Friday, November 6, 2015

From The Eyes Of An MS3.

The following have been written by and then posted with the permission of the three 3rd year medical students currently completing their week rotation of nights with us.  They were asked to reflect and relate in as few or as many words as needed about their perspective surrounding the critical level 1 trauma we had a few nights ago.
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My name is Lydia Bunker and I'm a third year medical student at NYMC. I'm from the suburbs of Boston and I've always wanted to be a doctor.

Last night, my fellow classmates and I were working with the on-call trauma team when we got the page for a Level 1 motor vehicle accident. Within minutes the ambulance pulled up, the ER doors opened, and the prior calm of the trauma bay was shattered. The tall bulky young man on the stretcher looked to be beyond humanly help, but nevertheless two dozen people sprung into action around him, each with a look of extreme focus and determination to perform his or her role perfectly. Suddenly he regained a pulse and our interventions seemed less futile. There was a chance he could live, and that possibility lifted the feeling of dread I realized had enveloped me.

I wanted so badly to help with the resuscitation, but was afraid of getting in the way of the expert staff who were doing the real work of saving this young man's life. So I hovered on the margins of the crowded room, ready to jump at the first call for assistance. Anything - from doing chest compressions to simply offering a timely piece of tape. What struck me most was the thought of how we must have looked from above. Dizzying motion and cacophonous noise.

Miraculously, the patient stabilized, unknowingly advancing himself to the next step in the algorithm of trauma care. Almost as if forgetting that this young man had been essentially deceased an hour earlier, preparations started being made for the trip up to Interventional Radiology. We left the trauma bay strewn with empty plastic packets and stained gowns. The litterbug police in me thought absentmidedly about picking up a discarded syringe cap on the way out. Such an absurd thought when a life was on the line.

Over the next few hours, the resident and I occasionally left our trauma patient to attend to consultations elsewhere in the hospital. It was hard not to compare cases. A little kid with a bellyache seemed of such minor importance. Yet to him and his father, there was nothing more important that knowing whether he could go home or not. The teenager in critical condition upstairs meant nothing to them. It struck me that in medicine, you really can't think in "relatives". Each person's problem is uniquely important to them and we as physicians are challenged to adjust our delivery of care accordingly.

Later, back upstairs, we huddled around glowing screens in the CT control room, waiting for the next layer of digital information and keeping vigil for our patient. I watched the tired eyes of the attending surgeon as he scrolled through the images, up and down, up and down. I could see him envisioning the upcoming surgery, choreographing a plan of action, weighing benefits and risks.

The students were dismissed before our patient went into surgery, leaving the attending and residents to complete the work they have been primed to do. I drove home as the sun rose, wondering how they had the mental and physical strength to carry on through exhaustion. I hope that someday I'll have the knowledge and stamina to do the same, to stop at nothing for my patients. That's why we work so hard in medical school, why we spend long hours in the hospital, why we practice our skills at every opportunity- so that when the time comes, we will be ready.
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My name is Andrea, I am a medical student and this is my first surgery rotation ever. I have dreamt of being a surgeon for a very long time. The adrenaline of the job and the direct impact on patients are two of the reasons I am so attracted to this specialty. Funny enough both of these qualities came into play last night. Last night we attended to a level 1 trauma which is the most serious type of injury that requires immediate medical attention. Our patient came in unconscious and in cardiac arrest. All of a sudden the adrenaline rush that I had been so excited to feel turned into a feeling of nervousness when I quickly realized every move we made could be the patient's last chance to live. The patient's condition waxed and waned throughout the night and as each hour passed the trauma team worked harder and harder to keep him alive. This experience made me realize the immense impact that the medical team has on these emergency situations. I specially realized that the role of the surgeon is not only to cut, but their role is have the knowledge and experience to attend any situation. The most important lesson that I have taken away from last night and from my experience with the trauma team is that the adrenaline and spontaneity of the job do not compare to the satisfaction of being prepared with the knowledge and compassion to take on any situation and go home each day feeling that you did everything in your power to help someone's loved one.
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My name is Nathan Carberry. I am a third year medical student on my second week of my surgical rotation. I came to medical school because I wanted to be a source of healing for people in their most desperate of circumstances. In the years of training and dozens of exams that it takes to finally reach a position of utility in the medical world, I often find myself distanced from this primary directive. However, I feel closer after last night. I found myself as a member of a team for a level one trauma that received a young man who was facing darkness – no breaths, no heartbeats, no thoughts. The setting was deadly serious and the staff as solemn as a funeral, and I was in a terrifying position to help as the patient received compressions, chest tubes, and central lines. I watched as the man regained his own electrical rhythm and soon after vitality to his face. By the end of the long night, the young man had his life again and the parents their son. Very generously, the trauma team also gave me back my direction.
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Much Love.

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