A blog about the inner workings of the field of medicine and its theoretical, practical, and ethical complexities.
By: Aaron Rothstein
June 5, 2014
Ambulance image via Shutterstock The Emergency Department is one of the most active and exciting parts of the hospital because it is the hospital’s sieve. The ED physician determines whether an injury or complaint is life-threatening or not and then treats or admits the patient to the hospital if necessary. Someone usually comes in by...
May 12, 2014
Pediatrics rounds are similar to what I described in one of my initial posts. We spend most of the morning visiting each pediatric patient with the attending physician and deciding on a treatment plan with the parents. Frequently we encounter patients on “contact precaution,” which means they have a highly communicable infection. In...
April 22, 2014
At this point, I have spent one month on pediatric surgery, one month on trauma surgery (a service that deals mainly with adults who need emergency general surgical procedures), and one month on general pediatrics. It’s clear already that physicians treat pediatric and adult patients very differently. Children need high levels of...
April 16, 2014
One of the things I hope to accomplish in this blog is to document my change in perspective as third year progresses. Part of this means addressing the topic of cynicism in medicine, which refers to an unhealthy skepticism towards patient complaints, callous detachment from death and sickness and even, perhaps, nastiness in situations...
April 7, 2014
In the hospital, older patients frequently go through a process called sundowning or delirium, where they see and imagine things that don’t exist. The etiology of this has to do with an aberrant sleep-wake cycle. Nurses and doctors constantly check in on patients throughout the night and wake them up to get blood tests, check...
April 2, 2014
There’s no question that one of the most difficult things to get used to about the hospital is the smell — or, rather, the smells. This is especially true on a surgery service where many patients undergo multiple operations. Some need a leg or foot amputated. Others need open abdominal surgery and can’t control their bowel...
March 28, 2014
There is much in Leo Tolstoy’s frightening and brilliant story The Death of Ivan Ilyich that is relevant to my previous post about CPR in the hospital. The novella concerns an upper-middle-class judge, Ivan Ilyich, his rise within the Russian legal system, and his subsequent death. Tolstoy describes Ilyich’s unremarkable and...
March 26, 2014
Can storied urn or animated bust Back to its mansion call the fleeting breath? Can Honour’s voice provoke the silent dust, Or Flattery soothe the dull cold ear of Death? — Thomas Gray, “Elegy Written In a Country Churchyard” The graveyard shift, or overnight shift, in the hospital is a singular experience —...
March 24, 2014
Doctors practice “grand rounds,” ca. 1920s. (National Library of Medicine) This post is meant to provide a bit of background about how the day works and how a medical team functions so the references I make in future posts are clear. Let’s begin with the team. Nearly every medical team at an academic hospital consists of an...
March 24, 2014
In Robert Louis Stevenson’s The Strange Case of Dr. Jekyll and Mr. Hyde, Dr. Jekyll says, “when I reached years of reflection, and began to look round me, and take stock of my progress and position in the world, I stood already committed to a profound duplicity of life.” It is appropriate that Stevenson chose a physician as...