doc w/ Pen

journalist + medical student + artist

Tag: trauma

A newly prudent pedestrian

Medical school is one of the most intense experiences I can imagine. As such, I expected it to change me. It has. And in some unexpected ways.

On a recent summer evening, I walked some 15 blocks to a Thai restaurant to meet a friend for dinner. It was a lovely evening. I enjoyed the fresh air after spending so many hours cooped up in the hospital over the last several weeks. On my walk, I noticed something. Since completing my four-week trauma surgery rotation, I’d become a much more cautious pedestrian.

When waiting to cross a street with lots of traffic, I didn’t tip-toe into the street, or even stand at the edge of the curb. Instead, I hung back a few feet. I still jaywalked, but only if there were absolutely zero cars in sight. None of this dashing across the street to beat an oncoming vehicle. And when I saw someone else do that, I shook my head (literally). Even when simply walking on the sidewalk, nowhere near an intersection, I found myself paying close attention to the traffic running parallel to me — something I’d never really done before.

I had abandoned my aggressive pedestrian stance because darting into traffic saves you no more than a few seconds, and can cost you so much. I paid more attention to my surroundings because even when you’re on the sidewalk, minding your own business, a car could jump the curb and smash into you.

Technically, legally, pedestrians may have the right of way. But legality melts away in the face of a 2-ton steel monster barreling toward you.

That reality is now all too clear to me. While on trauma surgery, I’d seen too many pedestrians hit by cars. In medical lingo, this type of trauma is referred to as a “pedestrian struck.” Often the collisions resulted in simple lacerations or minor broken bones. But sometimes they resulted in coma, intubation, and craniectomy (removing part of the skull to relieve elevated pressure in the brain).

Maybe increased caution and attention won’t make being a pedestrian in New York City much safer. But they make me feel better. And that’s something, I suppose.

Four weeks of trauma surgery: lessons learned

Friday marked the last day of my four-week rotation on the trauma surgery service. As expected, it was an exhausting four weeks. But it was also incredibly exhilarating and educational. And it was filled with many profound moments that will stick with me forever.

This, in large part, was due to working with such a phenomenal team: An attending who taught me that if a trauma surgeon can take 10 minutes to sit down and talk with a patient, every physician should have time to do so; who inspired me to learn and ask questions; and who made me excited to go to work every day — even when that meant waking up at 3:30 a.m. A chief resident who carefully followed a patient’s blood tests after I got splashed in the face during a case, and personally kept me updated. A senior resident who was willing to put a nasogastric (NG) tube down my nose and throat because I wanted to know what our patients with small bowel obstructions were going through. (I’ll be writing more on that soon.) Interns who clearly wanted these four weeks to be an educational experience — and proved it by inviting us medical students to practice starting IVs on them. A fellow medical student, one I barely knew going into the rotation, who quickly became a confidant.

These are just a few examples of how my team helped make the oft-feared surgery rotation such a meaningful experience.

In medicine, you learn from your team. You also learn from your patients. Working on the trauma service for four weeks, I am now acutely aware of how a person’s life can be permanently changed — or even snuffed out — in the blink of an eye. I helped care for patients whose legs were now useless after a car crash, a gun shot wound, or even a freak fall from standing. “Pedestrian struck” was another too-common reason for admission to our service. Usually, the result was a laceration or some broken bones — things that were painful, but that would heal, with time. But sometimes the trauma of being hit by a car results in a brain bleed. Sometimes these resolve. But sometimes, they result in irreversible brain damage, or death. All because you were walking on the sidewalk, or crossing the street, at the wrong place and the wrong time. This hits especially close to home when the patient is close to my age, or reminds me of someone I know. This could happen to me. It could happen to any of the people I love. As could appendicitis, cholecystitis, or a small bowel obstruction — three other very common complaints I’ve seen on this service.

So as I interact with patients and their family members, I attempt to do two things. I first try to put myself in their shoes, as best as I can. This helps me understand (and if needed, forgive) any angry outbursts or other nastiness. It’s not personal. Second, I do my best to treat the patient, and the patient’s family, like they were my own family. I would want a doctor, nurse, or medical student to treat my parents, sisters, or friends that way. One of the trauma attendings modeled this behavior so well. When patients and their families thank him for his kindness, he tells them outright that his goal is to treat people like his own family. I’ve taken to doing the same.

These are not lessons I necessarily expected to learn on my surgery rotation. But they are important lessons that will remain with me, whatever I do in medicine.

Don’t get me wrong — I learned about surgery on my surgery rotation too — suturing, knot-tying, and so on. But I could learn those things from any surgery attendings or residents. My team helped teach me so much more.