Medicine

She was spitting mad....

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.

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.’

Jigsaw puzzles were a traditional part of our family’s summer vacations.

(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.