First Patient

[fantasty]

I thought there was one of these but I couldn't find it. Brickhouse's comment in the other thread made me think of it though.

Mine was on internal medicine. Our team was on call the first night of the rotation, and she was admitted around 8 pm. She had a rash with fever, and intermittent arthralgias. It took over a week to nail down the diagnosis - the list on the differential was huge and nothing quite fit the picture. Finally (after a dermatopath consult, I think), it was determined to be a cutaneous t-cell lymphoma, but it certainly wasn't a textbook case. She was still in the hospital when I rotated out to the VA (3 weeks after admission). She was very nice, and although her family lived several hours away, they were always there (the husband slept in the room when she didn't have a roommate).

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[Hernandez]

Mine was on medicine as well.

and mid 50's AA male. H/o aids/Hep c/ schizophrinia. Came in with fever and was goofy as hell. He was a burned out schizo and we could not keep him on meds cause they kept putting him in renal failure. So one day he'd be saying "I feel holy" to cursing us when he was off his meds, "You hoit (hurt) me, ya hoit me inside, mutherfocker" It turned out he was septic with TB and died later that month.

 

[Dr. Will]

I can't even remember my first patient anymore.

 

[raidermedic]

All I can remember about my first patient is that she had a problem list a mile long and there wasn't a soul around to show me how to attack this 6 inch thick chart. Meanwhile most of my class mates are on outpatient rotations working up URIs and UTIs and and getting compliments on it. My interactions with attendings was mostly them scratching out my note, giving me dirty looks, and yelling at me for not asking if pt had some obscure sign because the 48th drug down on the list can cause it. Needless to say I didn't like that rotation and don't have a very nice memory of my first clinical experience.

 

[BigNavyPedsGuy]

My first patient was on a Peds Cards rotation, and he was 51! s/p tetrology of fallot repair over forty years ago. He kept sneaking out to smoke. That's not so normal at the Children's Hospital.

 

[ms. a]

I was also on IM night call the very first day of rotations. My first patient was a 553 lb woman who had the most disgusting case of cellulitis all over her right leg. At one point, I had to be the one person to hold up her leg while others looked under it to see how far the infection had gone around the back. I could barely keep it up and had to constantly remind myself to breathe through my mouth for fear of gagging and dropping the leg on my resident. She also told me that she had a rash on her hip, but I was never actually able to find her hip. When I was looking for it, I just had to keep picking up folds of skin and fat. At one point, I picked up what I thought was another fat/skin fold, but it turned out it was her right breast, hanging somewhere in the vacinity of her hip. She told me she had 6 kids, the youngest of which was 6 months old (although by hospital records, it was born 4 months ago). We were all wondering how exactly that happened.

 

[ESPNdeportes]

My first rotation was emergency medicine. First patient was a 71 year old guy with uncomplicated diverticulitis. Easy diagnosis, made me look good in front of my attending.