I’m not going to tag anyone else for this meme, but I liked the idea that Ramona Bates (Sutured for a Living and @rlbates) put out on her Twitter feed from Wing of Zock. Play along if you want and drop a comment in the comments section if you do. I’d like to read them.
Describe the three patients that had the greatest impact upon you and how they shaped your career as a physician.
Not exactly sure I can say how each of these patients shaped my career, but below are three of the patients who have had a large impact on me.
The first patient I ever saw in an emergency department as a student was probably what turned me on to emergency medicine. Before my emergency medicine rotation, I was pretty much set on going into orthopedic surgery.
It was kind of a crazy situation. Inner city emergency department. Patients stacked up in the hallways. People pushing me out of the way. Me getting lost. Where is the attending around this place? Then one patient on a bed in the corner caught my attention. She was yelling at another patient down the hall. He’d yell at her. She’d yell back at him.
He was there for a bite wound on his finger. She was there for facial trauma. Another guy was there for a bite wound to the chest.
She was performing oral sex on him for fun and profit. While she was doing so, an accomplice tried to steal the wallet out of his pants. He felt his wallet being taken and pushed the woman away. She bit down on his finger, narrowly missing his woo hoo. He punched her in the face. Another man jumped in and grabbed the friend. The friend bit him on the chest and drew blood before running away.
A budding emergency physician was born. Who could ever in their wildest dreams even try to make up stories this good?
Then there was Ed. While I was running the ICU during my residency, Ed was a regular at the hospital. He had very bad COPD and was repeatedly hospitalized for breathing problems. He stopped smoking many years before his COPD got bad and always told everyone how much he wished he had never picked up a cigarette. Usually he needed a day or two in the hospital for his “tune ups” and he’d be able to go home. He knew most of the nurses and the staff by name, but took a liking to me because we both cheered for the same college football team. So when Ed had to be admitted, he’d always ask the other residents if he could be put on my service. I’ve never been one for formality, but most patients call me “Doctor.” Ed never called me “Dr. WhiteCoat” – he always just called me “Whitey.”
Ed liked his morning coffee, so when I saw his name on my list, I’d always stop by with a cup of joe. Black, two sugars. “Whitey, you’re the best,” he’d always say. When Ed’s family would come to visit, he’d sometimes page me to his room. He even knew my pager number. His whole family was very welcoming. I found out that Ed also liked strawberry ice cream. One weekend that I was on call, there was a big college football game. I surprised Ed with a quart of strawberry ice cream. We sat in his room together watching college football and eating ice cream. Then the pager went off. Intubated patient in the ED. “Sorry, Ed, duty calls.” “C’mon, Whitey, it isn’t even half time.” I left him sitting there with a half-finished bowl of ice cream. When I popped my head in later that afternoon, our team had won. He got all excited and out of breath just telling me about it.
Ed got admitted one afternoon before I left. Same diagnosis. I got a page to the ED and admitted him. “See you tomorrow morning with some hot coffee.” “Whitey, you’re the best,” he said from behind his nebulizer mask.
The next morning, I went to his room and his bed was still made as if no one had slept in it.
I checked the computer. Ed wasn’t on my patient list. I paged the resident on call over night.
“Did you guys discharge Ed last night?”
“Ed died last night, WhiteCoat. The respiratory tech found him dead in bed. I’m sorry.”
I sat on his bed and cried.
And I still think about him when I watch college football games.
Patients are people, not just diseases.
There’s another reason I remembered Ed so well.
Probably six months after Ed’s death, his daughter came to the emergency department. I don’t remember what her problem was, but she gave me a hug and told me how glad she was that I was her doctor.
“Did you ever get the letter we wrote?”
“No. What letter?”
“After dad died, our whole family had a meeting with the hospital administration. We brought them a letter we had all signed telling them how fortunate our father was to have a doctor like you taking care of him. You didn’t hear anything about it?”
“Not a thing.”
“That’s disturbing. We thought at least they would have mentioned your name in their newsletter or something.”
I never did see anyone from Ed’s family at that hospital after that day.
Finally was a beautiful young girl who was brought in as a full arrest. Pinned to her shirt was an envelope. In the envelope was a letter. I kept a copy of this letter to remind me of the importance of a lot of things.
If you are reading this, I am dead.
My life has no meaning and I feel this way because:
I am a loser socially, physically, psychologically, musically, domestically, and intellectually. I have done so many things to hurt my family and myself.
My grades seem to be a big thing with this family and I’m not coming through. I will finally admit, this is all my fault!!
I am hurting on the inside. You guys never seemed to care what was wrong with me. I called for help so many times.
I know you tell me I’m pretty and I truly believe you just say that because you love me and you don’t want to hurt me. I and everyone else knows I’m ugly. So stop lying to me. That only hurts worse.
I’m a loser in school, church, home, everywhere. I guess it’s my personality. I try to make friends wherever I go, but it never works. So I figure “just keep to yourself.” That doesn’t work either. It only makes it obvious. I’m a loser. Get over it. I have.
The problems that you all are having was because of me. In envy so many of you guys because of the love you have for each other. I wish I was a part of it.
One of the things that really pisses me off was when I wrote down how I felt and gave it to mom and dad. They laughed at me.
I’m a nobody. Only a nobody doesn’t get put in the yearbook
I’m a nobody. Only a nobody doesn’t have any friends to talk to.
I’m a nobody. Only a nobody’s family doesn’t realize she’s a nobody.
I’m a nobody. Only a nobody wishes she was dead every day of her life.
I’m a nobody.
I’m a nobody.
I’m a nobody.
I’m a nobody.
I’m a nobody.
May God have mercy on my torn battered soul.
Her glassy fixed and dilated pupils, her perfect hair and make up, and her perfectly pressed blouse still haunt me.