The best job in the world

Technically, it’s not my job yet (I doubt anyone would pay for advice from a 2nd year med student behind on his reading). But that was my thought as I rolled myself out of bed at 6:00 AM this morning to go on my preceptorship at the hospital (basically tagging along and seeing everything they do).

That and, “Crap, I better be out the door in ten minutes.” Also, “How did I turn off my alarm without waking up?”

Thinking of the trauma surgeons who have to get from their bed to the hospital in 20 minutes, I quickly got dressed and ready, grabbed an orange for breakfast, and drove down to the medical center.

But I really was looking forward to it. So many exciting things happen at the hospital, you’re there working with a team of smart and good-hearted people, and it’s full of intellectual stimulation and personal challenges.

I’ll share two vignettes:

1.
The resident I was following asked everyone whether they had any interesting cases for me to see. A third-year student suggested her patient, Mr. D, who had a heart murmur. “Ooh,” said my resident, concerned. The student said, “Yeah, he won’t be happy when we come in again.” This was a man with metastatic cancer, which led to a number of other conditions, and who had been biting and sarcastic to most of the people who saw him (for good reason). The student asked if I was up for it, and I said I was, and braced myself.

She cautiously opened the door and asked if it was okay if we came in to ask some more questions. He agreed, and we came in.

And then he was perfectly responsive to our questions, made jokes here and there, and graciously let me listen to his heart. This was a totally different person than the one I imagined. When we got back to the station I told the MS3, “He seems to be in a good mood today.” She said, “He’s in a *really* good mood!”

2.
Mr. F (name changed) had a low O2 saturation and was on an oxygen face mask, which was not on his face when we came in. “You need to wear it over your mouth and nose,” said the resident, putting it over his face. He was in some pain but managed to tell us he didn’t like wearing it, and he pulled it down to his neck. “I know, it’s not comfortable, but it’s important, though. Your blood oxygen is very low,” the resident said. “How about this?” She put it on his face with some space for the room air to flow in, and he sort of gave up and left it there.

When she started asking questions, he didn’t respond. She tried to get his attention, and then started asking him if he knew where he was (assessing his mental state) and he said, “I know where I am. I already answered all these questions. Where’s that Asian?” (referring to the intern who interviewed him earlier that morning). My resident was a little fazed but managed to get him to say his name and the date correctly.

Her next question: “Is there any pain?” He nodded.

“Where?” He didn’t respond. She asked again.

“In the ass,” he said.

I tried not to laugh as we took our cue to leave.