Sunday, November 25, 2007

One of our second year courses requires that we do 40 hours of clinical experience and write about some of the cases we see. I chose to do one of my clinical experiences in rural emergency
so I spent this last weekend in a rural emergency. It was great experience. I hesitate to call it fun, but it really was. The town is pretty small but they have a pretty big catchment area so everything from croup to motor vehicle accidents come in on the weekend.

I arrived at the hospital on Friday evening to pick up a key to the student housing. The emergency was pretty quiet at that time so I went to get settled in and find some dinner. When I arrived at the hospital the next morning the big talk was all about a case that came in at about 11pm. Patient came in GCS4, blown pupil, aspirating vomit; with no known cause. And I guess things got worse from there. They had 4 doctors, a resident, a med student, 3 ambulance teams and 4 nurses involved.

I was really jealous. If only I had been there a few hours later.

Usually I can honestly say that I would never wish anything bad to happen just for my own learning sake. But I do really wish I had been there. I think the reason is that the patient has died in every real code I have been involved in. I am about 0 for 5 now. This guy was about as bad as they come and last I heard he was stabilized in ICU in the big city. I guess I want the rush of feeling like I really helped save a life. It may be horrible and selfish but I want someone on the brink to come back for me.


Tall Medstudent said...

An interesting post.

It's odd how med students/docs develop this desire for the 'cool case'. I am thinking that it's less about schadenfreude than it is an acceptance of fate; these events or diseases happen, and like you say, we want to be there to try to help when it does, because that is our purpose.

One of the most puzzling things in medicine is, of course, analyzing our own reactions to the death around us...

Anonymous said...

U know, from a former premed, I can totally see wanting to see the 'action.' If you see this, you will be a witness to what most people view as medicine on the breaking edge. And yes, it is gratifying to know you helped a person in their greatest time of need.

Cases can be definitely clinically cool to wrap your brain around the disease or trauma, even though it causes much suffering. If you can balance thinking clinically and compassionately, you will make a good doctor.