Even the best

[secretwave101]

---

Members do not see this ad.

On my MS-3 surgery rotation, our group got word that a lady was bleeding retroperitoneally and was going to undergo surgery emergently. According to the angio, she was bleeding from somewhere in the distal gastroduo artery. The angio team had occluded that vessel proximal to the bleed, but the problem persisted so it was decided that surgery was the next option.

The patient is 60yo and is a senior physician on staff. So is her husband. Thus, the head or our department and the most senior general surgeon (FACS) in our 600 bed medical center was called in to do the surgery. Even the residents weren't allowed to assist - that job was left for the #2 and 3 surgeons on our ward.

My student group of 5 people all crammed into the surgery along with our resident who teaches us. But what was supposed to be a show of the formiddable surgical talent of our hospital turned into a nightmare. The lead surgeon, while trying to expose an artery, lacerated the portal vein. In the course of suturing it, the team mixed up which vessel was which and thinking they were transecting the pancreatico-duo artery...they cut the freaking common bile duct.

Our lead surgeon was swearing at the nurses, the team had to open this lady's abdomen even further to repair the damage, and they ended up doing a chole for some reason. In the end, they never even found the source of the bleeding and she ended up with a HUGE scar along the length of her abdomen, two drainage tubes and a T-tube sutured along the side of her body.

As a student, I can't be sure of everything that happened, or exactly what went wrong. I DO know that this lady will require a significantly more detailed explanation of WTF! than your average patient. And I am fairly sure she'll be back in surgery shortly to actually repair the bleeding (unless it stopped itself).

I am still a little in shock from what I saw. The error, I'm told, could easily kill her. As I left for the night, I saw the great surgeon sitting alone at his desk, a single light on, long after he normally goes home. He wasn't working, he was aimlessly searching through desk drawers. I realized that he was waiting for the patient to wake up from anesthesia so he could explain the situation to she and her family. What in the world would he say? For 5 weeks, I've been intimidated by this man's persona and in awe of his intellect. But as I left for the night, I saw a lonely man consumed by a profession that in the end betrayed him.

Recently, I was asked by an internist if I'd developed a guilty conscience since starting my surgery rotation. I didn't understand what he meant at the time. Now I think I do. Although my intern and others who I've asked about this surgery have been fairly forthcoming in saying that the CBD was mistakenly cut, they've also been VERY careful about how they describe events, and who was at fault. But I suspect we all know what happened: a basic human error was made by the best surgeon in the hospital and a woman will suffer for it. I've been enthralled with surgery during this rotation - to the point of wanting to do it. But I'm not sure I could handle the burden of error...or the guilt that follows.

Since this is the surgery forum, I'll pose the question: How often, really, do these kind of things happen? Is it common for you to wonder if you could have done things differently? Or, worse, how often do you KNOW you should have done it differently? I've realized recently that surgery in particular is a field that has SO many oportunities for error - surgeons must spend an enormous amount of time covering their a**, and feeling guilty about it. Is that the case?

 

[bobbyseal]

I'm just a 3rd year clerk on surgery too now, but I can tell you that the chief resident pimps us endlessly on hypothetical complications in the OR. He's constantly asking during a case or rounds, what would you do if you cut this or burned that, etc. I think these kind of questions are very important in surgical training so that when these complications happen, as was the case from your story, the surgeon is ready to treat it.

On another note, maybe having two attendings operate at the same time wasn't the best idea. Call me crazy, but I've been told that studies were done comparing high echelon care (ie the chief of anesthesia comes to put the iv line in on some high profile patient) as compared to routine care (ie the nurse anesthetist does the job). From what I was told, routine care is better. So maybe they needed a med student in there to have done what med students do best, hold retractors. Those attendings haven't held retractors in ages...maybe they didn't maintain the field well and that's why they cut the CBD. This statement is a likely a bunch of bolagna, but hey, it's a stab at an explanation.

 

[Meritina]

I think one thing that's not realized by many before medschool is how risky surgeries in fact are. You hear of alot of people saying they want to go into surgery or even patients who say they want to do surgery, but they don't really know how aweful the experience can be. The first code I ever saw, not even during surgery rotation, was from a lady who hemorrhaged after ENT surgery - apparently a more common mistake described as occuring from unseasoned ENTs.

So why would I pick surgery if this is the case? Because this is the type of situation I do better in. But in fact, surgeries are even less complicated and more successful from the critical view I had. SO after having this pessimistic view, I'm now pleased about how successful things usu run.

 

[droliver]

Was this a bleeding duodenal ulcer? Those are often very hard to control & the inflamation from the ulcer is what likely caused the portal vein to tear rather then being cut. Injuring the CBD is regretable, but those emergent operations are setups for it when things are bleeding fast and furious. If some of those patients make it out the hospital its a success in and of itself. Trying to embolize a bleeding duodenal ulcer is a pretty questionable decision unless the patient is some medical train wreck (eg. Child's C cirrhotic) and probably just delayed a needed operation adding physiologic insult to injury.

I think you're reading too much into what you think that surgeon is feeling. Most don't carry a lot of guilt around on things like that, especially on emergent cases. You tend to rationalize it as a risk of the ooperation. The things that tend to stick with you more are decision making errors that hurt people. Those are the things you play back in you head & remember for a long time. There's a saying in surgery that Good judgement comes from experience & experience comes from bad judgement.

 

[dry dre]

Secretwave,

Very good thought-provoking post. I think this kind of trainwreck occurs from time to time and most of us have probably witnessed such an event at least once (or been part of).

When I look at medicine, I see the different specialities having their own unique types of trainwrecks (to overuse the term). I think that in surgery the mistakes are often simply glaring and undeniable when compared with mistakes in other specialties. Missing a diagnosis until it's too late on the medical floor is easily explained away....cutting the wrong structure in the OR isn't. Both events can have the equal bad outcome (death), though it seems that surgical mistakes are somehow seen as more preventable. Maybe they are, who knows.

During my second lap chole the attending was describing to me the hazards of the procedure. He was explaining the normal and abnormal anatomic variation, the influences of inflammation on presentation, the incidents of error, how to fix errors...on and on. Then he cut the common duct. Before this mistake I held him in high regard and I still do. What's weird to me is that his mistake made me question my own skills and knowledge (not his).

Regarding your question, it seems to me that older surgeons are more 'comfortable' with the notion that surgery is inherently dangerous and that mistakes will happen, and bad outcomes will result. In non-elective surgery, people come in the door with a problem. You study 13+ years to try to help them with that problem. After a 13+ year committment to helping others it's still a risky business. It can't be fun to make a mistake, but surgical work is work that someone has to do.

 

[secretwave101]

Droliver,

I guess it could have been a duo ulcer, but nobody mentioned that as a possibility. I probably should add to your point about "bleeding fast and furious" to make the case clearer. She came in the day before with vague abdominal pain and a Hgb of 13, and 24h later her Hgb was down to 10.0. CT showed the retro bleeding...angio showed the location of the bleed. So, you're description is probably accurate, she was losing blood pretty quick, it seems.

I also think you're right about my projecting my own feelings on to the surgeon. He's a pro with lots of years behind him and has likely dealt with these things more than once. But it just seemed like such an elementary mistake. The CBD was deliberately cut - I watched him do it - it didn't get torn or somehow injured in the course of other work (you're right about the portal vein though...it was torn just by light touch). I don't understand why they didn't just trace the vessel back to the source before cutting it if there was any question.

One thought is that they were just stressed: We students estimated that she'd lost around 1L of blood before the surgery, and then quickly lost close to another L before they got the portal vein repaired (if the suction collection container was a vaguely accurate indicator). So, even though things were quiet and seemed calm in the OR that day, maybe the surgeons were moving and thinking much faster than usual...and it led to a mistake.

 

[Foxxy Cleopatra]

Originally posted by droliver
The things that tend to stick with you more are decision making errors that hurt people. Those are the things you play back in you head & remember for a long time. There's a saying in surgery that Good judgement comes from experience & experience comes from bad judgement.

This is very true. Technical complications are easier for me to accept, as they are a risk of even the best surgeons. The things that keep me up at night are the clinical decisions where I debated between 2 choices and second-guess myself. I don't know why, but these are much worse; maybe it's because you can't completely justify yourself on one side or the other.

 

[njbmd]

Originally posted by Foxxy Cleopatra
This is very true. Technical complications are easier for me to accept, as they are a risk of even the best surgeons. The things that keep me up at night are the clinical decisions where I debated between 2 choices and second-guess myself. I don't know why, but these are much worse; maybe it's because you can't completely justify yourself on one side or the other.

Hi Foxxy,
I can say exactly the same thing. I have tended to get into trouble when I have second-guessed myself continuously. Yes, we are going to make mistakes and experience will teach us.

In the original post about the VIP surgery, I have generally found that the chief residents do far more technical operating than many of the attendings. As an attending, you are in the role of assistant on many operations with the chief resident. The reverse is true in a private hospital where the attending is the the chief operating surgeon and might be assisted by a surgical assistant or nurse. It is the experience of the attending coupled with the technical work of the chief that generally gets most patients out of sticky situations.

If I am a patient, I will opt for the chief resident and attending surgeon every time over a couple of attendings in a teaching hospital. They might have more experience but being cast in the assistant role most of the time tends to dull some of your hands-on skills. It is no wonder that attendings in teaching hospitals hate to do cases uncovered by residents, even junior residents.

My residency director is a world-renowned laparoscopic surgeon. Sometimes patients will request that no residents or medical students be present in their surgery. My residency director tells them that it takes three people to perform the surgery. One to operate, one to assist and one to drive the camera. Since he doesn't have six hands, he can't do the procedure alone and that he will have to pass on doing the surgery if his team cannot assist. Almost every patient changes their mind after his talk. I can tell you that doing a case with him is great because he is a master at the anatomy. In the times that I have been totally confused, one word from him can totally orient me. I am always amazed at his teaching ability.

njbmd 😎

 

[HiddenTruth]

I think the OP is on target abt how he feels abt the surgeon. Granted, these things are risks and what not, but I mean the guy totaly screwed up, not criticizing him by any means-- but we have to accept that because of a human error someone suffered--we can't deny that. And yes he will think abt it and yet he wished things would have gone differently. I mean unless youre totally in medicine for the business aspect, you would share a mutual feeling--hell, I do not even being there, not even knowing the surgeon or the pt, because it can potentially happen to any of us. Also OP, you should check out "Complications: A Surgeon's note on an Imperfect Science", it's a book by Atul Gawande, a PGY-7 in surgery at Harvard who talks about multiple cases and stories abt how much of medicine we dont know, and how doctors become who thye do after so many yrs of practice. And how some of medicine is just pure luck. It's an amazing book if you like me and others think abt the other side of medicine, that the avg joe or the normal human being does't even know it exists. Anyhow, best of luck, and I think what you should get out of this experience is not that you can't be a surgeon because of this high-risk and the inevitable force of error which is a part of human nature, but the other side of it--how many procedures has this doc performed that indeed were successful?. I think there is a distinct demarcation btwn human error and a "bad" doctor. Think abt the internists, and the medicine doctors who make judgement calls everyday--granted, they can't go completely wrong (unless they totally are idiots and jus' screw up) like surgeons (mistakes such as cutting the CBD), but they do make those judgement calls, and that can lead one way or another--pronosis becomes worse, pt dies--things could have gone differently for the internist im sure? So medicine, in all is a field of high risk and yes we all are humans have those emotions and capacity to make error--but that is part of it. if you cure 100 people and because of you working so hard one is a poor prognosis--think abt the good you have done. Anyways, those my two cents on this topic. I think you have to establish middle grouends somewhere, where you cannot be too emotional but rather also not be the wall street business man trying to rack in all the dough and that is all you care abt. Good luck...

 

[neutropeniaboy]

Originally posted by Meritina
The first code I ever saw, not even during surgery rotation, was from a lady who hemorrhaged after ENT surgery - apparently a more common mistake described as occuring from unseasoned ENTs.

What operation did she have, and what were her underlying comorbidities?

 

[Whisker Barrel Cortex]

Very thought provoking post. I just wanted to add that every specialty faces the same dilemma and people make mistakes in all specialties.

A medicine resident friend of mine had a young 30 y/o lupus patient admitted with vague symptoms. She was tachycardic but not febrile on admission. Turned out she had bacterial meningitis, but this was not suspected until 12 hours after admission and antibiotics were not started until too late. She died.

Radiology is by no means insulated from this, although we do not have the burden of talking to the families or the patient about the error, we often must talk to the clinician and making a wrong call that led to a bad result is gut-wrenching for us as well.

Although we can minimize these mistakes with extensive training, we cannot eliminate them completely and that is a fact of medicine that we must learn to live with.

 

[phenolphthalein]

Actually, the OP brings up a larger point that oftens go unmentioned and that is all of the secrecy in medicine that stems from the fear of malpractice liability. It doesn't have to be this way. I posted this article from the NY Times earlier and here it is again. It offers a better solution to situations like the OP described.
---------------------------------------------------------------------------------
September 23, 2003
ESSAY Beyond the Blame: A No-Fault Approach to Malpractice
By DAN SHAPIRO

The room is filled with physicians from all over the country. It was silent until a few moments ago, when the first sad gasp was heard from the far corner. Now tearful faces fill the room. I've asked each doctor here to write a letter to a patient about something unresolved. The doctors will never mail these letters; instead, they have been instructed to write as openly and truthfully as they can.Now, Ellen, an obstetrician is reading her letter aloud. It is about something that happened 15 years ago, when she was practicing independently for the first time. She performed amniocentesis, inserting a needle into her pregnant patient's amniotic fluid to check for genetic disease, and induced a miscarriage.Ellen was not sued, and she has never spoken about it, until now.As the afternoon continues, most of the letters are about mistakes, errors these physicians made that continue to haunt them, years later. As a clinical psychologist, I have done this exercise with more than 300 doctors, assured of anonymity, in physician wellness seminars. And as a former cancer patient who spent five years struggling with chemotherapy, radiation and operations, I am aware that patients often split doctors into two groups, the good and the bad.The truth, of course, is more complex. Most physicians, even those whose skills are excellent, make terrible mistakes at some point in their careers.Most doctors are genuinely committed to their work and carry their mistakes with them, secretly, for the rest of their lives. Unfortunately, a vast majority do not tell their patients when they have made mistakes that harmed them.It is not surprising that so many doctors who are successful and usually ethical will cover up their mistakes. And it is not surprising that many doctors, as well as patients, find the current system of accountability unworkable, especially in medical malpractice cases.Fear of malpractice is rampant. Research studying physicians' responses to being named in malpractice suits has revealed that the experience is traumatizing for most and that 20 percent of doctors who are defendants describe the experience as the most traumatizing of their lives.Part of the trauma is financial; doctors are personally responsible for damages beyond the amount that malpractice insurance will pay.The trauma is also psychological, as most physicians derive much of their self-definition from their knowledge that they are good doctors. In suits, it is to the plaintiff's advantage to characterize the doctor as uncaring, negligent and unskilled. Physicians who have been trained to expect perfection from themselves usually find this battering.This may explain why so many mistakes go unreported. In 1999, Dr. David Studdert, a Harvard researcher, published a paper in which doctors and nurses reviewed 14,700 medical charts from Utah and Colorado for evidence of negligent care.Then Dr. Studdert and his colleagues tracked how often bad medical care resulted in malpractice suits. "Of the patients who suffered negligent injury in our study sample, 97 percent did not sue," they wrote.The authors also concluded that roughly 5,000 uncompensated injuries resulted from medical negligence in Utah and Colorado in 1992. Dr. Studdert's results were similar to those reported in the 1970's and 80's in California and New York.In 2000, the Institute of Medicine published a report suggesting that a majority of doctors' mistakes were products of flawed systems that did not provide the checks and balances necessary to prevent errors by physicians. Many are preventable. In the last decade, malpractice insurance costs have skyrocketed, leaving many doctors unable or unwilling to pay for coverage in their chosen specialties.This year in an effort to address the problem, Representative James C. Greenwood, Republican of Pennsylvania, and Senator John Ensign, Republican of Nevada, introduced legislation to cap financial awards to patients in malpractice cases.The legislation was voted down this summer. The flaw with this plan was that even if it worked and liability insurance prices dropped, secrecy in medicine would still not be addressed.A better plan would call for motivating physicians to report their own mistakes by offering them no-fault judgments in exchange for their disclosures. This will work as a "carrot" only if there is also a "stick" waiting for those doctors who chose to cover up their errors. In such a system, instead of physicians' paying for malpractice insurance, the doctors and patients would pay into local injured-patient compensation funds. In this way, the burden of reimbursing injured patients would be shared, and everyone would enjoy the benefits of better care resulting from changes in the way medicine is practiced.Physicians making serious mistakes would voluntarily report them to local commissions.The commissions, which would consist of physicians and patients, would strive to compensate the injured patients according to guidelines established to ensure that reimbursements were uniform.In exchange for disclosing mistakes, physicians would be granted no-fault judgments and avoid liability. If the commission agrees with the physician that harm has occurred, the patient will be compensated according to guidelines designed to ensure uniform compensation.The compensation would be more modest than the occasional enormous judgments in the courts today, but many more patients would be compensated, because the reporting onus would be on the doctor (who is in a better position to perceive the mistake), rather than the patient.Separate boards would take over the role of the state boards of medicine and investigate doctors and nurses who did not come forward. The boards would investigate medical errors and substandard practices reported by patients by studying incident reports and patient complaints to discover mistakes and by auditing charts at random.Doctors who were justifiably unaware of mistakes would have an opportunity to present their perspectives. Those who appeared to have ignored or covered up their errors would have no protection and could lose the right to practice medicine.In this system, many doctors who showed patterns of substandard practice would eventually be caught, while doctors who were honestly doing their best would have a way to apologize and promote healing by telling the truth about their involvement in the mistake.As long as the harm was a result of medical care (and not a criminal act) and the doctor showed no pattern of neglect or abuse, then freedom from payment would be granted for complete disclosure.Clearly, the introduction of no-fault malpractice would require a drastic shift among doctors trained under the prevailing philosophy. Learning to trust a system that does not penalize honest mistakes will take time.Putting such a system in place will also be challenging, assuming that all physicians will have to serve some time on local medical compensation boards and that some cases will have to be referred to other jurisdictions so that well-trained peers can be identified.Patients may wince at the idea of not holding doctors personally responsible for their mistakes. Most patients are unaware of how little protection they now have. A brief survey of patient advocacy Web sites reveals that most patients oppose any limits on financial awards, erroneously assuming that the current system is working to protect them.As someone who has lived on both sides of the sick bed, I know that patients and doctors want the same thing: a system that builds trust, helps each group learn from mistakes and compensates those who are injured.The current system meets none of these challenges, but a system combining no-fault judgments with aggressive hunting for those covering up mistakes, will.
Copyright 2003 The New York Times Company

 

[Tenesma]

i think this thread points out the main issue:

we work long hours and spend our lives learning how to take care of the sick --- and there is so much at stake. Frankly I am surprised that so many people survive their hospitalizations!!!
the practice of medicine/surgery is an amazing mysterious thing, and it is so prone to mistakes and errors in judgement, that are always made with the best of intentions....

 

[2ndyear]

secretwave101, I just have to say that that is far and away one of the best posts I have ever read on here. Very mature and introspective. You obviously have a very mature outlook on the more humanistic sides of medicine that we all tend to forget about too much.

On a side note, I think that stories like that and what you learned from it make excellent personal statements for ERAS, when the time comes. Good luck to you.

 

[5oProlene]

Originally posted by 2ndyear
On a side note, I think that stories like that and what you learned from it make excellent personal statements for ERAS, when the time comes. Good luck to you.

Yes, always remember to never pass up the opportunity to take advantage of other's misfortunes to pad your residency application. 👍

 

[Starcraft]

Originally posted by 5oProlene
Yes, always remember to never pass up the opportunity to take advantage of other's misfortunes to pad your residency application. 👍

you're right, it would be terrible if something positive came out this experience. 🙄

 

[5oProlene]

Originally posted by Starcraft
you're right, it would be terrible if something positive came out this experience. 🙄

I guess that's what you can tell yourself to make you feel better as you pad your application with another person's misfortune.

 

[aphistis]

Originally posted by 5oProlene
I guess that's what you can tell yourself to make you feel better as you pad your application with another person's misfortune.

I wasn't aware Jesus himself was posting on SDN. Get over yourself, champ.😉

 

[5oProlene]

Originally posted by aphistis
I wasn't aware Jesus himself was posting on SDN. Get over yourself, champ.😉

No thanks

But feel free to ignore me if you want.

Have a nice day. 👍

 

[Starcraft]

Originally posted by aphistis
I wasn't aware Jesus himself was posting on SDN. Get over yourself, champ.😉

he's not jesus. he's probably a disgruntled FMG. leave him be in his misery. chances are he's a troll returned anyway.

 

[secretwave101]

UPDATE on this case:

The patient was placed on our ward after the surgery, and I've been able to talk with her about the surgery from her perspective. Ostensibly, I was "admitting" her, and I haven't revealed that I was at her surgery.

When asked how she feels now, she smiled and simply said "MUCH better". She described the bleeding, including the retroperitoneal location which was more detail than I would expect from most non-medically trained patients.

It was quickly clear to me that she was more concerned about the relieved pain than she was concerned about whatever mishaps occured. She then said "they also took out my gall bladder" and only obliquely mentioned "some problem with the bile duct".

Playing my role as the ignorant student, I asked her to explain the "problem" she mentioned. She said that the bile duct was damaged, she wasn't sure how, but that these kind of things happen in surgery. When asked why they removed her gall bladder, she said "they told me it was inflammed due to my initial problem". This sounded bizarre to me (cholecystitis due to retroperitoneal bleeding?), so I restated the question and she said firmly "it was taken out because of the other problems."

My first sense was that she was, a priori, willing to accept the story given to her by the surgeon. I also felt a great amount of personal resistence to the thought of providing her with fuller details of her surgery, FOR HER SAKE, rather than to protect our surgeon. I felt as though there was an unspoken collusion between us - I don't say anything, she doesn't ask anything. It is clear that she doesn't want to ruin anyone's career, and isn't interested in getting rich. She simply wants to feel better, and it appeared, WANTS to trust her doctors - to the point of avoiding any line of questioning that would probe deeper into how the damage occurred.

It also appears that the chief surgeon really was honest with her, at least linguistically, although the specific details of the error were not described. He may or may not have been ready and willing to impart those details to her, but he wasn't asked for them. There was some damage, it happens sometimes, that's enough.

According to the drainage bag, her T-tube appears to be functioning normally. She's hoping to go home in the next 8 days or so. She's already up and walking around. If the fibrotic process continues normally around the T-tube, I suppose there will not be further complications and things will return to normal.

Finally, her chart did provide a legitimate description of the surgery - sans details: "exploratory lap, ligation of gastroduo artery, cholecyctectomy, accidental injury of CBD - primary repair on T-tube."

A John Edwards-type could probably have used something like this successfully for financial gain. But in the end, I suppose it is the quality - even nobility - of the patients themselves that are a doctor's best protection from catastrophy. The story ends because the patient wants it to, not because of anything we did - right or wrong.

 

[5oProlene]

Truly heart warming...

Do not pass up the chance to put it in your personal statement.

 

[Celiac Plexus]

Originally posted by 5oProlene
Truly heart warming...

Do not pass up the chance to put it in your personal statement.

LOL!!!!!!!

 

[secretwave101]

Enough with the self-righteousness!

ALL of medicine is a profession that profits on another person's misfortunes in some manner. Surgery, especially for students, is particularly so. I learn when someone's life blows up (or their appendix does, anyway). It sucks, but at least I'm trying to learn from it.

Will this experience come up in my application, especially if I apply for a surgery residency? I guess so. It has made quite an impression on me. It will be a contributing factor in how I think about, maybe, all of medicine. Had it EVER crossed my mind through the course of these events? Not until this thread was hijacked.

Please, let it go. I've appreciated the responses from the thoughtful people who deal with this kind of pressure for a living.

 

[5oProlene]

Originally posted by secretwave101
Enough with the self-righteousness!

ALL of medicine is a profession that profits on another person's misfortunes in some manner. Surgery, especially for students, is particularly so. I learn when someone's life blows up (or their appendix does, anyway). It sucks, but at least I'm trying to learn from it.

Will this experience come up in my application, especially if I apply for a surgery residency? I guess so. It has made quite an impression on me. It will be a contributing factor in how I think about, maybe, all of medicine. Had it EVER crossed my mind through the course of these events? Not until this thread was hijacked.

Please, let it go. I've appreciated the responses from the thoughtful people who deal with this kind of pressure for a living.

Don't include any of this in your personal statement. It makes you sound angry. All the rest though has been golden.

Be sure to have your personal statement proof-read by somebody else. Maybe the surgeon involved in the case wouldn't mind editing it for you. You might even try to get the patient to read it over as well, it's worth a try. Keep us updated on how it goes. Good luck.

P.S. Do you mind if I alter some of the details in the story and use it in my personal statement also??

 

[ecpiii]

secretwave,
Resistance is futile. Face it...this is still funny.

 

[5oProlene]

Originally posted by ecpiii
secretwave,
Resistance is futile. Face it...this is still funny.

What's so darn funny about it? This is the making of a touching personal statement that will pull at the heart strings of even the hardest residency director.

 

[eddieberetta]

I do not think it is very wise to post this much detailed information about a patient's stay in hospital, right down to the OR note.

 

[Loves_Chai]

Prolene,

You are going crib off another poster's story to put in your own personal statement. Please tell me you are kidding....

 

[2ndyear]

OK, ok maybe I shouldn't have mentioned that stuff about putting this or any other story in a personal statement. For the record, my personal statement does not have any story and what I learned from it. I do wish I had one, I just may have used it. The parts about the seasoned attending deep in thought after the case really did touch me though. But don't use it. Make your PS another boring life story like mine. I am sorry I brought this subject up here.

 

[Neuron]

Originally posted by secretwave101

The patient is 60yo and is a senior physician on staff. So is her husband.

...

Originally posted by secretwave101
She described the bleeding, including the retroperitoneal location which was more detail than I would expect from most non-medically trained patients.

So is your patient an MD or no?

Maybe 5oProlene is on to something, and you're really posting draft versions of a cooked up case that may ultimately find use as a heart rending PS! 😛

Careful you're more consistent with the actual application though 😀

 

[secretwave101]

Uuuumm, what's inconsistent?

I was TOLD she was a doc...and then when I interviewed her she showed more sophistication than I would expect from a non-medically educated patient. She later told me she was an MD, but prior to that, she appeared to be one just by the type of answers she gave.

At the moment, I haven't decided exactly who's terrible misfortune I intend to use to advance my career, but I'll make sure my story's straight. Thanks for the help.

 

[5oProlene]

secretwave, your story is truly special. Have you considered trying to publish it in JAMA as one of those "personal experience" articles. That way you would have both a terrific PS as well as a publication in a highly reputable journal to go on your CV! Just some food for thought.

 

[Spidey]

Great post secretwave, thanks for sharing it. (Being sincere, thought I better mention that considering some of the sarcastic posts in here. Was a great post, would love to see more like it.)

 

[medstudent2005]

man, you guys sure are caustic...nothing like living up to the surgeon stereotype.

adios