I managed to find myself as the first physician present in a code situation today.
Talk about terrifying.
The nurses were performing chest compressions and giving bagged breaths for a patient this morning by the time I walked into the room.
I simply stood at the foot of the bed with a deer in headlights look and asked, “What’s going on?”
After an initial smart-assed response of, “Well, he’s not breathing”, I managed to get a bit of an event progression from the nurse who was already drawing up some epinephrine into a syringe.
Lucky for me…and the patient…a few more white coats with more experience arrived just as the nurse was finishing the history. I was off the hook for “leading” the code–and the patient was better off for it.
Of course, I broke the number one rule of code situations…
I forgot to take my own pulse.
What a morning.
*Editorial Note: On Friday I carried the code pager for the day, and it did go off. I was half way across the hospital and by the time I got there the code was finished. Apparently the patient was a DNR–or some such. As such I don’t count that as the first code of my career.
I admitted my first patient today.
Last month I worked on a consult service–so I never had any of my “own” patients.
That all changed today when I admitted a patient with pulmonary hypertension.
It was mostly grunt work–filling out orders, doing a rectal, etc. Ya know, the normal intern stuff. We got the patient a bed and I then promptly “checked out” to the intern on call for the evening. I felt a bit guilty dumping a sick patient on the overnight intern–but that’s what the 80 hour week does for us.
It’ll be my turn on Sunday when I have my first call day/night.
Should be a blast.
I like to think I do a reasonable job and reducing medical explanations into something just about any patient can digest. Saying things like “bugs” for bacteria or “your body fights back” for immunological response help tone down the high brow medical discussion. Simple stuff. No big deal.
But I’m often amused by the way patients comprehend the disease process.
For example, I was recently seeing a young, homeless, female patient who was dealing with a simple pneumonia–nothing spectacular. But during a routine screen of her liver function via a complete metabolic panel–a series of lab tests that evaluate liver function, blood constituents, and electrolyte levels–we noticed that she had poor liver function.
I decided to interrogate the patient as to the potential causes of the bump in liver enzymes. While she couldn’t put her finger on any one process that may have caused the problem–she wasn’t drinking anymore and she rarely used Tylenol–she did mention that a bunch of years ago someone told her she had a “touch of hepatitis”.
I’m still trying to figure out exactly what a “touch” of hepatitis is.
Must be a similar condition to “a little pregnant”…
On Thursday evening, I took the following oath:
Today, in the presence of family, friends, teachers, and colleagues, I dedicate myself to the profession of Medicine.
I pledge myself to the service of humanity. I will use my skills to care for all in need, without bias and with openness of spirit. The health of my patients will be my first concern. I vow to hold sacred the bond between doctor and patient. I will hold in confidence all that my patients entrust to me. I will strive to alleviate suffering. I will respect the dignity and autonomy of my patients in living and dying.
As a Physician, I recognize my duty to society. I will work to promote health and prevent disease. I will advocate for the welfare of my community. Even under duress, I will not use my knowledge or my skills against humanity. I will acknowledge my limitations and my mistakes so that I may learn from them. To uphold these responsibilities, I will maintain my own well-being and the well-being of those close to me.
I will promote the integrity of the practice of Medicine. In the tradition of my profession, I honor all who teach me this Art. Through honest and respectful collaboration with my colleagues, I will seek new knowledge, reexamine ideas and practices of the past, and teach what I have learned.
Above all, the health of my patients will be my first concern.
This Oath I take freely and upon my honor.
Continue reading ‘The Contemporary Oath of Hippocrates’
