• About
  • Academic Publications
  • Bioethics
  • Blog!
  • Columnist: In-Training
  • Narrative Medicine: Why I Write

Sarab Sodhi

~ My Life in Medicine

Sarab Sodhi

Tag Archives: Residency

Three Patients

19 Tuesday Dec 2017

Posted by Sarab Sodhi in Education, Emergency Medicine, Medicine, Philosophy

≈ 1 Comment

Tags

Emergency Medicine, medicine, Residency


Another publication from way back when, detailing the insanity of intern year.

 

At 0622, I walked into the resident room. I pulled on my scrubs and clipped my stethoscope, cellphone and trauma shears to my waist. A patient had joked I looked like a gunslinger from an old western. I felt more like Don Quixote, with my makeshift strapped on armor, trying to do good against all odds.

 

I walked into my shift at 0645, into the busy urban Emergency Department I called home. The night intern signed out to me. The sign out included the usual scattering of the very sick, and the very intoxicated, everyone else had gone home before dawn broke.

 

I walked up to see a new patient that EMS had just rolled in, an elderly Vietnam vet who’d fallen and couldn’t get up. He was terrified he’d broken his back. I reassured him and his wife as best I could without lying to him. Leaving, I got a call from the nurse of one of my patients. “The woman in 19 wanted to leave, is at triage.”

 

Stale alcohol wafted through the air. As I tried to make sure she was sober, she grew irate. When I asked her to walk, she huffed and took two steps to me with her middle finger raised, stopping right before she slammed into me. I went to print her discharge to a commentary telling me where I could put it.

 

I’ve been a resident in Emergency Medicine for two months now, but I’ve already begun to find those encounters blasé. As I bade her good health and walked back, the veteran called me over. He and his wife seemed terrified so I reassured them and explained what to expect as the day went on.

 

I walked over to go see my new patient and I got a call “Bed 14 wants to talk to you”. As I approached, I saw the half-naked, well built, angry looking fellow I’d been signed out and had a sinking feeling. He cursed at me with a fluency I’ve grown to expect, with his sweet, old mother sitting next to him holding his dirty shoes and clothes on her lap. “Let me go!” he spat, as I kept my distance, a muscular technician at my side. As I tried to examine him, his anger grew. He ripped off his C-collar in one mighty swipe and his blood pressure cuff in another. As he was rising from bed, security officers materialized, as if beamed down from Star Trek. Under their gentle, watchful gaze, I finished examining him and finding him sober, discharged him.

 

As my day progressed, I saw a handful more patients, dispositioning them with the eagerness and ineptitude of an August intern.

 

The veteran ended up having a compression fracture, and as I helped put him in his back brace, he thanked me effusively. As I said goodbye, he looked me in the eye and said, “I don’t know how you do it. I heard that woman curse at you, and I saw how badly that kid wanted to rip your head off. How do you do it? All this pain and suffering day in and day out would destroy me…” I smiled, shrugged my shoulders and said “It comes with the job.”

 

As I walked away I was forced to confront my flippant answer. I’m an intern, two months into residency and already I’ve lost a handful of patients. I see terrible violence every day and as I dip into and out of people’s lives I feel a faint echo of their misery. To survive as I tilt my lance at windmills, I wear a coat of emotional armor that allows me to take the hits and keep working. My armor is adaptive: titanium when I see angry, intoxicated patients and cotton when I see scared sick people.

 

Then I sign out, walk out of the Emergency Department’s bright neon lights and try to leave it all behind me. As I get home, to a loving significant other and puppy, I take a deep breath as I walk in the front door, take off the armor, piling it carefully by the door. After all, I work again tomorrow.

“You Set the Tone”

05 Tuesday Dec 2017

Posted by Sarab Sodhi in Education, Medicine, Philosophy

≈ Leave a comment

Tags

Emergency Medicine, Empathy, Medical School, medicine, Residency


Another walk down memory lane, as I finished my ED months and did my medicine sub-internship. A good reminder, that when all is said and done, you do set the tone and you choose the job. I still vacillate between the emotional teflon being extra thick and it being porus enough that the insanity of work spills into my personal life. And I probably will keep doing that forever.

 

“Don’t ever say you’re sorry. See, there’s two kinds of doctors… there’s the kind that gets rid of their feelings, and the kind that keeps them. If you’re gonna keep your feelings, you’re gonna get sick from time to time – that’s just how it works. People come in here and they’re sick and dying and bleeding, and they need our help. Helping them is more important than how we feel.  But it’s still a pain the ass sometimes. Sometimes, I just want to quit and do somethin’ else.”

-Mark Greene, ER

 

I’ve realized recently that there are a few things medical school teaches you nothing about. There’s the fabled four year curriculum that all neophytes believe will make you into an educated, caring, considerate and capable physician. And then there’s the reality that most of what it is to really be a physician is learned in the “unwritten curriculum”, the curriculum you learn from watching the residents, attending’s and nurses. Handling death, seeing suffering and being unable to do anything about it, and how to handle the abuse that a day in the hospital sometimes throws at you- all of these are things you figure out on your own, and hope you’re doing right.

Today, the Match list opened. I’m going to put in my list of programs I want to go to and in March, I find out where I go. And then on July 1st, I become an Emergency Physician- terrified, marginally capable and hopefully guided as I try to take care of people. I’ve spent a lot of time recently watching season after season of ER, and I’ve come to realize something terrifying.

Three and a half years of medical school have hardened me. They’ve acted like a forge, providing tremendous heat and a constant pounding to beat out the ‘imperfections’ and to expose me to the wonders and terrors of clinical medicine. They’ve taken a humanistic person who read Wordsworth, Sarte, and Dostovesky and replaced him with someone deeply familiar with the PERC rule and the CHADS2. I’ve become capable of taking care of patients to some degree, I walk with the strut of someone comfortable with much of daily patient care. My training has helped me save a couple of lives already, and will likely be responsible for saving many more over my career. But I can’t help but wonder what I’ve lost along the way.

The last patient I did CPR on died. I had my hands poised over her sternum when time of death was called. I realized later, that when I left I walked out without a second thought as to the life that had just ended, moving on efficiently to the next task.

More than anything else that terrifies me. I’ve never been overtly or overly emotional, but recently in the hospital it’s as though I’ve developed this protective Teflon coating that blunts both the great saves and the terrible losses. I can’t imagine functioning in a busy Emergency Department without it- the fear would probably render me catatonic, but the existence of it makes me wonder if I’ve become the soulless automaton I swore I would never become- the soulless automaton so far from the physicians identified by Mark Greene and John Carter.

As my mind wanders down this tangent, I’m reminded of another patient I’d seen that same day. He was an elderly gentleman, a veteran of World War II and Vietnam. A patrician gentleman with a regal bearing, I was admitting him to the hospital for pulmonary edema. When I told him, this man who’d survived the landing on Normandy and pushed on despite seeing scores of his friends die, broke down in tears. He was terrified he was losing his independence to a disease that crept on insidiously with age. My heart broke a little inside, because he reminded me of my own grandfather, a 85 year old general who hated the hospital. So I sat with him for ten minutes just talking, and holding back tears.

I do set the tone, I do decide how I’m going to see and manage and handle the emotional onslaught contained in the walls of an Emergency Department every day. And despite how useful my emotional armor is, I think I need to continue to live in fear of it. The day I grow to like it too much, is I think the day that I should hang up my stethoscope.

May that day be far, far away.

 

Transitions: A Reflection

28 Tuesday Nov 2017

Posted by Sarab Sodhi in Education, Medicine

≈ Leave a comment

Tags

Graduation, Medical School, Residency


Written a month before graduation from medical school. It reminded me of that infinite medical school wisdom, when all is said and done, P=MD.

 

I walked into the medical school today morning, smiling at being back in a place I’d not seen too much of in the last year and a half. I stopped midstride, as I saw a sea of new faces sitting in the common area. The faces I saw were young, eager, full of promise, hope and fear- clearly new first years.

It struck me then, as I began to walk more slowly through the hallowed halls that had educated me- I was officially an old man.

I recalled, four years ago, walking into the medical school for orientation. I can relive the emotions that roiled inside my chest in each moment. Eagerness, disbelief that I had made it, the confidence from college that I would be the smartest, the fear that I wouldn’t, and most of all the angst of the unknown path I was treading.

I remember walking into our big lecture hall and sitting on the left sided batch of seats- something I still do to this day. I remember sitting there just watching my peers, who in a few short months will be MDs and wondering what kind of MDs they would be. I remember seeing those same people that evening at the social event uninhibited by copious doses of alcohol and wondering all the more.

I remember the drive to do well on my tests and get that honors, the degree to which my self worth was tied up so intimately in the letter my course gave me. I recall the gnawing feeling in my gut when I didn’t get honors, or did “okay”. I smiled when I thought of the first time someone had let me do something in the hospital and how cool it felt. I remember how uncool it felt when I had to do something after my 5th surgery call night.

That walk wasn’t a long one, but my mind walked the ups and downs of the three and a half years I’ve spent here during it. I had a discussion group to run for the new first years about a book they all read. After I was done, one of them came up to me to talk. Bright eyed and bushy tailed, she reminded me of myself during first year. As I left I gave her a parting word of advice, “Don’t worry too much during med school”, I said, “It ebbs and it flows- but ride it out and you’ll be just fine.”

My journey here will end soon. In a few months I’ll be an MD. In a few more I’ll be a resident. And sometime after that maybe I’ll be a good doctor. But I know that leaving this door will also mark the next unknown path my feet will follow. And I know now that I’ll be just fine.

Scut Monkey

22 Saturday Mar 2014

Posted by Sarab Sodhi in Uncategorized

≈ 1 Comment

Tags

Lifesucks, Medical School, Residency, Scut, Third year


Image

The comic says far more than I can really. Came across this gem on:

http://theunderweardrawer.blogspot.com/p/scutmonkey-comics.html

 

As a present third year who does a lot of these, I can’t help but wonder why scut is so prevalent on medical student rotations….

Till I figure it out, monkey see, monkey do?

Match Day

Match Day 2015March 20, 2015
The day my future is revealed

Blog at WordPress.com.

Privacy & Cookies: This site uses cookies. By continuing to use this website, you agree to their use.
To find out more, including how to control cookies, see here: Cookie Policy
  • Follow Following
    • Sarab Sodhi
    • Join 51 other followers
    • Already have a WordPress.com account? Log in now.
    • Sarab Sodhi
    • Customize
    • Follow Following
    • Sign up
    • Log in
    • Report this content
    • View site in Reader
    • Manage subscriptions
    • Collapse this bar