My blog represents my personal experiences and perspectives. This includes many anecdotes from my medical practice. I have been scrupulous to anonymize these anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
The call came just after breakfast on a Saturday. A patient of one of my partners was hoping I could do him and his employer, Bates College, a favor and see a woman who was not a patient in our practice. She was visiting from out of town to see her grand nephew graduate on Sunday but had taken ill, and was reluctant to visit the ED.
Over the years, experienced clinicians develop a sensitive and largely unconscious radar that supplements their cognitive analysis of patients. From the moment we enter the room, we are processing multiple subtle and seemingly irrelevant clues: how sick does she look, how nervous, how is he dressed, does he make eye contact, is he alone or accompanied, what is her mood? Mostly we let this intuition work undisturbed, drawing on it selectively when we want - or on those occasions when it speaks up unbidden - but walking into the exam room to see Ms.
She was spitting mad....
It was well into my third year. Because I lived a distance from the medical center and shared cars with a group of other medical students, it was not unusual that I would spend the night at the hospital. When this happened, I would split my time between the library (or some other place to read and study) or sitting near the front desk of the emergency department, watching for interesting cases that I might follow and learn from during the course of the evening. I still remember ‘cluster night.’
It’s hard for me to believe that there was a phase of my life - once upon a time and long, long ago - when Nordic skiing was unknown to me, rather than the abiding passion it has become. But it’s true.
It’s obvious, of course, and nothing more than basic behavioral psychology: if you reward a behavior, you will get more of it.
Try as I might, I cannot remember when or why my father and I began collecting stamps.
Jigsaw puzzles were a traditional part of our family’s summer vacations.
A meeting is an unnecessary gathering of the unwilling, led by the unknowing, doing the impossible for the ungrateful. (Slogan from a popular poster during the 1960s.)
(Dedicated to Robert J. Haggerty, MD)
It was winter and I was almost halfway through my third year of medical school in Rochester, New York. I was enjoying my pediatric rotation, even though it meant I was up much of every third night, and chronically sleep deprived. Getting to bed by 2 am and having three or more hours of uninterrupted sleep was considered a good night. In addition to pediatrics, I was learning to nap, and trying to learn to function despite exhaustion.