#medstories #intraining

“She was just up, walking, and jovial last week doctor,” Shauna told me less than an hour after I placed a central venous catheter into a large vein in her mother’s neck. Just shy of fifty years old, her mother, Jameela Carter, had discovered far too late that she had endometrial cancer.

By the time I met Jameela in the Emergency Department (ED), her cancer had made its home in every recess of her abdomen, traveling as far as her lungs, breasts, and possibly even her brain. Every patient I had seen with her brand and degree of highly metastatic endometrial cancer had less than a year left to live. Having just discovered her cancer a month prior to meeting me, she was at a doctor’s appointment to follow up on her condition, when staff found her blood pressure to be low. Really low. Her systolic blood pressure (the top number) was in the 50s as opposed to 120, where it’s supposed to be. …


#MDmeetsMom #globalhealth

There’s a difference between caution and commotion — and the way we discuss any outbreak or illness determines where on this spectrum we end up. Without transparency, trust, and timely messaging, we create commotion. Caution on the other hand is best encouraged in a calm, familiar, non-dystopian environment with a fact-based and rational conversation.

That’s why I followed my mother around the kitchen while she was making dinner, asking her what questions she had about 2019’s gift for us when we abandoned it for 2020: COVID-19.

“Aww, man, Pavitra, this isn’t a dinner conversation!” some of you will say. To which I’d like to remind you that my parents have not been able to ask me how my day went around the dinner table since I started medical school. …


#medstories #intraining

“40-something year old woman, history of metastatic breast cancer, now with pneumoperitoneum likely secondary to hollow viscus perforation. Surgery consulted, dispo based on reccs.”

The patient was uneventfully signed out to me that night. I knew I was in for a long shift, but the ED looked relatively quiet. My patients were “tucked away" nicely, which means they were waiting for scan results or recommendations from consultants. I signed up to see some of the new folks waiting for a doctor to evaluate them. After I spoke with one of them, Surgery caught me in the hallway.

“Hey, that patient — she’s palliative,” they said. I looked at them, thumbing through the mental notes I had made about the patients signed out to me. …


#medstories #intraining

When I was on the residency interview trail, I made it a point to make every conversation an interesting one. After all, the interview trail was the single biggest opportunity I would have to pique the brains of Emergency Medicine (EM) faculty and leaders from around the country. For me, the “do you have any questions for me?” segment at the end of every interview was an opportunity to learn just a bit more about my field through the eyes of a person who lived it every day. …


#medstories #intraining

If you had to pick a month that made the most sense with this article’s title, I’d argue that with Valentine’s Day and the romantic festivities that come with it, February would be the clear winner. And, in all honesty, though I intended to publish this post in February, I felt it fitting to delay by a day because, for me and approximately 37,000 other medical students who likely applied through the National Residency Matching Program (NRMP) for residency this year, March is Match.

March is the month that most fourth year medical students build their calendar around. It is the month when we find out where we’ll be spending the next 3-6 years of our lives, and which program will introduce us to new lifelong friendships and a new professional family. During the month of March, Zillow likely has record numbers of medical students searching for places to live in the cities they hope to call home, program’s websites likely have repeat views from students hoping a program will like them too, and significant others start to consider what their lives and careers may look like once all is said and done. …


#medstories #intraining

It happens to all of us who relentlessly run after our dream of one day becoming a doctor. We put our heads down and study through college to get into medical school. We spend the first two years of medical school living in the library so that we can keep up with our clinicals. We spend our clinical rotations learning how to study for exams while gaining practical skills in the hospital. And then comes fourth year: the year I once heard would be the best year of my life — “the closest to a vacation I would have before I start drinking out of yet another firehose” during intern year of residency. Fourth year of medical school is the year when the impending reality of finally becoming a physician becomes so obviously tangible. …


#improvchallenge #experiencelife

This article is a part of the Improv Challenge — an initiative meant to build resilience and self-awareness through the use of improvisation principles in everyday life. The challenge follows a series of exercises outlined in Patricia Ryan Madson’s book, “Improv Wisdom.”

Exercise 2: For one day, say yes to everything. Set your own preferences aside. Notice the results. See how often it may not be convenient or easy to do this. Obviously use common sense in executing this rule. If you are diabetic and offered a big piece of pie, you will need to find a way to protect your health. …


#improvchallenge #experiencelife

This article is a part of the Improv Challenge — an initiative meant to build resilience and self-awareness through the use of improvisation principles in everyday life. The challenge follows a series of exercises outlined in Patricia Ryan Madson’s book, “Improv Wisdom.”

Exercise 1: Support someone else’s dreams. Pick a person and, for a week, agree with all of her ideas. Find something right about everything he says or does. Look for every opportunity to offer support. Consider her convenience and time preferences ahead of your own. Give him the spotlight. Notice the results.

I implemented this first exercise while still in college, where life was great with my absolute best friend in the world, Evelyn. We called her Ave — as college students, we figured Eve was a bit too common. Ave and I knew each other for ages. We had this comfortable vibe filled with support and brutal honesty as necessary. The week I spent implementing this exercise, I ignored the brutal honesty part of things and just supported Ave in everything she did and said. …


#improvchallenge #experiencelife

Improvisation is a life skill — it helps us accept the opportunities around us and turn disappointments into small victories. It’s a way to hold on to the roller coaster called life and dodge a heart attack when it zips through an unexpected curve. I was first introduced to improv as a college freshman and it absolutely changed my worldview — it opened doors that I never knew existed and gave me the strength to take life events and challenges in stride throughout my education. …


#medstories #intraining

Lights. Sirens. Action. In almost every Hollywood medical drama, there is a scene in which a patient crashes. Usually, it is an obvious event, with a nurse immediately calling a Code Blue and hordes of doctors quickly painting the room white. Suspenseful music keeps viewers holding their breath as providers burst into action and give life-saving CPR. Thanks to their heroic actions, the patient takes a deep, life-affirming breath once again.

Although a 2015 study showed these lucky Hollywood patients survive to discharge 71.9% of the time, real life is not so forgiving. A National Academy of Medicine-commissioned report published the same year noted that only 24.4% …

About

Pavitra, MD

Without critics, society would not exist. Without the people who defy them, society would never progress: Live. Appreciate. Contribute.

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