What a day!!!
Since yesterday I’ve been shadowing my primary physician in his family practice. It’s only a three-day deal but I’m really thrilled I’ve asked him and he let me follow him! This experience is priceless!!!
First of all I’m amazed by the amount and variety of problems that family doctor can deal with. I’ve always thought that you go to see a family doctor when you have a flu or a stomach bug; and with everything else you’d go straight to a specialist. I saw so many different cases: - lots of muscle and bone pain cases, few colds, skin bacterial infection, new born baby with an inflamation of skin around umbilical cord, narcolepsy case, hormonal disorders and whole bunch of other things. Second thing - the doctor I’m following is just a wonderful person! The patients love him! He has a story to tell about every patient who he’s seen before. It’s fascinating to witness how people open in front of him, and trust him so much that they didn’t even mind telling some very intimate things with me in there.
But coming to the point of the post! Or maybe not the point, becasue what I’ve written so far is equally improtant…but let’s say to the title of the post 
Yesterday was a quiet day. I was sure today wouldn’t be any different. First two patients came with quite rutine issues - warts on the fingers, physical exam and back pain. About 10:30 we went to see a 22 year-old girl who came with her mom (for support) to have a small, pea-size cyst removed from her abdominal area. I was assisting the doctor - holding the gauze in place, handing him things etc. I had a biopsy made myslef and was looking at all times at what the doctor was doing and it didn’t bother me at all. And I was actually shadoiwg a doctor in an OR earlier in the spring and saw ‘worse’ procedures before - lung cancer surgery, back surgery and a toe amputation. We were almost all the way through the procedure when I suddenly felt hot, and the next thing I remeber is me lying down on the floor, with the girl’s mother and the doctor talking to me and making sure that I’m OK. It was so weird and unexpected. I wouldn’t say I was embarrassed…I was just surprised that it actually happenend. I’ve never passed out in my entire life. And I have no idea why that even happened. It wasn’t a sight of blood - I’ve seen plenty of blood and I’ve seen worse things and it never made me sick. I was OK through the whole procedure and it happened right at the end when we were ready to put the stiches on. He wasn’t angry or anything. He said it happens to everyone at some point. It happeened to him. Maybe I didn’t get a proper breakfast (which I didn’t) or something… I have a nice size bump on my head (because I actually hit a chair) but I’m fine otherwise. I took a short break after that to have something to eat + hydrate and was back to normal for the rest of the day. But it still bothers me…why did it actually happen? What triggered it?
But that’s not the end. About 3 o’clock when we finished with a patient, and were getting ready to see another one, a receptionist ran in from the lobby area and said that a doctor in needed in the elevator. Since all other physicians were attending the patients ‘my’ physiscian went in there. I followed. An older man, with lots of issues - diabetes, high blood pressure, heavy smoker and not really taking care of himself, who just left ‘our’ practice, passed out in the elevator. He was with his daughter. My doctor + the nurses started CPR and called the ambulance. They came in 5 minutes, since the practice is only 5 minutes away from the local hospital, but unfortunatelly they didn’t save the man. He died - right there in the lobby. It was just shocking and sad. Noone really expected that. And I’ve never seen anyone die. I saw dead people, but I haven’t witness the act of death itself. I could write forever about that, and the atmosphere in the office afterwards, and about his daughter flipping out and other things. But I guess everyone can imagine how it feels when you see a person die and cannot do anything about that. I did not stay there much longer, becasue the police came and they were just trying to keep the order and asked everyone to leave.
That’s my day…
I’m coming back tomorrow and I hope that it won’t be ‘so’ eventfull…
Wow… I can certainly appreciate seeking an uneventful day after all that. To put something of a positive spin on it: days like this can help prepare you for your future practice, and if after going through all of this, you still have a passion for medicine… that is telling, I think.
Sounds like you’re getting broken in. 
Watching someone die is a moving experience. It makes you realize how precious life is. The first person I saw die was in an ICU. He was surrounded by family though. Things were so final. We watched his heart rate slow and then as if it was an every day occurance, they unplugged the monitors. Watching them do so went against everything I believed was right. You begin with, “But it’s a hospital! You save people here, not kill them!” I racked my brain wondering about what else cold have been done for him.
But there was nothing that could be done for this man. Everything had already been tried. Yet, you want to see more done. It’s almost like the patient has been abandoned. Yet, we know death is inevitable for everyone.
I’ve passed out before. 
Before deciding on being a doctor, I wanted to be a vet. I worked for a veterinarian for a while and was assisting in restraining a 130lb german shephard while the vet removed a small tumor.
I began to feel a little sick to my stomach and the next thing I knew, I was staring up at flourescent lights while the vet stood over me, shaking my shoulders. It’s definatly a “Huh?” moment 
They called my parents (I was in highschool at the time) and I went to the ER. I had actually fallen through the swinging door which came back on me, giving me a nice laceration on my noggin requiring stitches. My blood sugar was a little bit low so it was chalked up to an insufficiant breakfast and possibly keeping my knees locked while restraining a dog that outweighed me!
Because of that episode, I was so nervous the first time I shadowed a surgeon, I nearly threw up. I knew for sure that I would pass out. I imagined taking down monitors and equipment with me, ripping tubes and lines from the patient and killing them.
Luckily, none of that happened. lol!
Hope the next time is better!
I had been to a few family funerals, but the first person I watched die was my mom. After that, I saw a bunch of folks through my time DHMC’s ER. One was a guy who hit a lightpole in his car and was ejected 100’ from the car (massive blunt injuries to chest). The cool thing was that they cracked his chestin an attempt to revive him. Another was a woman who had taken a shotgun blast to the face. I have never fainted, but I did feel light-headed after both of those.
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My blood sugar was a little bit low so it was chalked up to an insufficiant breakfast and possibly keeping my knees locked while restraining a dog that outweighed me!
What’s the deal with locking the knees?
I had my knees locked for sure. Simply it was easier like that to stand for a long time over the table. I didn’t even consider it might be a problem.
When I came back home and told the story to my husband, the first thing he asked was if I locked my knees.
I don’t quite understand the locked knees thing–something about impeding blood flow. But if you have to stand a long time, it’s good to bend one knee and then the other, just ever so slightly, from time to time.
Okay - so I did some surfing on the correlation between locking your knees and fainting. The scientific theory behind it (which kind of makes sense) is that when you lock your knees, your leg muscles are not used as much to maintain your standing posture. When you stand, gravity forces a large proportion of your blood to your feet/legs. Normally, the leg muscles act as “pumps” while standing, helping return the blood to the heart, etc. So - locking your knees interferes with your body’s compensatory mechanism for circulation while standing, causing syncope (fainting).
Amy
PS - I’m glad you had a great experience shadowing (other than the fainting!)
Locked knees or no, plenty of people have this fainting reaction. The best thing about this event for you is that you now can recognize what it feels like as it is coming on, and you will be able to respond by squatting or sitting down, breathing fully and slowly, and thus avoid fainting. (Also! Eat breakfast! It’s good for you!) When you are a student in the operating room, one of your first tasks for yourself will be to locate a chair and how to move away from the table from wherever you are sitting. Never be ashamed to do this. And your doctor is absolutely right–this happens to just about everyone in one way or another at some point. The other task is to make sure you are well-fed. At various times I’ve carried bags of almonds, energy bars, or trail mix, just to make sure I’m well-nourished before long days in the clinic, the emergency dept, or in the OR.
One of my mentors put it this way: “You don’t eat, you die. So never let a patient stand between you and food.” He always emphasized that following this law was based on the need to be able to continue giving good care.
It sounds like you had an amazing day in so many respects; actually it sounds like all of medical school encapsulated into one day: learning, falling down, witnessing tragedy, and feeling great human connection, all jammed up next to each other.
Joe
This happened to me too, a couple years ago when I was volunteering in the ER. It happened twice! I think I even posted on here about it.
I found it pretty embarrassing. I didn’t even know what had happened until I woke up on a bed in the hallway, where the doctor I was observing had carried me. But at least no one was inconvenienced. Since I was a volunteer, I just got up and remade the bed with new linens. I’d made it the first time too.
I think people remembered me better after that. Since then, not locking my knees seems to have helped.
Quote:
Okay - so I did some surfing on the correlation between locking your knees and fainting. The scientific theory behind it (which kind of makes sense) is that when you lock your knees, your leg muscles are not used as much to maintain your standing posture. When you stand, gravity forces a large proportion of your blood to your feet/legs. Normally, the leg muscles act as “pumps” while standing, helping return the blood to the heart, etc. So - locking your knees interferes with your body’s compensatory mechanism for circulation while standing, causing syncope (fainting).
This is why us Scottish country dancers always pas-de-basque whilst standing in one place for a long time. It also helps to whistle a Scottish jig. Don’t know how this would go over in the O.R., though.
Pas-de-basques? With cold muscles on a hard OR floor? Not me, buddy! I’ll just wiggle my feet like a regular person.
You’re just trying to injure me so you can have my spot in med school!