We have a shadowing program in place with the local college. Pre-meds who are interested in emergency medicine — or who need to buff up their med school applications — show up in the ER from time to time to follow us around. Since I’m a “young doctor” and relatively easy going they come during my shift a lot which is great except that I hate it. No offense aspiring doctors but I didn’t go into academics for a reason. These shadows with their constant presence and questions imploring me to explain every little thing I do while I try to simultaneously run a busy ER make me want to go a little crazy — really I just want to be left alone to do my job. But I’m too nice (or too much of a wuss) to tell the pre-meds no after they’ve taken the time to show up. At least this latest guy got the full experience:
8:44pm — Pick up a chart that says “rash.” The shadow is just a little too super-duper fired up about it.
8:45pm — “Are you really this excited? Because you don’t have to fake stuff around me you know.”
8:47pm — Looking at the rash when “Code Blue” gets paged overhead. There is just one doctor in the hospital and it’s me. ”You’ll have to excuse me,” I tell the little girl and her mom.
8:48pm — Meh. Codes used to be really exciting but like anything else repetitive they’ve become much more mundane. Now I’ll be returning to a backed-up chaotic ER.
8:48pm — I still run to all the codes. There’s no “code team” where I work so sometimes even basic stuff isn’t being done when I get there. Plus, running is really the only thing I excel at compared to all the other docs.
8:48pm — If this was 3rd grade track and field day I’d be getting a hug from the teacher’s aide while the shadow would be getting a “participant” ribbon.
8:49pm — I get to the patient’s room and see he’s already intubated which frees me up to just run the code. His initial rhythm is asystole.
8:52pm — After some meds and chest compressions we actually manage to get a strong pulse back.
8:53pm — He has one “tenuous” IV according to the nurses so I decide to put a central line in.
8:58pm — I stick the needle under his collarbone and am rewarded with a syringe full of dark red blood.
8:59pm — WUMP…CLANG…CRASH!!! What the heck was that?
8:59pm — Oh yeah, I forgot about the shadow. The blood was a little much unfortunately. He passed out, taking a mayo stand with him.
9:02pm — While I finish putting the line in the nurses put the shadow’s feet up and give him some juice. He comes to, no worse for the wear.
9:03pm — We retrace our steps to the ER, this time walking. The shadow feels kinda sheepish, I tell him not to worry about it and give him a soda from the doctor’s lounge.
9:04pm — “Looks like a contact dermatitis,” I tell the little girl and her mom.
Note: that’s two posts in two days. Take that Nurse K!! Whew, I’m exhausted.
Mayo%20Stand%20-GIF-LM-T.jpg){kind=link}
January 7, 2009 at 11:23 pm
I would guess the only thing worse than a premed shadow is a preclinical med student. He knows just as little as the pre-med student but is expected to know more.
January 7, 2009 at 11:37 pm
I loved this post, especially the 8:45pm remark. I wish all attendings said the same to shadowing students.
January 7, 2009 at 11:52 pm
I always felt bad shadowing, like I was unwanted. I suspect that was true to some degree, but bless ‘em for tolerating me.
Loved this post.
(Some docs really like it, just not me.)
January 7, 2009 at 11:58 pm
Yeah this is why it’s annoying you don’t post much—hilarious stuff.
January 8, 2009 at 12:21 am
The rash patient only had to wait 20 minutes, that’s pretty good considering what you had going in the background.
January 8, 2009 at 7:30 am
Well, the Shadow got to see the two extremes of medicine. Nice day for him.
January 8, 2009 at 7:42 am
This is hilarious.
January 8, 2009 at 8:04 am
I am suprised he did not faint at the site of the rash.
BTW, that TOTALLY sucks that you have to run codes upstairs. Your hospital needs to hire a house doc!!!
January 8, 2009 at 8:48 am
why would you want to become a doctor if you faint at the sight of blood…
January 17, 2009 at 6:51 pm
NICE program … whoever arranged it did not go over a few minor details. We have the ER as a volunteer service area where a volunteer will get to have a lot of learning experiences, but at the same time, we actually get a lot of stuff done for the staff (stocking supplies, transporting patients to radiology or up to the patient floors to clear beds). There are “transporters” who get paid for what we do. Either way, it takes maturity and experience to know when not to piss off the staff, not just the doctors. There is a time and place to ask questions and to know when to stay out of the way. I understand why you did not “go into academics,” but why waste an opportunity to share some knowledge? Doctors are life-long scholars, and what is the purpose if one is just not feeling up to dispensing any expertise every now and then? I guess that it is the fact that this person is following you all over. There have been certain cases that will always be engraved in my brain. One example is when a patient’s chest was cracked open and internal defibrillations failed as a last resort, and as you can imagine, the time of death was subsequently called. Even with such a terrible outcome, my favorite ER doc (not young) let me put on gloves and feel what the lung tissue felt like and the sharpness of the ribs & etc. If it really bothers you, go ahead and put your foot down and define boundaries. And no, we are not a Level I trauma center … yet.
February 2, 2009 at 11:38 pm
If the shadow faints at the sight of blood, maybe a career path other than medicine would be a better choice for him. Something safe and boring, like accounting. Oh, wait – maybe the sight of red ink would make him pass out too???
February 9, 2009 at 6:47 am
I guess when they pass out, it deprives you of the opportunity to scream “Oh crap!! Where’s that coming from?!?!”
March 3, 2009 at 4:25 pm
Passing out does not mean he will not be a good doctor, but it does make for a memorable experience.
April 7, 2009 at 1:03 am
[...] vs academic medicine was easy, since the latter requires the double whammy of research and med student/resident supervision, for half the pay no [...]