Day 8: Rounding in Critical Care

“Sometimes even to live is an act of courage.” ― Seneca

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Each patient is a puzzle for the doctor to solve. Whatever ailment they have can stem from one to a dozen issues and in internal medicine it seems like its their job to figure out each and every single possibility.

Today's shadowing involved Shivali, A Ja'Nay and I following the Critical Care team in ICU. It included a group of internal medicine residents (the one we were assigned being Dr. Stovall), the attending Dr. Brevetta, and one M4 student. I will say this: we learned a plethora of acronyms.

Starting off the day with a team meeting, the residents went over the different patients they were responsible for. Most of it was overviewing their overnight stats to know what the days plan of action would be. One the longest conversations was discussing the "vent settings" (or breathing machine settings) for one patient.

TV / RR / Peep / .FO2

Never forget.

That and the acronym FAST HUGS BID.

I could probably fill the entire blog post with all of the medical shorthand the residents explained to us but I'll just leave those in my notebook for now.

Once we went on the floor with the critical care team the first few patients that we visited were in the Med/Surg (MS) ICU. Many of the cases we saw throughout the day were difficult to see, especially with how helpless the patients and their families were to their situations. Its no wonder that the ICU has its own social worker to handle difficult situations. All of the patients that we saw that day were intubated and it was Dr. Brevetta's job to explain to the families the most likely outcomes as well as the decisions they would have to make. His bedside manner was fantastic, especially since it was extremely straightforward yet he was still very compassionate. From past shadowing experiences that I've had this seems to be a very common theme in physicians and a delicate line to balance on. It certainly takes a lot of practice to get to that point.

Once all of the rounding on the floor was completed, the afternoon was more similar to the team meeting in the morning. When discussing the ground glass capacities and crazy paving pattern on one patient's CT scan, Dr. Brevetta stated that there were about 40 different scenarios that could have caused it. I think we only got through about ten of them before he had to leave.

Dr. Stovall and the rest of the critical care team were nice enough to answer all of our questions about medicine and the fact that you can have a life at the same time. I've tried not to consider that too much with my decision to enter medical school but it nice to hear their perspectives that life still carried on outside of their studies.