Fellow Physician Contributing Writer
Junior Clinical Fellow in London
Grace is a UK-qualified physician and holds honours degrees in both pharmacy and medicine. She has worked as a research scientist in the fields of drug delivery, gastroenterology and hepatology; runs two organisations pertaining to sustainability in healthcare; and holds fellowships with both the NHS Clinical Entrepreneur Programme and the Royal Society of Arts. In spite of all of this, she still can't afford London house prices. It's a mad world.
Earlier last week, one patient had been referred in from their family physician, and the onsite senior resident, Adam, had been the doctor to assess them. Symptoms were vague — generally unwell, off food, bit of a cough, possible headache. Viral swabs were taken, because pretty much anyone that had lately walked through the hospital door with even a suspicion of sepsis now had samples sent off.
As an internal medicine resident working at Mount Sinai Hospital in Manhattan, COVID-19 has taken over our workroom conversations as the number of new cases enters exponential growth. As an anthropologist who lived in Wuhan for a year and has regularly kept in touch with physicians there since the city was placed under lockdown on January 23, 2020, COVID-19 has proved to be an unprecedented crisis.
You could feel it in the air, in how the nurses double-checked the orders, how the attendings’ notes bloated in size, and even in how the patients, despite their general lack of knowledge towards the inner workings of the hospital, exuded mild apprehension. It was day one of the academic year, the day that the new interns — my new interns — started.
Caffeine’s effect waned, stomachs rumbled, attention spans faded after rounding on nine acutely ill patients on university wards. It was nearing lunch. I was the senior resident, so I chose the order in which we saw patients. As we arrived at our last patient’s room, I snapped out of my under-caffeinated daze and realized I had made the rookie mistake of leaving our newest and sickest patient for last.
When I am asked about my future plans, my response is rightfully met with confusion. I am entering the workforce as an academic internal medicine physician devoting my practice entirely to the outpatient setting. Yet, two-thirds of my residency training has been managing patients within the walls of a hospital. That disconnect raises interesting questions about my career choice, and, naturally, makes me an anomaly among my peers.
They said to stop compressions. We all agreed. This baby had no life when she was born, and we had fought for twenty whole minutes with our arsenal of medicine to give her life.
Residency is a challenging time plagued by long hours, overwhelming clinical service loads, escalating documentation requirements, and inadequate resources for support. A recently published study in the New England Journal of Medicine illustrates how mistreatment in the training environment takes an additional toll on medical trainees.
@PsychResChat is the newest sub-community on Twitter, short for Psychiatry Resident Chat, the brainchild of Dr. Tolu Odebunmi, MD, MPH who is a psychiatry resident at the University of Minnesota. The co-hosts use the account to share information and news relevant to psychiatry residents. Additionally, @PsychResChat is the home of bi-weekly live discussions, aimed at engaging the #PsychResTwitter community.
It wasn’t caterpillars turning into beautiful butterflies, that’s for sure. “The Change” was when a bright-eyed, optimistic female junior resident turned into an angry, and sometimes mean, senior resident with very little patience for anyone.
My senior and I had been on night float together for a few weeks. That night, the dimmed lights of the hospital corridors spilled into the workroom which was lit only by my computer screen, but that was enough. Despite the few months that I had been there as an intern, I could describe each inch of this room with my eyes closed.
It was 2 a.m. and I was downward-dog in the call room. Earlier during this maternal/child health rotation night shift, I had labored with three other moms in so many different positions that my back felt like it might actually break.
Over the last year, our collective minds have been captivated by stories about child and family separation, detainment of citizens and immigrants, and the quality of the health care within detention facilities. These stories have been jarring and traumatic, and have also awoken an important level of national consciousness about the nature of detention. What has not received as much coverage in recent discourse is the ongoing nature of solitary confinement in our justice system.
Resident Physician Contributing Writer
Harvard Medical School
Aishwarya Rajagopalan is a PGY-1 psychiatry resident with the Harvard South Shore Psychiatry Residency Program. Her interests include the intersection of psychiatry and social justice, especially among women and transition age youth, public mental health and policy. In her free time, she loves partaking in spirited policy debates with friends and family, spinning, yoga, dark chocolate, bad reality TV, and green tea with lemon. She is an in-Training alumna and is excited to continue on in this space.
Policy Prescriptions
Policy Prescriptions is dedicated to exploring and challenging contemporary health policy issues, especially in the fields of behavioral health, health care access, and inclusion.
