It’s okay that you don’t remember me. My name is Shara, and I’m part of the surgical team. I’m checking to see how you’re doing after your surgery. Do you know where you are right now? Actually, you’re in the hospital. You had surgery a few hours ago, for a broken hip. You used to be able to walk before you broke it, so it was important to fix it as soon ...

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There was a very large lesion in his left frontal lobe, and no one knew what it was. He had been admitted earlier that day, after a neighbor found him in the hallway, confused and covered in urine.  Now he sat in his bed quietly, while we stared at his brain and the bright spot that didn’t quite resemble something. It can’t be tissue death from a stroke, insisted one resident. It ...

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On my second day of fourth year, I had to make a decision. “Mr. K would like Miralax,” read the nurse’s page. A medical sub-internship, which a student completes in her fourth year, is designed to be an internship with training wheels. The main difference between third and fourth year is that the  third year reports to an intern (who makes a decision) while the fourth year replaces the intern. Last year ...

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Our medical education system does not tolerate emotional cracks When we told the patient and his family that the mass in his lung was highly concerning for cancer, he didn’t say anything.  His daughter asked about his symptoms.  His son-in-law asked when and how he could get a definitive diagnosis.  His wife asked when he could go home.  Finally, he spoke. “I’m sorry for being so much trouble.”  The tone was casually apologetic, ...

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“Your hands feel like velvet,” the 94-year-old woman told me as I pushed on her abdomen in the emergency department on a Friday night. “That’s the nicest thing anyone’s said to me all day,” I told her. “That’s pretty sad,” she said, and her abdomen quivered as she suppressed a laugh. I walked out of the curtained room and briefly presented her findings to the resident on call. In return, he showed me ...

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“You’re not sorry.” Within two days two different patients said this to me, each with hatred in his voice.  Each time I was alone, each time I had known the patient for only a few minutes, and each time the rage was directed at me and only me. For seven months, I had avoided being the bad guy.  When a patient got upset, he accused my superiors, and I hid behind their ...

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I pull up a test result for my patient, and the senior resident standing behind me lets out an excited squeal. “I’ve never seen the imaging come back positive for this,” she says.  Our two-week-old infant, who already has a rare infection, also has a rare associated structural abnormality.  It’s not benign, but it is fixable.  The fix usually requires surgery. As we walk over to the patient’s room to update her ...

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She had only been in the hospital twice in her life: once when she was nine and now, 60 years later.  She had gotten tonsils out then.  She was getting tumors out now. Her abdomen hurt when she was awake.  Her abdomen would also hurt during exploratory surgery, although she wouldn’t be able to feel it under general anesthesia.  Her body would feel it, though, and could respond by dangerously spiking ...

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“By the way,” my chief resident told me on the first day of my inpatient psychiatry rotation, “don’t lick your lips in front of him.” “Wait, what happens if–” I fell silent as the patient walked into the interview room.  The resident wanted to discuss his paranoid delusions; the patient wanted to discuss his discharge. The patient wasn’t ready to leave because the medications that made the demons stay away were also making his ...

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An elderly man startles awake after a man in a white coat touches his shoulder.  He looks around and sees three other white-coated people standing around his bed. “Sir? Good afternoon, sir. How are you?” says the man who touched the patient’s shoulder. “Oh, I’m fine.”  He’s perfectly calm. “I know this is a silly question,” continues the man, “but do you know where you are right now?” “Of course, of course. I’m at ...

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