She was talking when she came in. The paramedics wheeled in a 21-year-old woman sitting up in the stretcher, trying to stay calm as she watched the doctors and nurses hook her up to various monitors. Her boyfriend, by contrast, was beside himself with panic: his girlfriend's heart rate was 232 bpm, and she did not have a blood pressure. But surely the cuff was just faulty, if the patient was able to speak. No one was too worried about the prospects of a strong young woman, even when the patient started vomiting yellowish liquid. However, the x-ray showed her lungs full of fluid due to a thrombosis of a replacement heart valve, which resulted in the backup of blood. Mere moments after the doctors realized the seriousness of the situation, the patient's heart rate plummeted to a flat line, and she never recovered a pulse.
This was the start of my sixteen-hour overnight shift.
By the end of my summer internship in the emergency department at the New York-Presbyterian Hospital, I had met amazing doctors and nurses, listened to many patients' stories, watched routine examinations and fascinating procedures, and, yes, witnessed deaths. The two months were filled with new experiences that left me even more eager to begin medical training.
I was initially drawn to medicine because of the science: the delicate chemistry within a cell, the incredible complexity of the neural network, the elegant intricacy of the human hand. During the past several years I have been involved in a variety of research projects, ranging from organometallic chemistry to applied mathematics to diabetes and transplantation research. While I appreciate the beauty of pure science, I find myself more attracted to the human side of medicine, working directly with patients. Being actively involved in the college outing club as well as various intramural and club sports made me keenly aware of the risk of injuries and other emergency situations, and I wanted to be able to help. During college I became a wilderness first responder, and, inspired by my experiences in the emergency department the previous summer, completed the EMT-basic training after graduation.
In addition to allowing me an opportunity to serve others, medicine also provides a dynamic setting for personal growth. The fast pace of medical discovery means that a physician must constantly update her own understanding of medicine while simultaneously passing on her expertise to patients,medical students, residents, and colleagues. The doctors, nurses, and techs at the New York-Presbyterian ED welcomed me into this culture, inviting me to watch examinations and procedures, encouraging my questions. At the weekly seminars, the attending physicians and residents took turns presenting unusual cases and new studies, fostering discussions about ways to improve the patient experience.
Despite the medical community's best efforts and intentions, however, it is still impossible to save every patient. During my two months in New York, as well as a semester-long internship at an oncologist's office during my sophomore year, I faced the deaths of several patients, some of whom I had gotten to know over the course of multiple visits. The death of the young woman in the ED was especially difficult to cope with, even for the doctors and nurses who had "seen it all." The chief resident had to explain to the patient's grief-stricken boyfriend and mother what had happened, and after they left, I saw her slump in a chair for a few moments before going to see the next patient. The attending on that shift presented the case during the next week's seminar, inviting everyone to discuss what happened, and what could have been tried to save the young woman. Physicians keep learning, doing the best they can for everyone. That is what I want to do.
No comments:
Post a Comment