Wednesday, April 13, 2016

Embarrassing Residency and Med School Moments

Today I'm going to share a couple personal embarrassing residency and medical school moments, because we'd all like to think we don't make mistakes - but I know I do. Here are some times I wanted to sink through the floor. Details have of course been changed in order to protect patient privacy.

1. As a 3rd year medical student I was presenting a patient on the inpatient rotation who had recently had an Echocardiogram (ultrasound of the heart). The report included that the patient had "levocardia." Without thinking about it, in reporting the results I said, "The Echo was normal except that the patient has levocardia."

Levocardia means the heart is on the left. That's where it's supposed to be.

2. I was performing a lumbar puncture as an intern. This was not my first time - I was probably capable of performing the procedure by myself but it was early in the year and wasn't nearly as experienced as I would eventually become. My attending, who did not know me well and had not supervised me in this procedure before, chose to talk through each and every step of the procedure as I did it even though the parents had chosen to stay in the room. It definitely led to an an atmosphere that maybe I didn't know what I was doing. So what did I do? I proceeded to accidentally stab myself with a needle in the process of drawing up the lidocaine (fortunately a clean needle). I was bleeding a little, had to ask for a new bottle of lidocaine, new needle, new gloves etc. The parents pulled the attending out of the room and I'm sure basically said, "I don't want that shaky first-timer doing a lumbar puncture on my kid." It was an awesome moment. I still did the lumbar puncture, and it went fine, but goodness I'm on their side with that one. Did not exactly inspire confidence.

3. Often when a kid is hospitalized, multiple family members are involved in the care and sometimes one will relieve another at the bedside so they can take care of some things. This is great, and we love to see kids with lots of family support. Sometimes though, the switch happens ninja-smooth. More than once I've left a room just briefly and not paid close attention upon returning. The aunt often looks a lot like the Mom and I've definitely tried to pick up a conversation I was having earlier and taken way too long to realize I'm talking to someone else.

4. On my pediatric rotation in the 3rd year of medical school, I was a constant basket case. I mean, I did well on the rotation, but my stress levels were off the charts. I would overreact to not knowing answers to questions, and I cried frequently. It was only my second rotation and I just put a lot of pressure on myself because it was what I wanted to do.

My attending sent me into the room to examine a kid with an "interesting physical exam." She had clearly done this plenty of times before because the family was super chill about it. He had some interesting skin findings but otherwise seemed normal. I didn't know what he had, but after spending a while asking questions I couldn't justify staying in the room any longer and stepped out with a mounting sense of irrational panic. My attending asked me what I thought and I just stammered. I could have at least come up with a guess, but at that point I had a hard time making guesses I wasn't sure about and also with saying I didn't know (this did improve). Inexplicably, I felt myself starting to cry. That would be embarrassing enough, but then my nose started to bleed - a lot. Like staining the carpet of the clinic. In a way I was relieved because that was a distraction from the fact that I was crying. We got that all under control and I was informed the little boy had neurofibromatosis. That diagnosis now always sticks in my mind and I have no idea if the blood came out of the carpet.

5. Put Your Clothes On
Also on my 3rd year pediatric rotation, sign out was at 0600 and I was always on time, sometimes running into the residents on my way into the hospital. I once ran into a couple of the seniors on my way in, said hello, and proceeded to walk a little in front of them to the sign out room - which was a long way from the entrance (multiple hallways, multiple floors). When we finally arrived, one of them informed me that my skirt wasn't zipped. And it wasn't. I had done the hook at the top so I hadn't noticed a feeling that it was loose, but my entire lower back and the top of my buttocks were exposed the entire time I had been walking through the hospital. My shirt was long that day, but I honestly have no idea what they saw. At least she told me before I'd gone through more of my day like that.

I'm sure there are more, but these are the ones that still make me cringe when I think about them. I'll write another post if I think of another collection.

I hope you all get some joy from my moments of shame.

Thanks for reading, see you soon.

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