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Throwback…..

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When I was in my third year of medical school, the first rotation I did was internal medicine. Somehow, I ended up rotating with a cardiology attending for the first few weeks of the rotation.

She was extremely interesting, to say the least. She was tall, I would say about 6ft 3inches. Also, she wore these heels that not only exemplified her height, but warned everyone that she was approaching.

She took heavy, wide-based steps. Even the other senior doctors looked and acted different when they heard those steps coming. She exuded this aura of confidence. Not only that, she was also brilliant. A member of several boards, both medical and business boards. She was also renowned in the field of cardiology.

So here I was on my first rotation with her as my teacher. She asked me to examine a patient and then come tell her the results.

I did the examination and went to find her. Her first question was, ‘Does the patient have hair on their chest?’ I figured I would guess the answer and I said no.

She walked back with me to the patient’s bedside, bringing along the rest of the medical team with her. She then got the patient to lift their shirt and they had the hairiest chest ever.

She turned to me and started laughing, loudly. Then she said something that I have never forgotten to this day…….DON’T ever lie. It doesn’t matter if you get shouted at for not doing something or for forgetting to examine a patient. Once you lie to your team, you become untrustworthy, and, you become the weak link within the team. Don’t ever lie.

After that, I never gave a false answer even if it meant staying back for a couple hours to do something I should have done hours ago……..Even if it meant I was going to get shouted at by several seniors.

It means I can watch someone in the face and say either ‘yes’ or ‘no’ and they can trust me.

When working on a team, any team, medical or otherwise, trust is intrinsic to its foundation and proper development.

DON’T EVER LIE……

Breaking the mold…..

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One of the most difficult things for a doctor who has moved to a new hospital setting is gaining the trust of their colleagues and…..nurses. If you don’t have the nurses’s trust, things won’t run as smoothly as you may like them to run.

It took me awhile to do this. Nurses will watch you carefully. Especially those who have been around for a longer period of time and have gained a lot of knowledge.

When I moved to my new location, I knew that first and foremost, I had to be humble and yet strong in any decisions I made for my patients. That was not the time to be making mistakes.

You know you have ‘broken the mold’ ,when ,a nurse ask if you are working the shift with them tonight and then looks disappointed when you give a negative answer.

But whatever happens, don’t ever drop your guard. Like so many things in life, it may take a period of time to build the trust of the team, but only seconds to lose it.

I recall as a medical student in my fourth year doing a sub-internship in trauma surgery. One night, this guy came in unconscious. He had been beaten by a group of people using skateboards. It was difficult examining the patient because he was not responding appropriately. He had also lost most of the teeth in his mouth.

The chief surgical resident was well liked by everyone. He was there when the patient came in and fully assessed the patient. However, he believed that the patient had an abdominal injury which was more life-threatening than any of the other injuries.

A CT scan proved him wrong and that the main injury was to the patient’s brain which was being compressed by blood from a skull fracture.

Neurosurgery assessed to patient, and all was well. However, I noticed afterwards that for sometime, attendings started to show up whenever trauma victims came in and that chief resident was on call.

It took awhile for him to prove himself again to the team.

Trust is such a fickle thing to earn.

I finally broke my clogs…..:)

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I initially bought a pair of Danskos clogs waaaaaaayyy back in medical school for my 3rd year surgical rotation.

That shoes is a TROOPER!!!!

Years later, and now as an ER doctor, I looked down to figure out what is wrong with my shoes. The under sole had broke.

Unfortunately I will now be retiring my favorite pair of shoes. It really served me well.

But I will definitely be getting a replacement.

I love Danskos.

Noone, not even the patients taking BS today

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Funniest experience a few nights ago. A patient who had been discharged decided to go on an angry rant, complaining to anyone nearby. The patient’s family decided to take forever to come and retrieve him.

Somehow, we became the ‘scapegoats’ who were keeping the patient trapped at the hospital.

The patient stood in the middle of the ER screaming that he would ‘light us up’ if we didn’t get his family pronto.

Before security could even reach to pacify him, another patient jumped off his bed and screamed at the guy…..’SHUT-UP!!!! Can’t you see I am trying to sleep here. Just SHUT the hell up!!!’

The ‘angry’ patient immediately got quiet and sat on the edge of his bed pouting.

I think we need to hire that other guy as security. He was effective!!!!!!

Weekend Blues…..

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You know, I love medicine. But,I could never quite enjoy working on weekends…..especially Sundays. I hate working on Sundays.

I like my Sundays to be calm, peaceful and filled with fun magazines that I never quite get to read fully.

I don’t like to be disturbed on Sundays. That is my quiet time. I don’t even answer my phone. It will take a message.

I also enjoy a little siesta on a Sunday. A day off to think without any distraction, can do everyone a little good.

Of course that won’t be happening this weekend, because, I will be working. NO siesta for me….:(

So to those of you not working on Sunday….enjoy it fully.

Backup….

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And no, I am not talking about backing up the data on your computer.

I mean backup by someone else.

Police have backup, people on sports teams have backup….even criminals have backup.

As a doctor, you work on a team. Even if you have a solo practice, you can always find someone else to share ideas with.

For myself, I work in an ER. There are times when I need, ‘backup’. And trust me, I am not ashamed to go and grab a colleague and say, ‘I need your help with this trauma patient.’ It is as simple as that.

Medicine is not a ‘hero sport’. This is not the Olympics. You are working on a team of doctors, nurses…etc…etc. You need a fully functional team, in order for everything to work out properly.

I cannot treat a trauma victim, stabilize him, take bloods, splint any fractures, start meds, etc….all by myself.

If you need backup. Ask for it.

Runaway patients

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I don’t know whether to be grateful or worried when patient’s disappear from the ER.

Sometimes it is the patients that I know all too well. The pain-seekers, the smoking asthmatics, the non-compliant diabetics.

If I am juggling several patients at the same time. I know which ones I have to check on every few minutes and which ones I can write orders for and check on in 30 minutes.
The familiar patients definitely know the doctors and nurses,and, they know the layout of the ER, and how to sneak out with noone realizing.

They will wait until they see everyone busy with a critical trauma case and slide through the nearest exit, only to be back a few days later…….no surprise there at all.

I never know whether to be grateful that they have just lessened my workload…..OR…..be irritated because they will be back most likely on a day when I am busy.

I drive big SUVs……

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So there I was explaining to my patient’s son that his father was alright and we were sending him back home.

The son kept thanking and saying….how is he gonna get into my….’Big SUV name’…..I was wondering who he thought he was trying to impress???

Every two sentences involved the ‘BIG SUV’……I wanted to ask him if it belonged to his dad……ugh!!!

Ummm….are you seriously telling me this.

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SleepyDoc: So what brings you here today Sir?

Patient: Well doc my back is hurting me. While I was trying to get into my Suv I fell backward onto the grass.

SleepyDoc: have you had any liquor today…(I could smell it all over him)

Patient: Yes doc I have had some hard liquor and some beer…

It was only 1pm. He was drifting in and out of sleep, and slurring his words. Plus the nurses told me her is always here in the same drunkard state. AND he will walk out when he wakes up…..

Patient: oh SleepyDoc, I also forgot to mention that I fell out my Suv about a month ago…..I was also drinking then to.

…….UGH!!!!!

I took a little time off……sorry….:)

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I was apartment hunting and working and packing….ugh!!! I hate moving. And I am also thinking of starting an MBA.

I was really really too exhausted to blog….but I am back!!!…:)