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Show Voices From the Wards A Collection From The Class of 2021 The University of Utah School of Medicine March 2021 Voices From the Wards A collection of stories, experiences, and poems written by the University of Utah School of Medicine Class of 2021 in their final semester of graduate medical education. Produced by Ellie Gilbertson, Roselyn Neville, Zachary Fica, and the 2020 Gold Humanism Honor Society at the University of Utah Cover photograph “Spiral Jetty” by Roselyn Neville Compiled and edited by Zachary Fica Foreword These Voices represent a humble endeavor to transmit emotional knowledge learned from the Wards and keep our hippocratic oath to “share such knowledge as is mine with those who are to follow.” I hope these 55-word vignettes provide insight into the emotional odyssey of a new clinical trainee and help you on your own journey. Zachary Fica Table of Contents A Needle Longer Than You Would Ever Be 1 Against Medical Advice 1 Any Last Questions? 2 Assumptions 2 Birthday Party 3 Can We Hurry This Up? 3 Chief Complaint 4 Choosing a Specialty 4 Connected, Not Present 5 crack 5 Deceased 6 Everything Is (Not) Fine 6 Goals of Care 7 Helpless 7 How to Cope 8 Inside Out 8 IR 9 Joy 9 Keep Your Nickel 10 Lucky 10 MICU Day 2 11 Mother, Human 11 Not Your Fault 12 Periviable 12 Salad Fingers 13 Source Control 13 The Harvest 14 The Reality of Third Year 14 Toes Too Small to Make a Footprint 15 Unbuckled 15 UTES 16 Yellow Peril 16 A Needle Longer Than You Would Ever Be Lauren Fay Texted my dad: “We used your blood type today in a fetal transfusion! How exciting!” His reply: “Isn’t modern medicine great?!” Never said: How many pokes they poked And poked and Never poked the right vessel in That tiny floating cord, or What fetal exsanguination looks like during c-section. Never asked: What is the lesson here? Against Medical Advice Andrew Carey “5306 left AMA. She was clearly withdrawing and would not reason with us, so we sent her with some oral antibiotics per ID… Don’t worry about writing a note for her today, I already did the Discharge Summary.” I helplessly delete my draft of the progress note outlining my plan to save this woman’s life. 1 2 Any Last Questions? Andrew Carey “Any last questions?” asked the doctor, already walking towards the door. “Is this life-threatening?” She had been ignoring her symptoms for the better part of a year. She had no family, no support system, no transportation, and no steady income. I am clueless as to how she made the 8-hour drive from Wyoming. “Oh. Yes.” Assumptions Veronica Urbik An epiglottitis transfer from the ICU. The words unvaccinated and immigrant in his chart. A conversation with his mother, A tablet between us bridging our languages. No no, she says. My son was born in Utah. He had all his vaccines. A treatment plan, based on false assumptions. A failure of the healthcare system. 3 Birthday Party Addie Brandenberger Baby’s out... And pass! Warm dry stim. Tap out that heartbeat, definitely over 100. Great limb flexion. One off for color. Listen to those lungs fill with oxygen for the first time and scream it right back out. Dad isn’t the only one with tears in his eyes. Birthday parties have always been my favorite. Can We Hurry This Up? Veronica Urbik 6:55 AM new admit. Female, hip fracture. Walking to the bathroom on the morning of her 90th birthday. Place orders, page ortho, call radiology. Book an OR. “Young lady!” she says “Can we hurry this up? I have to be out of here by 2:00 or I will miss my birthday party.” 4 Chief Complaint Sierra McLean I read your chart. I knew you were assaulted. After seeing you, the word “assault” didn’t fit. You could barely open your eyes to talk to us. Everything was black, blue, and swollen. We walked out and my attending turned to me, “She had the shit kicked out of her.” I nodded. That fit better. Choosing a Specialty Rachel Tsolinas I’m going into internal medicine. Eight hours on rounds – again? I’m going into pediatrics. One more well-child visit and I’m going to vomit. I’m going into general surgery. The scrub tech looks ready to kill someone. I’m going into emergency medicine. The patient is currently breastfeeding a raccoon. Yup, I’m absolutely going into emergency medicine. 5 Connected, Not Present Anonymous My intern’s name popped up on the screen. I was not on service with her anymore. Pressing the phone to my ear, I heard a sob. He had been readmitted only two days after discharging. She coded him; he flatlined. I hadn’t been there. New rotation, new team, new patients. Move on. I still remember. crack Veronica Urbik crack! went the ribs under my palms in the code blue that morning. crack! a branch broken off a tree trunk. crack! a glow stick on the fourth of july. crack! an icicle snapped off a roof. crack! we have a pulse. crack! i felt in my palms, as i tried to sleep that night. 6 Deceased Jared A Hilton I’m on a weekend trauma call shift at 4 am. I wonder how my surgical oncology ICU patient is doing after his washout? His stability was tenuous at best and things weren’t going well for him today. I search for his name. “Are you sure you want to continue viewing this deceased patient’s record?” Yes. Everything Is (Not) Fine Jessica Zhu “Do you ever wish you were dead or could disappear?” I ask patients, but can’t stop thinking of my own answer: Yes. Medical school, where everything is fine. Smile. Read. Be punctual. Be perfect. How easy. Constant internal dialogue screams: I am not enough, not doing enough. Everything is not fine. And that is okay. 7 Goals of Care Patrick O’Connell A stroke from a septic embolus knocked out his right arm, now another one hit his kidney. “I miss my dog,” he said. 84 and no family to visit him, kidneys failing I keep pushing my plan to treat him but no. A time to be born, a time to die. Sneak in his dog. Helpless Sierra McLean It was my third day of third year and you sat across from me and told me all the ways you imagined killing yourself. You were my age. You told me about the loss you felt. You were in so much pain you couldn’t find a reason to live for your son. I felt helpless. 8 How to cope Anonymous You told me about being gang raped in the Navy, the subsequent stalking and harassment. You spent years coping with it. Using drugs and alcohol. Pushing everyone away that you cared about. The attempted suicide. And now you, a burly, mid-fifties, grizzly man, sat across from me with your head in your hands and cried. Inside Out Serena Fang It hadn’t yet occurred to me that you could leave the OR without being sewn up Without skin covering what I previously might have called your inside At some point I realized I was pulling the dressing out of you instead of off of you Looking, reaching into a wet, raw canyon Your inside out 9 IR Chloe Cross The lead shield hangs on my shoulders. The weight reminiscent of an audience’s presence. My foot hovers over the pedal. I flex my fingers. And then, I play. I fine-tune my pressure and placement, pitch, tempo. Exchange my wire. A new key. I spin a symphony from a picture. A procedure from a song. Joy Ben Berger Our attending walked fast and talked faster. Coffee perennially in hand, I thought “he’s the last person who needs a venti.” He once pimped me excitedly on a patient’s urine electrolytes. I had just reviewed RTAs, and I guessed right. “You got it man!” he exclaimed with a high-five. Friends, please remember to have fun. 10 Keep Your Nickel Jessie Smith “What specialty are you going into?” everyone asked. “You have to put your nickel down in mid-March,” I was told. Wait until the end, I suggest. Once you decide, it’s hard to go back. Find joy in learning and let yourself be present where you are. You will find your specialty. All in good time. Lucky Zachary Fica I feel tired 6 hours in. This morning, the senior said I’m a lucky student to see such a unique case. I feel unlucky 6 hours later, to be assigned this room on this day. I feel guilty as I remember the lucky 25 year old, dying of cancer, whose blood is on my hands. 11 MICU Day 2 PR Tuesday morning. 20-something, admitted with a saddle pulmonary embolism. “When can I go home?” “Soon! You’re doing really well, you’ll leave the ICU today.” Tuesday afternoon. Cardiac arrest. 75 min down. On ECMO. Neuro prognosis poor. “I’m calling to update you on your son’s course in the ICU.” “...what? I didn’t know he was sick.” Mother, Human Lauren Fay Cachectic body hears the shouting soul and Feels what her young mind refused to know, Shivers, hyperventilates, sweats— Her sobbing torso rocking to and fro until “What kind of mother would I be If I don’t beat this--whatever it takes,” Becomes “I’m afraid to die; but I can’t tolerate the chemo one more day.” 12 Not Your Fault Taylor King A mother’s guilt, her son nearly drowned. Not her fault, he’ll recover, but she can’t let it go. I’m asked to teach water safety. What is there to say? I summon courage, humanity, purpose. “A baby can drown in even one inch of water.” Guilt’s ugly face reemerges. I’m so sorry, so sorry, so sorry. Periviable Jessie Smith Periviable. A 27-weeker with a TEF. He is the size of my hand; his chest and abdomen smaller than I can describe. His skin nearly see-through. Too unstable to move, his NICU bed becomes the OR. Small, precise movements. I’m scrubbed, but standing back. Breath held. The fellow and attending operate. Terrifying. Brilliant. Awe-inspiring. Alive. 13 Salad Fingers Serena Fang We walked in one morning to find you standing upright The first time all week Eating a cafeteria chef’s salad with dressing with your bare hands Macerated cucumber and tomato decorating your hospital gown and the floor Plus a flying olive as you greeted us “GOOD MORNING” Outside your closed door my resident sighed “meth” Source Control Jessica Zhu What is source control? Eradicate the bacteria. Fight with antibiotics, delivered straight to the heart until the last tube is clear. Wheel to the OR, replace the dead valve. What do you mean you’re back? “You left me alone.” The attending keeps asking, What is source control? This time I know: Treatment of the soul. 14 The Harvest Anonymous They opened his chest, the ice went in. It didn’t take a lot. His small frozen body abandoned by the anesthesiologist as the surgeons count down the minute. When did he die? It seemed like I watched it, the heart coming out, then the liver, for an adult the kidneys are a prize they said. The Reality of Third Year Rachel Tsolinas Fell asleep while scrubbed into a surgical procedure. Slipped on ice, face planted and showed up with a bloody nose. Lost in the pediatric ward for 30 minutes. Had two blood borne pathogen exposure scares. Spent hours trying to obtain outside hospital records. Covid 19 Pandemic. Third year is weird. Just roll with it. 15 Toes Too Small to Make a Footprint Katie Panushka At thirteen weeks she had spontaneous abortion. She waited for the tissue to pass. It didn’t. She awoke to fevers, chills, her bedsheets cover in blood. At 2 a.m. we rushed for an urgent D&E. In the OR she grabbed my hand, “Excuse me,” she said, “When this is over can I hold my baby?” Unbuckled Addie Brandenberger You visit my dreams often. So do your parents’ tear-stricken faces as our unfamiliar hands became the last touch you ever felt. I had witnessed death before and would encounter it many times again, but I watched every heart in that crowded rural emergency room break as your short life ended. I am so sorry. 16 UTES Dan Jones that feeling when you are standing in the trauma bay watching the helicopter land “chest compressions in process” and you feel your hair stand on your neck because you know you are about to really help someone & this is your dream Yellow Peril Jessica Zhu While you feared for a small virus covered in spikes as it swept the world. I feared of being followed on my runs, of my home being broken into because the color of my skin differed from yours. I worried that your fear would prevent you from seeing that I was actually just like you. 17 |
