This might just be my favorite one to date!
Since my primary field and time investment is the medical field, it’s natural that I’d derive some motivational moments from my work. Without such moments of fulfillment, it would be difficult to keep going with the intensity and time commitment that’s required. While these are quite far and few between the daily nonsense that goes on during this portion of my training (internal medicine residency), I hope that writing about these moments will put them to the forefront of my mind and remind me of the diamonds that can be found only by working within this field.
Successful Dialysis Catheter Placement
Image Source: https://link.springer.com/chapter/10.1007/978-3-319-91164-9_26
Mine was on the patient’s right side!
I didn’t know much about this patient… all I was told was that he required emergent dialysis (in simplest explanation, a machine acts similar to a kidney by filtering blood and removing fluids), and this would require a special dialysis catheter to be placed in his internal jugular vein, which is inside of the neck. This vein leads directly to the heart, so it’s something that has to be done in a sterile fashion, meaning that the patient gets sterile draping, and I scrub in to do the procedure.
Naturally, I got assistance in doing this since I haven’t done many of them before. However, I have placed central lines before, and the procedure has a lot of similarities; the difference here is that we’re dilating the hole in the neck more so that a larger catheter can be placed; the dialysis catheter is larger than the central line catheter. Additionally, my patient had a rather large neck and was partially awake (don’t worry, we gave him local anesthesia and made sure he was comfortable during the procedure!), so there were some technical challenges in positioning the line.
I am not typically very fast at placing these lines; I tend to take my time to make sure that I do things correctly, largely due to a lack of confidence, but also because I don’t want to kill my patients! This time around, despite being very careful, and with the aforementioned technical challenges, I was still able to place the catheter rather quickly while maintaining all safety precautions. It was a pretty proud moment for me.
Even though my shift ended at that point, I also made some phone calls to expedite a few other important things that he needed done. While I left late, I knew that I had done more than my due diligence to ensure that he would receive the best and timeliest possible care.
Unfortunately, all of this happened very late in the day, and the patient could not receive the dialysis he required. I found out that he passed away two days later. That’s the nature of the field… but at least I knew that I did my absolute best.
“Super Doctor”
A couple of days later, I was in a continuity clinic, seeing patients on an outpatient basis, as would a primary care doctor.
I had one very fascinating patient – a young man in his early 20s who suffered a stroke, went to physical therapy, and came to us for a follow-up appointment. He had planned to move away to a different state for a short period of time to recover, and was asking for refills of medications.
Although there was very little for me to do from the primary care perspective, the case fascinated me to the extent that I read through the entire chart over the course of about 20 minutes and knew the story as if it were my own, even prior to seeing the patient. The consequences of this showed when this young man and his father spoke me and understood how familiar I already was with the case.
Indeed, I answered their questions as best as I could, acknowledging when I didn’t know something (humility, honesty, and integrity is important!), and even joked around, making them feel like I truly listened and cared.
When the visit concluded, the patient’s father told me a couple of times, “Super Doctor!” and asked for my name. I believe that my supervising attending heard this, as he came into the room second after the patient and his father left. I know that the next time they’re here, in several months, he’ll be my return patient. It’s a tremendously great, validating feeling.
Conclusion
Another set of memorable, successful moments in my budding medical career! During more difficult times, it’s useful to reflect upon and write about these little moments of victory. Recalling these moments always improves my confidence. It’s fuel for further self-improvement. 😁
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