take everything they’ve got, everything they hand to you, and tell yourself how lucky you are to be on the receiving end — so you can be a doctor, and that’s no bad price to pay for the worry, the exhaustion.”
Every other person in my family assured me I have nothing to fear, that I shouldn’t toss and turn in my bed at night feeling powerless because I’m in Philadelphia, thousands of miles away from India. Most days I reminded myself that to go to India I must first drag myself across the finish line of first year. But late at night alone in my apartment, I was haunted by lab values. I wracked my brain over the latest hemoglobin, sodium, potassium and chest x-ray. What am I missing? Is there something I can see that doctors with hundreds of years of collective experience cannot? The reality is that I didn’t have the answers for the people I love, and that thought terrified me more than anything.
Welcome, Player One! First clerkship. Ready? Go!
LEVEL 1, PSYCHIATRY ACUTE INPATIENT SERVICE, MISSION NOTES: Med student didactics at 0700 daily. Rounds start approximately at 0800. Comprehensive interview with team at bedside. Ask about daily activities and goals. Enter orders while running list. PM schedule varies. Check desk for group session and recreation schedules. Plan to admit at least 8 patients in 3 weeks. Work closely with social services to coordinate disposition.
Obamacare subsidies were upheld Thursday as the Supreme Court issued its decision on King v. Burwell. Here is your two minute brief on what the decision means.
For most medical students, the third year of medical school is their introduction to life in the hospital. This results not only in exciting learning opportunities, but also emotional tolls — grief, fear, anxiety, exhaustion — that can lead to serious problems including burnout, depression, and anxiety.
Within the next three years, ketamine, the popular club drug referred to as “Special K,” may replace the current generation of antidepressant drugs. By substantially reducing the latency of antidepressant effect, the use of ketamine as an antidepressant may hold promise and is in fact in Phase 3 trials for FDA approval. But, how does ketamine work to alleviate depressive symptoms, and how does this approach fit with our current understanding of depression? Do we currently understand depression?
Your neck muscles heaved as you sucked in air through pursed lips. Pink puffer, I thought immediately, to my shame. That wasn’t why I was here.
Picture the following two scenarios: The funeral procession of Henry V passes through Westminster Abbey, and the following remark is made: “The King from Eltham I intend to steal, / And sit at chiefest stern of public weal.” The second scenario is a physician who goes into an exam room and hears the patient talking about his “stomach pain,” intake of “spicy foods,” and his “use of Advil for headache relief.” These are two entirely unrelated scenarios, yes, but the shared theme is that both dialogues contain important clues to a bigger picture.
Columnist
Weill Cornell Medical College
Tony Sun is an MD-PhD student at Cornell Medical College. He completed his BA in English literature at Washington University in St. Louis. Tony read Shakespeare unenthusiastically in high school, but he reread and rediscovered Shakespeare in college and has since remained committed to a lifelong appreciation of imaginative literature.
Shakespeare for Doctors
This column is about the benefits of reading Shakespeare and is written with medical students, doctors, and scientists in mind. Reading Shakespeare’s verse drama trains reading skills, in the broadest sense of the word “reading.” Reading well means doing active thinking, questioning, and imagining, which are the same skills involved in reading a complex patient, or an elusive scientific problem. Shakespeare offers excellent plays for practicing these skills outside the clinic or laboratory, and my goal is to give examples of how I read his verse drama — each installment will focus on one play.
