Telemedicine should never replace in-person care, especially in the patient-centric hospice environment, but when used appropriately it can provide benefits not found in any other care environment.
“Time of death: 12:26 p.m.” Hearing those words on the first day of my Intensive Care Unit (ICU) rotation was surreal when just a few hours ago we were discussing the patient’s status during rounds.
You tell me you’d like to be an engineer one day. You hesitate after the words “one day,” like you’re reconsidering the phrase. I want to tell you not to, but I can’t find the words.
Like an early Sunday morning in New York City or a football stadium the night before a game, it is a hospital on a holiday weekend. This is my first experience of how quickly peace can burst into bedlam in medicine.
The scent of illness, stifling and spoiled / Masked by antiseptics.
I had not yet guided a ‘goals of care’ discussion. This is the discussion that entails understanding a patient’s wishes regarding end of life care, and it is often in the context of determining what advanced medical interventions the patient might want. That day, my short white coat felt shorter, like it was yelling out to everyone I encountered that I had no idea what I was doing.
While I knew little about these patients at the beginning of the day, I always started out knowing one very important fact: they were already dead.
I was starting my surgery rotation, the second rotation of my third year, on the colorectal service. It was my first 24-hour on-call shift, which meant that my team would be responsible for multiple surgical services overnight.
I hate to say that there is something exciting about getting called in to the hospital in the middle of the night. Logically, I know that means something bad is happening to someone else, but it makes my heart beat a little faster and my adrenaline surge.
His breaths are heavy when we walk in. / Abdomen distended: / a large, perfect half-sphere…
I had just started my third year, and I had already witnessed six patients die. I had never been called a black cloud before this, but it immediately stuck and seemed fitting.
In retrospect, I regret that she was not allowed to die peacefully. I now am compassionate towards those who opt solely for palliative management in terminal illnesses.