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In a month, I’ll be an intern in EM @ Emory. The last two months have been crazy (read: scary, horrible, transformative, growth-inducing) bc a member of my nuclear fm got lukemia in the cranium
I spent 20 days as the sole visitor in the hospital & was allowed to enter bc of altered mental status. I didn’t want to come & go home bc the hospital is in a #covid hotspot so I marathon slept there
I learned some things (would be hard not to) that I wanna remember. Some “do not repeat” doctor things, some “definitely repeat” doctor things. Some life things. Here goes:
1. ICU nurses are the best people. They are an integral part of the decision making team. Trust them. They also have the biggest hearts. They know more medicine than I will for a long time. Use that resource.
2. Be deliberate about communication. Say what you know. Be honest what you don’t know. Don’t lie, don’t stretch the truth, don’t be unprepared. Promise to check the chart. Do it. Information is EVERYTHING in illness.
3. Acknowledge pain, fear, sadness. Especially in this pandemic. Say, “I am so sorry you’re dealing with this.” Say it when you mean it and when you almost don’t. Say it with every patient, always. This is NOT a good day for them.
4. Aim to over — never under — inform. Share your thought process, not just the end result. Draw, sketch, write, refer to web. Leave people w tangible evidence of their work-up.
5. Do a full physical exam. Just do it. Talk while you do it. Do it for “show”. Do NOT do it for show. Do not see a patient and not do a full physical exam. It makes them/loved ones feel like you don’t care, and you DO care.
6. This pandemic is still happening. Do not get alarm fatigue, and if you do, don’t express that to people in panic mode. Give space for fear. Redirect, reassure. Explain precautions you are taking.
7. Docs see 1/1000 of what happens. Know your care team and reinforce the team based nature of care. Eg: Denis? He’s AMAZING. You’re in great hands. There’s a lot going on today, but I’m confident he’ll take great care of you. *here’s your call bell*
8. Explain what’s *probably going to happen* all the way. Eg: you’re being admitted to a team of doctors known as ‘’medicine team A”. They will see my notes and I just spoke with them on the phone. They will round & discuss treatment with you ... logistics are SO CONFUSING
9. Consent patients (w risks v benefits) for procedures.
10. Talk about kids. Everybody has or knows or has seen a cute kid. Just bring them up (to ancillary staff, other doctors, patients, anyone.) Hey? Know any cute adorable kids? Me too!! We’re both human!
11. Be abundantly, explicitly communicative. Work on communication with a DBT or CBT worksheet if it’s not your thing. Practice. Be more clear than you think you have to be. Repeat everything twice. Hospitals are SO CONFUSING!!!!
12. Last one, care about that tiny rash, the dry hands, the pain w defecation. Treat it like it’s just as important as SOB or belly pain. A person is a contiguous organism and their concern might not be your main concern..... (cont)
12+ give a shit as if it were your fam with a TINY blister and realize that every single thing matters to people who are sick and that it should matter to you, too, at least in how you communicate about it, even in the ED or the ICU. You have enough empathy for all of it.
