Agraphia Medical Tragicomedy


Changing Roles

I'm really enjoying being a senior resident.  This month I'm mentoring our medical students, and it's been loads of fun so far.

Today we had a "simple" laceration that needed closing.  Typically this is the medical student's job, since the residents have traumas and coding patients to take care of.  I sent Medical Student to sew up the lac, but two minutes later he came out of the room, pale-faced and nervous.

"Dr. Zac... I took off this guy's pressure dressing and he's kind of... bleeding out from his wound.  Like, sort of spurting blood. Kind of everywhere. I think I need help."

I'm a pretty laid-back guy, but years of emergency training have instilled a GO switch in me.  I immediately popped in the room.  Sure enough, this guy was hemorrhaging blood from multiple severed arteries in his leg.  I grabbed Med Student's gloved hand and shoved it in the wound.

"You feel where that's pulsing?  I want you to keep your fingers right there and hold pressure.  I'll be right back."

There are varying degrees of emergency; this is one that can be fatal if left unchecked.  I ran out of the room, grabbing the necessary equipment and sutures.  Med Student seemed quite relieved when I returned.  Quickly I tied off the bleeding arteries while explaining what I was doing (throw your stitch under the artery, loop back around again, and tie it off.  This is called a figure-of-eight suture and it will save your ass in a pinch).  Within a minute I had the bleeding stopped.  Med Student appeared impressed.

Suddenly, it was a simple laceration repair again.  I supervised him closing the wound with little teaching points along the way, and to his credit, he did a fantastic job.  It will look great when it heals.

The patient's wife pulled me aside later.  "Doc, you really seem like a fantastic teacher.  We were both so reassured that you were there. Thank you so much for taking such great care of us!"

It was a great day, and it's been a wonderful month so far.  If the rest of my life is like this, I'll be a very happy physician.

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  1. You do seem like an ace teacher. I’m starting med school next year (very exciting) and I am hoping the doctors I get assigned to for clinical days will be as awesome as you. Another great post!

  2. That’s ABSOLUTELY brilliant! I am saying this as a medical student. I respect doctors so much already when they are saving lives in an emergency (I saw a patient crash on the wards and the teamwork and fast thinking skills and the way everything flowed like a symphony to resuscitate the patient was beautiful. He survived, I think. Touchwood.), and although my observation was not accompanied by teaching (understandable as their priority is the crashing patient!), I always always appreciate it when a doctor teaches. Doing that in an emergency situation is just brilliant. It must be so satisfying to teach something you love, I love the feeling I get when I help my junior medical students with their work, having been in their shoes not so long ago and probably screwing up a lot worse than they are doing. I also love it when doctors understand and acknowledge our stupidity and appreciate they were once in our shoes too. It gives us reassurance and confidence like nothing else! :)

    PS: I’m a Y4 UK med student, just blog-hopped on over… can’t even remember from where now! Hello! :)

  3. I am grateful that you’re willing to let us readers in on some of the specific joys and stresses of being a trauma doc.

    P.S. – any time to read? Have you read Cutting for Stone?

  4. I haven’t, actually; but it’s sitting on my nightstand. My parents insisted I read it but I’ve just been so busy…

  5. good post..this blog deserves to be known in the world.. Thank you for the information..

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