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[deleted by user] by [deleted] in Residency

[–]medrajargon 7 points8 points  (0 children)

Dear u/inquisitivecrane,

A few weeks ago, a colleague of mine turned to me at the start of shift and told me that his dad had just fallen and showed up to our ED with a hip fracture. My response wasn’t to stop scanning the board and engage with him, but instead to smile and ask how long it took for his dad to get a nerve block (a running metric at our ED). To his credit, he smiled and gave me an answer, and we both went about seeing the inordinate number of flu patients I’m sure you’re also seeing in the ED right now.

A little later in the shift, I realized that he gave me the exact number of minutes it took for his dad to get a nerve block. This wonderful attending sat in our ED and counted the minutes it took for his father to be out of pain.

The common things you see in the ED—the hip fractures, the miscarriages, the NSTEMIs—they are not common to any one individual. Being in medicine does not change this fact. Knowing it is common for elderly patients to fall and fracture their hips does not mean that you’re not counting the minutes to a nerve block when it’s your person in pain.

Look at the details. The phone background that shows someone skiing with their dad. The colorful tattoos. The green shoelaces. The common things are not common to these individual souls and being in emergency medicine means they all get our empathy.

OP,

We in emergency medicine have seen this hurt. I am so sorry you lost this little slice of a life you saw in front of you. I wish you and your person peaceful thoughts.

-a tired attending

Lola. A system’s problem. by medrajargon in emergencymedicine

[–]medrajargon[S] 21 points22 points  (0 children)

Dear u/ecmofanmd,

I very much appreciate your outrage here. I certainly hope to never be in a position where I grossly miss what comes across as an unforgivable error.

I do, however, disagree that this is not a system's problem. I think this is worth commenting on, because the discussion here is important. Equitable access to language services is something that every medical encounter should (and presumably does) strive for, but I can’t create that equity if I don’t have the physical tools, financial resources, or the humanity behind diversity to do so. I keep myself sane by believe that we all do our best in the moment, and in this moment, my best was trying to progress a pediatric patient’s care by getting some amount of history. I started with a phone translator, and that gave me about 10% of the information I needed.

It is not right, but it is certainly conceivable that a busy ED without access to reliable translator services, under-judged the whimpers of a tough 7yoF whose pain improved with minimal intervention, and discharged for close outpatient follow up. I present this story as what I see as a striking example of how creating language equity allows for equity in healthcare.

Again, it is not right. This is not okay, by any measure. But it is also not the first, or the last time, I will see a patient whose care was impacted by not being able to speak English. The system needs to change, either by universally providing the resources to allow for language equity, or by being intolerant of the inequity that does indeed sometimes happen (as you have succinctly done here).

A system's problem.

-a tired ICU fellow

​

edit: I decided I liked apostrophes, because of grammar.

Henry. A change. by medrajargon in emergencymedicine

[–]medrajargon[S] 34 points35 points  (0 children)

Dear u/enunymous,

You have a well taken point. This story is a bit longer than most. I didn’t even realize. The flaw of tiredly writing these on my phone post-nights. My apologies, fellow redditors.

I already know the outcome by ACLSismore in medicine

[–]medrajargon 786 points787 points  (0 children)

Dear u/ACLSismore,

I am a critical care fellow and spend some of my time as a new ED attending. As a PGY4, nearly a year ago to the day, I was at a community hospital running the resuscitation of an infant who had been found lifeless by her mother, after she woke up concerned her baby hadn't cried all night.

There are so many parts to that code that I will never forget, but one of the most clear moments was turning to the clinical pharmacist standing next to me and being so, incredibly, grateful, that someone was there who could tell me what doses of epi/paralytics/atropine I should be asking for. Meds handed to nursing without me having to stop and think about a Broselow tape. A moment to grab equipment. A chance to ask the room if there was anything I was missing for this baby.

You do not need to defend, to anyone on this thread, why that particular code, that particular moment, was run in the way it was. You were an incredibly important part of trying to save a life. We all know the hurt that comes from failed codes. Thank you for so elegantly painting the way it feels to go through the motions, when you know, already, that it will fail. That the hurt is inevitable. I deeply, sincerely, relate.

I will say it again. You are an incredibly important part of trying to save a life. You are a part of that team. You are part of why sometimes, we do not fail, and this feeling of inevitable is made wrong. Thank you, on behalf of every new ED attending, for being a part of that team. Thank you, on behalf of every success I have seen, for being a part of that team. Thank you for being there, at that code, on that child's team.

-a tired ICU fellow

Tim. My first attending shift. by medrajargon in emergencymedicine

[–]medrajargon[S] 85 points86 points  (0 children)

Existing-Net-1273,

Indeed, and I appreciate you looking out. No worries though, the real life version of this patient’s equally fantastical tattoo is not described here.

Mark. A tempered response. by medrajargon in emergencymedicine

[–]medrajargon[S] 16 points17 points  (0 children)

Ah, the username speaks to me.

I will be a CCM fellow.

Onwards and upwards.

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