I have always been fascinated by the brain and its mysteries, so this semester I took advantage of a medical hypnosis elective. It was just two classes, each two hours long, and really only served as a very brief introduction to the role of hypnosis in medicine.
What is hypnosis?
"A good date is a mutual hypnotic state."
Hypnosis is a special state of mind that is brought about by intensely focusing on something and is characterized by a sort of dissociation from self. Have you ever been driving home and, once you arrived, realized that you didn't remember how you got there because you had been driving on "autopilot?" You focused on the road and allowed your mind to relax into whatever thoughts it pleased so that you lost all sense of time, and your body mindlessly performed the motor tasks necessary to get you home. That's a hypnotic state: a combination of intense focus and relaxation that somehow lends a person more open to suggestion.
Inducing a state of hypnosis involves both of these elements, focus and relaxation. The instructor demonstrated this by hypnotizing the class, the five of us. He had us imagine a "safe space" in our mind and asked us to explore every little detail of it. I noticed that the suggestion was vague and open to interpretation. This is called a "lead and follow" technique: the operator (hypnotist) leads the patient in a given direction then follows where the patient's mind goes. The effect is to reinforce imagination as reality to induce a deeper hypnotic trance. Four out of the 5 of us experienced a hypnotic state. Some people are inherently more easily hypnotized, and some people are less so.
Being the hypnotist
Next, the instructor invited us to practice on each other. Sitting down with my classmate in front of me, ready to do and feel and imagine what I suggested, I had a much clearer understanding that only experience can teach of what it means to hold such strong control over another person's mind. The sensation was exhilarating and a bit unsettling. I quickly learned that not only my words themselves but how I spoke mattered greatly. So, despite the adrenaline pumping through my body, I was careful to speak in a calm and measured manner, slowly, so the full impact of my words could be absorbed.
I discovered that I am good at hypnosis! I induced a hypnotic state in my classmate quite easily, but I didn't know what to do with it. This was partly due to my inexperience as an operator, but it's also because there was no real purpose to the session other than to practice inducing a hypnotic state.
Hypnosis and medicine
Hypnosis is not just used in psychiatry, which is what I'm sure most people believe. The instructor pointed out that pain is a particularly good inducer of a hypnotic state because nothing better focuses one's attention than pain. In fact, a patient with pain is often in a hyper-suggestible state of mind. Then the doctor walks in the room wearing a white coat and/or stethoscope, which are both symbols associated with the promise of alleviating that pain. I have myself witnessed such a hyper-suggestible state in my own patients, for instance when a man in excruciating pain from a fractured rib allowed me to touch him in exactly the spot that hurt the most.
The meat-and-bones of this elective was first recognizing this unique psychological state that we'll see in many of our patients, and second to learn techniques to take advantage of it to better serve our patients. My favorite example was using a pinwheel to distract a child from pain (e.g. a splinter, a scrape, getting a shot). I wish I had had this trick up my sleeve last semester when I was giving children shots at Warren Village. Asking the kid to blow on the pinwheel first offers the child something else besides pain to focus on. More than that, though, there are physiological benefits to breathing deeply to blow on the pinwheel, and the pseudo-trance is strengthened by the immediate effect of watching the pinwheel twirl.
My first hypnosis patient
Some time after I finished the hypnosis elective, a classmate of mine was trying to study but couldn't concentrate because she was so tired. "I can hypnotize you to make you concentrate better," I suggested, half joking. But she said yes, and I got myself my first hypnosis patient. I hypnotized her easily enough and suggested that when she woke up she would feel energized to study more and a sharpness of mind so that she would understand and remember the material better. For what it's worth, she reported to me the next day that she was able to finish out the night studying, and she's sure that otherwise she would have fallen asleep in her books.
I'm eager to keep practicing hypnosis. Any volunteers?
Friday, March 12, 2010
Sunday, February 28, 2010
Pre-hospital medicine
As part of a pre-hospital medicine elective, I did a 10-hour shift ambulance ride-along with a couple of paramedics. I took this elective because I wanted to get a better idea of what happens with patients before they arrive in the emergency room, but the experience ended up teaching me more about the general job duties and perspectives of a paramedic.
My shift started at 2:30 pm and went to 12:30 am. It was a rather slow night - good that few people were getting hurt, but unfortunate for me since it made for a boring experience. We didn't get our first call until 5:30. Over the course of the night, we only had 6 calls total, 4 of which were Code 10 (sirens blaring). My classmates who also did a ride-along had vastly different experiences: one was doing CPR in the back of the ambulance while a patient was having a heart attack.
During all that down time, the two paramedics who I was shadowing talked a lot about their various interactions with nurses and doctors. I found it interesting that they grouped the quality of their interactions with nurses according to the hospital (apparently each hospital has its own "culture"), but the quality of their interactions with doctors was based more on individual personality rather than a particular hospital's culture. If I got anything else out of this elective, my two paramedic friends reinforced the interdisciplinary teamwork lessons that were drilled into us last semester: doctors are one component of a medical team, and patient care is maximized when the team works well together.
I enjoyed my experience overall, and would recommend this elective to someone interested in emergency medicine, but I do wish the ride-along could have been a bit more exciting.
My shift started at 2:30 pm and went to 12:30 am. It was a rather slow night - good that few people were getting hurt, but unfortunate for me since it made for a boring experience. We didn't get our first call until 5:30. Over the course of the night, we only had 6 calls total, 4 of which were Code 10 (sirens blaring). My classmates who also did a ride-along had vastly different experiences: one was doing CPR in the back of the ambulance while a patient was having a heart attack.
During all that down time, the two paramedics who I was shadowing talked a lot about their various interactions with nurses and doctors. I found it interesting that they grouped the quality of their interactions with nurses according to the hospital (apparently each hospital has its own "culture"), but the quality of their interactions with doctors was based more on individual personality rather than a particular hospital's culture. If I got anything else out of this elective, my two paramedic friends reinforced the interdisciplinary teamwork lessons that were drilled into us last semester: doctors are one component of a medical team, and patient care is maximized when the team works well together.
I enjoyed my experience overall, and would recommend this elective to someone interested in emergency medicine, but I do wish the ride-along could have been a bit more exciting.
Wednesday, February 24, 2010
Intubation night
The Emergency Medicine Interest Group (EMIG) hosted intubation night on Monday. We were up in the anatomy lab practicing on cadavers how to intubate a patient, which just means sticking a tube down the patient's trachea to start artificial ventilation. I have seen this done many times during my experiences in the ER, so it was especially rewarding to learn the how's and why's of intubation.
The emergency medicine residents taught us how to use an instrument that pushes the tongue out of the way and has a light at the end of it to see down the throat and pull up on the trachea to allow passage of the tube. This is a metal instrument, so it's actually difficult to do without chipping teeth. Then, a small balloon is inflated to secure the tube in place, and the patient is ventilated with an air mask.
If the patient (or in the case, cadaver) was intubated correctly, the chest will rise with ventilation. The tricky part about intubation is getting the tube into the trachea rather than the esophagus. In the ER, the doctors verify that the tube was placed correctly by listening with a stethoscope to breathing sounds in both the chest and stomach: breathing sounds in the stomach indicates that the tube is placed in the esophagus, which is obviously a bad thing. Standard procedure in the ER is also to take a quick x-ray to make sure the tube is placed correctly. If the tube is inserted too far, it could go down the right or left bronchus and supply air to only one lung. That's also an obvious situation to avoid and another reason why doctors listen for breathing sounds on both sides.
I suppose the chances are rather slim that I'll actually be able to do this on a real patient anytime soon, but it's something to look forward to.
The emergency medicine residents taught us how to use an instrument that pushes the tongue out of the way and has a light at the end of it to see down the throat and pull up on the trachea to allow passage of the tube. This is a metal instrument, so it's actually difficult to do without chipping teeth. Then, a small balloon is inflated to secure the tube in place, and the patient is ventilated with an air mask.
If the patient (or in the case, cadaver) was intubated correctly, the chest will rise with ventilation. The tricky part about intubation is getting the tube into the trachea rather than the esophagus. In the ER, the doctors verify that the tube was placed correctly by listening with a stethoscope to breathing sounds in both the chest and stomach: breathing sounds in the stomach indicates that the tube is placed in the esophagus, which is obviously a bad thing. Standard procedure in the ER is also to take a quick x-ray to make sure the tube is placed correctly. If the tube is inserted too far, it could go down the right or left bronchus and supply air to only one lung. That's also an obvious situation to avoid and another reason why doctors listen for breathing sounds on both sides.
I suppose the chances are rather slim that I'll actually be able to do this on a real patient anytime soon, but it's something to look forward to.
Monday, February 8, 2010
Earning it
This falls under the category of something that all medical students know but don't want to think about. (http://xkcd.com/699/)
Tuesday, February 2, 2010
Aortic valve replacement lab
The Surgical Society hosted an event that brought in a number of cardiothoracic surgeons to teach a group of about a dozen medical students the basics of aortic valve replacement. We worked up in the anatomy lab with one pig heart and one CT surgeon for three students, plus several other CT surgeons floating around the room who were apparently there just to play around with the hearts and have fun.
The surgeon teaching my group first pimped us on heart anatomy then walked us through the transplant procedure step-by-step. The three of us took turns playing "surgeon" while the real surgeon helped us with the technical details (e.g. where to cut and where not to cut, how to position the sutures, etc...) and by explaining why we were doing what we were doing. Whenever one of us made a mistake, our teacher yelled at us, "You killed your patient!" It's a good thing we were only working on a dead pig's heart.
Seeing how all the pieces fit together physically, in three dimensions, helped me wrap my brain around how it's even possible to replace a living breathing patient's aortic valve. It truly is amazing.
The surgeon teaching my group first pimped us on heart anatomy then walked us through the transplant procedure step-by-step. The three of us took turns playing "surgeon" while the real surgeon helped us with the technical details (e.g. where to cut and where not to cut, how to position the sutures, etc...) and by explaining why we were doing what we were doing. Whenever one of us made a mistake, our teacher yelled at us, "You killed your patient!" It's a good thing we were only working on a dead pig's heart.
Seeing how all the pieces fit together physically, in three dimensions, helped me wrap my brain around how it's even possible to replace a living breathing patient's aortic valve. It truly is amazing.
Saturday, January 30, 2010
Microbiology lab
Over the past few weeks, we have been spending some of our lecture hours in lab playing with bacteria. There are mixed opinions about the lab sessions among my classmates, but I enjoyed the labs overall.
Their purpose, really, was to have us perform experiments and observe the results to learn key concepts of bacterial morphology and development of resistance to antibiotics. That works out great for people like me who need a few modes of delivery for the material to sink in properly. Another up-side was that it cut us all some slack by decreasing the "information concentration" (volume of information per unit time).
I particularly enjoyed learning how to do a Gram stain, the archetypal protocol for distinguishing between Gram-positive bacteria (which have a thick cell wall and stain purple) and Gram-negative bacteria (which have a thin cell wall and stain red). Whether a bacterial is Gram-positive or Gram-negative is usually instructive as to which types of drugs it will likely be responsive to.
My favorite part of the lab was the experiment demonstrating how bacteria have developed resistance to antibiotics. The three plates above were all plated with Staphylococcus aureus, a particularly nasty bug that's responsible for skin (staph) infections, pneumonia, and a whole range of other problems. The plate on the left is a strain of Staph isolated from the community in 1945, the middle plate is a strain from 1965, and the plate on the right is a strain isolated in 1999. The little white disks each contain a different type of antibiotic, and you know that the bacteria are susceptible to a given antibiotic if there's a zone of clearance around a disk: the larger the zone of clearance, the more effective the antibiotic is at preventing bacterial growth or killing the bacteria.
Notice how every antibiotic was effective at clearing the 1945 version of Staph. aureus, but that effectiveness was markedly decreased against the 1965 strain. By the time you get to 1999, five of those eight antibiotics are completely useless against Staph. aureus. The doomsayers are worried about what happens when we don't have any antibiotics that are effective against highly resilient bacteria. As future doctors, we must be careful when prescribing antibiotics in order to delay the generation of new resistant strains.
Their purpose, really, was to have us perform experiments and observe the results to learn key concepts of bacterial morphology and development of resistance to antibiotics. That works out great for people like me who need a few modes of delivery for the material to sink in properly. Another up-side was that it cut us all some slack by decreasing the "information concentration" (volume of information per unit time).
I particularly enjoyed learning how to do a Gram stain, the archetypal protocol for distinguishing between Gram-positive bacteria (which have a thick cell wall and stain purple) and Gram-negative bacteria (which have a thin cell wall and stain red). Whether a bacterial is Gram-positive or Gram-negative is usually instructive as to which types of drugs it will likely be responsive to.
My favorite part of the lab was the experiment demonstrating how bacteria have developed resistance to antibiotics. The three plates above were all plated with Staphylococcus aureus, a particularly nasty bug that's responsible for skin (staph) infections, pneumonia, and a whole range of other problems. The plate on the left is a strain of Staph isolated from the community in 1945, the middle plate is a strain from 1965, and the plate on the right is a strain isolated in 1999. The little white disks each contain a different type of antibiotic, and you know that the bacteria are susceptible to a given antibiotic if there's a zone of clearance around a disk: the larger the zone of clearance, the more effective the antibiotic is at preventing bacterial growth or killing the bacteria.
Notice how every antibiotic was effective at clearing the 1945 version of Staph. aureus, but that effectiveness was markedly decreased against the 1965 strain. By the time you get to 1999, five of those eight antibiotics are completely useless against Staph. aureus. The doomsayers are worried about what happens when we don't have any antibiotics that are effective against highly resilient bacteria. As future doctors, we must be careful when prescribing antibiotics in order to delay the generation of new resistant strains.
A word on switching preceptors
Last semester, I found myself in the unfortunate position of not being satisfied with my preceptorship experience. We were semi-randomly matched to a physician, either associated with the University or out in the community, usually in a specialty that would afford us opportunities to practice general patient interaction skills and be exposed to a range of different patients (Family, OB/Gyn, Peds, Emergency, Internal).
I matched with a doctor practicing occupational medicine, which basically involves seeing patients who were injured on the job. There's also usually some sort of legal involvement: a lawsuit against the employer, requiring the doctor's signature to allow the patient to return to work, or something along those lines.
Being at the nexus of medicine and two arcane systems of law (Federal and State), there were many aspects of occupational medicine that I frankly found distasteful. First, in some circumstances, doctor-patient confidentiality does not exist. My preceptor sometimes had to preface a question by saying, "Now you don't have to answer this because my records are not confidential..." To me, taking away that privileged relationship between doctor and patient subtly shifts the role of the doctor away from first and foremost caring for the patient's health. The societal role that my old preceptor filled is a necessary one, but I didn't have any interest in spending the next two years of my preceptorship in that environment.
There were other consequences of being caught in middle of a tug-of-war between medicine and law. My old preceptor counseled some of his patients that they may be followed or videotaped by their employers who hope to prove that their injuries were not as severe as they claimed. Also, in order to determine how much worker's compensation should be given to a man with a rotator cuff injury, the deficit in the shoulder's range of motion was measured and applied to arbitrary guidelines imposed by the State and Federal governments. Again, I just didn't have any interest in gaining more exposure to that kind of medicine.
I feel it's important to emphasize that, personally, I very much liked my old preceptor. He seemed to enjoy his role as mentor, and I learned a lot from him. I felt bad telling him that I would no longer be coming in; it was like a break-up conversation. But at the end of the day, this is my medical education, and I need to do whatever is in my power to make the most out of it.
Finding a new preceptor
Finding a new preceptor on my own was a lot more difficult than I thought it would be. My strong preference was to work in the emergency room environment, but I kept an open mind to other possibilities, as well. After striking out with several promising leads, I began to grow discouraged about my prospects of finding a new preceptor.
Then, at the end of last semester, I attended a sonography workshop hosted through the Emergency Medicine Interest Group. Afterward, I approached the doctor who ran the workshop, explained that I was looking for a new preceptor, and asked if he knew if any of his colleagues might be interested. "I'll take you," he said, and that is how I met my new preceptor.
I feel very fortunate to be working with Dr. Browne.
I matched with a doctor practicing occupational medicine, which basically involves seeing patients who were injured on the job. There's also usually some sort of legal involvement: a lawsuit against the employer, requiring the doctor's signature to allow the patient to return to work, or something along those lines.
Being at the nexus of medicine and two arcane systems of law (Federal and State), there were many aspects of occupational medicine that I frankly found distasteful. First, in some circumstances, doctor-patient confidentiality does not exist. My preceptor sometimes had to preface a question by saying, "Now you don't have to answer this because my records are not confidential..." To me, taking away that privileged relationship between doctor and patient subtly shifts the role of the doctor away from first and foremost caring for the patient's health. The societal role that my old preceptor filled is a necessary one, but I didn't have any interest in spending the next two years of my preceptorship in that environment.
There were other consequences of being caught in middle of a tug-of-war between medicine and law. My old preceptor counseled some of his patients that they may be followed or videotaped by their employers who hope to prove that their injuries were not as severe as they claimed. Also, in order to determine how much worker's compensation should be given to a man with a rotator cuff injury, the deficit in the shoulder's range of motion was measured and applied to arbitrary guidelines imposed by the State and Federal governments. Again, I just didn't have any interest in gaining more exposure to that kind of medicine.
I feel it's important to emphasize that, personally, I very much liked my old preceptor. He seemed to enjoy his role as mentor, and I learned a lot from him. I felt bad telling him that I would no longer be coming in; it was like a break-up conversation. But at the end of the day, this is my medical education, and I need to do whatever is in my power to make the most out of it.
Finding a new preceptor
Finding a new preceptor on my own was a lot more difficult than I thought it would be. My strong preference was to work in the emergency room environment, but I kept an open mind to other possibilities, as well. After striking out with several promising leads, I began to grow discouraged about my prospects of finding a new preceptor.
Then, at the end of last semester, I attended a sonography workshop hosted through the Emergency Medicine Interest Group. Afterward, I approached the doctor who ran the workshop, explained that I was looking for a new preceptor, and asked if he knew if any of his colleagues might be interested. "I'll take you," he said, and that is how I met my new preceptor.
I feel very fortunate to be working with Dr. Browne.
Friday, January 29, 2010
Multi-tasking in medical school
The first test of the semester is done. But the higher-ups are testing our multi-tasking skills by throwing at us two concurrent courses: Disease and Defense (this morning's test), and Blood and Lymph. The first test for B&L is coming up this Thursday, which means that I won't be getting as much relaxation and decompression time as I would have liked for this weekend.
It's interesting to compare my classmates' different strategies for this juggling act. Some people focused intensely on preparing for today's D&D test and resigned themselves to falling behind in B&L. The lecture hall was very empty this week. Others managed to keep up to date on both courses even though it means that they didn't have as much time to cram for the D&D test.
I hate falling behind for many reasons and chose not to miss lecture this week. My compromise was that I just didn't spend as much time preparing for the lectures as I normally do. Because of that, and because my mind was drifting off into the land of antibiotics and bacterial toxins during lecture, I'm not sure if my compromise was necessarily any better than not going to lecture at all. We'll see if I'm brave (or foolish) enough to try that option the next time we have a double-header.
It's interesting to compare my classmates' different strategies for this juggling act. Some people focused intensely on preparing for today's D&D test and resigned themselves to falling behind in B&L. The lecture hall was very empty this week. Others managed to keep up to date on both courses even though it means that they didn't have as much time to cram for the D&D test.
I hate falling behind for many reasons and chose not to miss lecture this week. My compromise was that I just didn't spend as much time preparing for the lectures as I normally do. Because of that, and because my mind was drifting off into the land of antibiotics and bacterial toxins during lecture, I'm not sure if my compromise was necessarily any better than not going to lecture at all. We'll see if I'm brave (or foolish) enough to try that option the next time we have a double-header.
Sunday, January 24, 2010
Crazy Saturday night in the ER
I went into the ER yesterday for my second preceptor session with Dr. Vaughn Browne. It started off rather slow in the afternoon but turned into quite the night.
There was the guy who came in with possible neck and intracranial injuries after he was hit repeatedly with a blunt object in a drunken fight. It took four security guards and a team of doctors just to keep this guy down, he was thrashing around so bad. "I'm a human being, not an animal!" The decision was finally made to intubate him (sedate him with assisted breathing) in order to protect his neck and head injuries. During all of this, I stood by as a passive observer, shocked.
Then there was the Pentacostal preacher who prophesied the night before that God would inflict him with pain so that his congregation would Believe. He came in with ambiguous chest and flank pain and brought with him half his congregation camped out in the waiting area. The whole work-up was done on him, just in case there was actually a medical basis for his pain, but I'm not sure how that turned out.
Learning how to insert an IV line
Toward the end of the night, I spent some time with Vicky, a nurse who taught me how to insert an IV line. After all of the passive observing I had done so far, I was eager to actually do something and to pick up a new skill. My first patient was a sweet old man who called himself a "professional patient." He was having a tough time of it with kidney problems. His veins were particularly difficult because of his chronic illness, but I was able to get the line in on my second try with minimal fumbling.
My last case of the night was a drunk driver who got in a minor accident that didn't involve anyone else. This guy was very, very drunk. "I'm not sure if this is the best person to practice on," I told Vicky, wary of him becoming belligerent and uncooperative in the middle of my novice attempt to stick him with an IV. Two security guards were in his room, and two more were hanging out outside in case he got out of control. "Come on, he's the perfect person for you to practice on!" Vicky replied with a twinkle in her eye.
At this point, the two security guards were arguing with the patient, trying to get him to lie down. "Watch this," Vicky whispered, "I'm gonna sweet talk him. I'll put on my mommy-face, and he's gonna give us his veins." Vicky has been doing this whole nursing thing for quite some time, and she's good. She calmed the man down in no time, introduced him to me, and before I knew it, I was this guy's best friend. Of course I could take some blood, no problem! In the middle of the procedure, my best friend started thrashing around. All four security guards descended on him, but I had already lost the vein. "That was his fault, not yours," Vicky reassured me. With security holding him down, I got it on the next try. Adrenaline was pumping when I left the room, and I didn't really calm down until I got home.
"Now try doing that in the back of a speeding ambulance."
There was the guy who came in with possible neck and intracranial injuries after he was hit repeatedly with a blunt object in a drunken fight. It took four security guards and a team of doctors just to keep this guy down, he was thrashing around so bad. "I'm a human being, not an animal!" The decision was finally made to intubate him (sedate him with assisted breathing) in order to protect his neck and head injuries. During all of this, I stood by as a passive observer, shocked.
Then there was the Pentacostal preacher who prophesied the night before that God would inflict him with pain so that his congregation would Believe. He came in with ambiguous chest and flank pain and brought with him half his congregation camped out in the waiting area. The whole work-up was done on him, just in case there was actually a medical basis for his pain, but I'm not sure how that turned out.
Learning how to insert an IV line
Toward the end of the night, I spent some time with Vicky, a nurse who taught me how to insert an IV line. After all of the passive observing I had done so far, I was eager to actually do something and to pick up a new skill. My first patient was a sweet old man who called himself a "professional patient." He was having a tough time of it with kidney problems. His veins were particularly difficult because of his chronic illness, but I was able to get the line in on my second try with minimal fumbling.
My last case of the night was a drunk driver who got in a minor accident that didn't involve anyone else. This guy was very, very drunk. "I'm not sure if this is the best person to practice on," I told Vicky, wary of him becoming belligerent and uncooperative in the middle of my novice attempt to stick him with an IV. Two security guards were in his room, and two more were hanging out outside in case he got out of control. "Come on, he's the perfect person for you to practice on!" Vicky replied with a twinkle in her eye.
At this point, the two security guards were arguing with the patient, trying to get him to lie down. "Watch this," Vicky whispered, "I'm gonna sweet talk him. I'll put on my mommy-face, and he's gonna give us his veins." Vicky has been doing this whole nursing thing for quite some time, and she's good. She calmed the man down in no time, introduced him to me, and before I knew it, I was this guy's best friend. Of course I could take some blood, no problem! In the middle of the procedure, my best friend started thrashing around. All four security guards descended on him, but I had already lost the vein. "That was his fault, not yours," Vicky reassured me. With security holding him down, I got it on the next try. Adrenaline was pumping when I left the room, and I didn't really calm down until I got home.
"Now try doing that in the back of a speeding ambulance."
Witnessing death
During my preceptor experience yesterday, I watched for the first time as someone died in front of me. A man in his mid-50's had a heart attack. He got CPR right away, even before the paramedics arrived at the scene, but he flat-lined soon after arriving at the ER 20-30 minutes later.
In these situations, the medical students are usually told to stand by in case the team needs CPR relief. This man didn't make it that far, though. I watched as the emergency team did their thing, trying my best not to get in the way. Then, before I knew it, the attending physician called time of death, and the entire operation was shut down.
I looked at the man on the table, who was now just a body to all the doctors and nurses and techs in the room. His eyes were partly open, and he still wore a bling watch on his left wrist, as if time still mattered to him. I wondered what he experienced, if anything, in those last few moments before the doctors decided that he could not be saved. If he had survived, would he have reported some sort of near-death experience like walking toward a bright light or talking to a dead relative? That would be too Hollywood.
I asked another doctor, after all the excitement had passed, why his death was so quickly called. Her answer was that we have to weigh the morbidities for someone who has been down for almost a half-hour. Even if they had been able to re-establish a heartbeat, it's likely that this man would have suffered severe brain damage, possibly to the point of persisting in a vegetative state.
In my training to become a doctor, I am certain to witness death again. It is inescapable, because Life is the currency of the profession that I chose.
In these situations, the medical students are usually told to stand by in case the team needs CPR relief. This man didn't make it that far, though. I watched as the emergency team did their thing, trying my best not to get in the way. Then, before I knew it, the attending physician called time of death, and the entire operation was shut down.
I looked at the man on the table, who was now just a body to all the doctors and nurses and techs in the room. His eyes were partly open, and he still wore a bling watch on his left wrist, as if time still mattered to him. I wondered what he experienced, if anything, in those last few moments before the doctors decided that he could not be saved. If he had survived, would he have reported some sort of near-death experience like walking toward a bright light or talking to a dead relative? That would be too Hollywood.
I asked another doctor, after all the excitement had passed, why his death was so quickly called. Her answer was that we have to weigh the morbidities for someone who has been down for almost a half-hour. Even if they had been able to re-establish a heartbeat, it's likely that this man would have suffered severe brain damage, possibly to the point of persisting in a vegetative state.
In my training to become a doctor, I am certain to witness death again. It is inescapable, because Life is the currency of the profession that I chose.
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