Resident Physician Contributing Writer
Northwestern University
Michael Cloney is a recent graduate of an MD/MPH dual-degree program at Columbia University's College of Physicians & Surgeons and Mailman School of Public Health. He writes as a Communication in Health and Epidemiology Fellow for The 2x2 Project, and a health columnist for Impakter Magazine. After 10 years in New York, he is excited to have moved home to join Northwestern University’s Department of Neurological Surgery this summer.
I didn’t know what it was, but it hurt — a subtle, gnawing soreness that I wouldn’t think about, but was never quite off my mind. Medical school had just started. I was beginning a new chapter in my life, and everything was good — everything except that unusual pain in my back.
While there is always an intrinsic desire to root for patient recovery and ultimate survival, I struggled immensely with the decision to pursue invasive measures. This is a poem that helped depict my feelings for this patient encounter.
It really doesn’t take much to remind you just how human you are. I utilize the adjective “human” because most believe, both inside and outside of the confines of the medical community, that physicians are entitled and even expected to behave in somewhat robotic ways, with the long hours and constant absorption and dispensation of medical knowledge that often comes with performing the job and doing so well.
Realizing that we have both inpatient and outpatient months, which require different skill sets, I feel that it would be better to split these lists into both outpatient and inpatient suggestions. After a few month of being on outpatient rotations, here is my list of eight things to master in order to break the successful intern barrier in the outpatient world.
Twenty minutes of cardiopulmonary resuscitation. Fifteen beats per minute. Seven nurses. Five doctors. Three paramedics. Two anesthesiologists. One transcriber and me. And then the eerie silence of the trauma room as the death was called.
“Hey hey! How are you?” someone calls out as I walk into the fluorescently lit emergency department I call home. “Living the dream,” is my habitual answer, and it’s only half facetious.
Everyone warns you that intern year is hard. It’s a year of little sleep, a rollercoaster of emotions both good and bad. Frustration and guilt in wanting to know everything now because everything you don’t know might be what matters for this patient, this time. And tremendous successes. Some of the things I did this year, I really can’t believe I was able to do. And survive.
Sometimes, it’s difficult to recall that single defining moment or person that sends you on the path you’re meant to take in life. I was fortunate in that I found that experience halfway through my undergraduate career at the University of California, Davis. I had recently lost my grandmother — although I’d wanted to help, all I’d been able to do at the hospital was translate for her. That overwhelming sense of helplessness I felt due to my lack of medical knowledge fueled my desire to help and serve others as a physician.
A surgical resident writes: “Several recent studies suggest current general surgery residents are poorly trained and unprepared for independent practice at the completion of residency. In general, do you agree that current general surgery residents are poorly trained and unable to operate independently at the completion of residency?”
Have you ever had that experience when you think what you’re doing is futile, and that thought goes through your mind: “Why am I doing this? I’m torturing him. This feels wrong.”
I feel like there are so many things to work on in medicine. I need to be more efficient at taking a history; I need to gather morning data more quickly; I should be better at chart review when I get a new admission; I need to be more thorough at following up on labs; I could write the H&P more quickly, and so on. I also feel, from time to time, I do poorly on one thing — maybe I stay at work way too long writing my H&P — and then I obsess over how I can get faster at it.
It’s 2 a.m., and the patient’s blood pressure is beginning to rapidly decrease. Every IV line is occupied by an antibiotic or IV fluids, and we are in need of a vasoactive medication. The nurse comes to my computer and sternly states, “We can no longer avoid it. I think the patient needs a central line.” I quickly say “okay,” but I don’t move. I am momentarily frozen by my unease with the bedside procedure ahead.
Resident Physician Contributing Writer
University of Pennsylvania
Briana is a proud southern girl! She was raised in the suburbs of Atlanta before heading to Chapel Hill, North Carolina, for both college and medical school. She is a hardcore Falcons football and Tar Heel basketball fan! After medical school, she decided to take a chance on the northeast and head to Philadelphia. Briana joined the University of Pennsylvania internal medicine program where she is now serving as chief resident. When not at work, Briana enjoys baking, reading a good book, and catching a yoga class. Her immediate family includes her loving parents in Atlanta and her younger brother in Amsterdam. Briana plans to pursue a career in primary care with a special interest in medical education and community health outreach programming.
