It was 5 months into my intern year, and things had been going well. I figured out how to navigate the hospital, could document notes in my sleep, and developed a hefty repertoire of ways to address common pages such as post-op nausea, pain, and tachycardia. The increase in responsibilities from medical school helped me feel validated. I was still a learner, but I could help the team in more significant ways. I was finally starting to feel comfortable. That feeling did not last for long. It was during a night shift in the neurosurgery intensive care unit (ICU) when I got the page: “Patient brady in the 30’s, difficult blood pressure.” I was on another floor seeing patients at the time, but I called the nurse back immediately. I could sense the panic on the other end of the line. “The patient coded, they’re doing chest compressions, please come now!” I called the nurse practitioner who was covering with me that night and alerted the team as I raced toward the ICU. When I arrived, there were 5 nurses in the room performing CPR. The one doing chest compressions looked up at me expectantly and said, “Are you the doctor?” My stomach dropped. “Yes,” I responded, attempting to mask my uncertainty. This team needed someone to lead CPR, and I was supposed to be that person. This was my job. This was part of the responsibility that comes with wearing the letters “MD” behind my name. In that moment, though, I forgot everything that I had been taught. Fragmented thoughts spun around my head—Shockable rhythms. Dose of epinephrine. Time intervals. Joules of shock. I had never been in a real code before and I was not prepared for this. I managed to ask a nurse to draw up some epinephrine and set up the defibrillator. But that was it. After 4 years of medical school and multiple rounds of advanced cardiovascular life support training, that was all I could muster. The code team arrived shortly thereafter. I watched as they flawlessly assumed leadership, designated roles, started the timer, and resuscitated the patient. The rest of the night I continuously replayed the events in my mind. I read and reread the algorithms, fearing that the same patient would go into cardiac arrest again at any moment. But nothing else happened, and eventually the day team arrived and it was time for us to sign out. On my way out of the hospital, I ran into a coresident who empathized with my story. “It could happen to any of us,” she said. A little bit of weight was lifted. Up until that night, so much of intern year had been about learning how to be an efficient resident that I had forgotten I also needed to be a doctor. I had been too focused on finishing progress notes before first case start, making sure consents were uploaded, calling rehab facilities for discharge planning, and negotiating with consultants to come see my patient. The list goes on. All of these tasks are necessary for patient care and become bread and butter for any resident, but they should not detract from doctoring. My experience that night in the ICU was the wake-up call I needed. It was a reminder to shift my priorities back to the patient. It was a reminder that my job was more than check boxes and administrative tasks. Ultimately, it was a reminder that I was a doctor, and that requires a commitment to lifelong learning.
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Dec 1, 2022
Zsófia Wlasitsch-Nagy + 6
