Contributing Writer
Temple University School of Medicine
Philadelphia medical student tying to navigate the narrow straits between biomedical science and the humanities.
One of my friends told me today that she shadowed in the emergency room on Friday night. She told me they had a patient who was pronounced dead on arrival after being shot 24 times. Unfortunately, this is a typical narrative for our emergency room on a Friday night. I wish I was surprised, I wish I didn’t already know the story, and I wish the news of another young life prematurely and senselessly erased from this earth even made the news.
A torrential thunderstorm forced nearly the entire homeless population of Tampa Heights out from under their tents and awnings in favor of the more generous cover of a highway overpass. It was the closest Tampa had come to a publicly funded homeless shelter.
The first day of my medicine rotation, I proudly put on my white coat and stuffed its pockets with my stethoscope, reflex hammer, otoscope and a few pocket-sized books to help get me through the day. The stress and anxiety of taking Step 1 was over. I was going to treat patients! Heal the sick. Comfort those in mourning. I was finally where I wanted to be: in the hospital.
I looked up from my computer to motion the next patient in line and saw before me an elderly gentleman who resembled many of the other patients attending our health fair in Key West. Casually dressed: a white V-neck T-shirt and track pants. Hair: gray and wispy. Skin: tan and leathery from the sun. He was over six feet tall, with an athletic build for a man his age. It was approaching lunch hour and the line for my Med IT station was dwindling.
“In all seriousness,” the attending physician says, “he can wear women’s underwear to minimize the pain.” “Can he really?” “Absolutely,” replies the attending. “If we can’t prescribe any pain medication, then tighter fitting clothing can help keep things from jostling about too much.”
Her story started pretty similarly to any other patient I had over the past week and a half since starting my family medicine rotation. The nurse told me she had another patient who was checking in. I asked her for the name and began looking up the previous clinical notes and labs in the computer while waiting for her arrival from registration. She had a history of arthritis, GERD and uncontrolled diabetes — all diagnoses I had become comfortable discussing with patients.
During morning rounds, the resident and I stopped by our young patient’s room. He was technically five weeks old, but was born five weeks prematurely, so all in all, he was delightfully newborn-sized. The nurse was sitting in a recliner, holding him. He was well enough to be held. We finished rounds, ate breakfast, and headed to the OR. Our work unexpectedly finished early for the day, and I was free to go. Instead of immediately leaving the hospital, I headed back to our young patient’s room.
“If I begin to repeat myself, just tell me. I have Alzheimer’s. At least, I think I do,” the elderly gentleman said with a smile. This elderly patient of mine was a jovial gentleman and in fantastic shape with unremarkable vitals on physical examination. If it was not for his diagnosis of Alzheimer’s disease, the physical and emotional state of this patient given his age is nothing less than enviable.
She asked me if I was from New York. I told her I wasn’t. I was from California, actually, but enjoying myself in New York City while I was here. I asked her where she grew up. She said Brooklyn. She asked to see my referral card. I asked her to clarify. She said she wanted to see my referral card. For coming here. And did the super know I was here? Where was my card?
“I have diabetes.” Shadowing at a pediatric endocrinology office, I was told this statement by a four-year-old patient. As weeks passed, I could not stop thinking about it.
“What can you do here that we can’t do at home?” This question angered my resident. How dare a patient admitted to the hospital ask for justification of their plan? The progress note had already been written and orders entered; assent to the plan was assumed and having to walk the patient through the options would extend rounds considerably. What an inconvenience.
It was a night of restless dreams. So when my phone blinked to life at 1:42 a.m., my eyes snapped wide open. [ALERT] **VDEM** FRONT ROYAL SAR. VDEM is the Virginia Department of Emergency Management, the state authority in charge of all emergency responses, including incidents involving missing persons. In those situations, VDEM sends out an alert to local search and rescue groups like the one I had just joined.
Medical Student Editor
Georgetown University School of Medicine
Daniel graduated from Tufts University in 2004. His subsequent pursuits included everything from cell cycle research to manufacturing shampoo. Medically, his interests lie in emergency and wilderness medicine, infectious disease, and health care sustainability. Daniel is medical student at the Georgetown University School of Medicine, Class of 2017.
