About the Book
Title: PLAYING DOCTOR; PART TWO: RESIDENCY: (Blundering along with imposter syndrome)
Author: John Lawrence
Ready to learn how (not) to be a doctor?
Well, neither was John.
John’s adventures in medical training continue with this insightful, often hilarious, self-deprecating medical memoir of bumbling into residency with a severe case of imposter syndrome. This second part in the series brings John’s unique, irreverent and candid med-school storytelling to the world of residency training.
Initially, John penned email blasts while being held captive on-call nights. His descriptions of the escapades, mishaps, disorder, and terror that surrounded his training, led several friends to enquire if he has broken into the hospital pharmacy. Eventually, someone asked to publish the stories, so John replied that he’d write down the whole adventure of becoming a doctor from medical school through residency.
My very first patient on my very first day in the ER was a young woman with a severe headache. When I entered the room, she was moaning on the exam table with the lights turned off because lights exacerbated her headache. I spoke calmly and quietly to not make her head feel any worse, “Hi Nancy, my name’s John, I’m one of the doctors here today. I understand you have a headache?”
She attempted a brief, small smile for my compassionate efforts, “I’m having the worst headache of my life…feels just like a migraine…,” her smile replaced by a grimace of obvious pain.
That phrase however, worst headache of my life, is a catchphrase that medical students have been trained to respond to like Pavlovian dogs, drooling with excitement (and in my case, fear), because they were the words patients typically used to describe the pain associated with a hemorrhage in their brain.
I did a rapid battery of physical exam tests, and quickly went to discuss this potentially fatal headache with the attending physician.
My attending for the day was a fantastic doctor and great guy: always very relaxed and instructive, who appeared more likely to be crafting micro-brew in the ER office, while lecturing about existential philosophy in between poetry jams, than saving lives. I was very concerned about the patient and just blurted out, “I’d like to order a stat head CT to rule out a subarachnoid hemorrhage for this patient.”
“Stat” sounded kind of cool to say in this, my virgin, and quite emergent, ER case.
The attending appeared nonplussed, awaiting further explanation without any reaction to my urgent use of the word “stat.”
So, I blundered on, “This patient, Nancy Beckstead, twenty-seven-year-old woman, here with a chief complaint of a headache that she describes as… (drum-roll please) the worst headache of her life (dramatic pause… but still no reaction from the attending). Uh…the headache woke her early this morning…”
“Did you say Nancy Bankstead?”
“Nancy’s a frequent flier here. Every Saturday. Just don’t give her any narcotic drugs.” And then he went back to casually reading his newspaper.
What? I was shocked. My patient was probably going to die; I wasn’t worried about pain meds—although, I did need a plan to treat her pain because, well, doctors are supposed to help relieve their patient’s pain. But I still needed to figure out what to do.
“So, don’t order that stat CT?” I asked.
The attending shook his head at either my silly re-use of the word stat, or more likely, my inability to grasp that Nancy was a big fat liar.
“No. Tell her to follow up with her doctor this week.”
I sulked out of the office, while the carefree attending turned back to his bagel and morning newspaper, calmly calling out to the nurses’ station, “Barbara, can you pull a recent
DOPL on Miss. Bankstead?”
I returned to Nancy, tiptoeing back inside the dark, quiet room, and politely asked her what medicines she had used for headaches in the past that had helped. Amazingly, all of them happened to be narcotics—the exact same medications I had just been instructed not to give to her.
I suggested a non-narcotic pain medicine.
She was allergic to it.
I suggested a different non-narcotic pain reliever.
Remarkably, she turned out to be allergic to every single non-narcotic pain reliever ever available in the world. I told her about a brand-new pain medicine that did not have the opioid effect of narcotics—but she was allergic to that one too.
Turned out she was a complete medical anomaly, and allergic to every class of pain medication except narcotics. Now what was I going to do? She was in pain, and the only medicines that helped were narcotics.
We were in a serious conundrum. Fortunately, Nancy was quite helpful and forthcoming about telling me that she didn’t even like taking pills, but in the past, when she absolutely needed something for pain, a medicine that she thought sounded something like, “Perk-o-sot?” had worked really well.
And regarding following up with her doctor, unfortunately, he was out of town all week, so her care, her well-being, her only chance of breaking the horrific migraine pain cycle, was left in my caring hands.
I returned to the attending’s office to inform him of Nancy’s allergies, and her doctor being out of town all week. My medical career was now reduced to playing messenger boy and patient envoy.
The attending tossed his newspaper aside, strode back to Nancy’s room, flipped on the lights, and loudly announced, “Hi Nancy, we’re not giving you any narcotics today. Anything else?”
She left the ER two minutes later walking upright, and not appearing to be in any pain.
I was shocked. She had barely been able to lift her head ten minutes before. She had lied right to my face!
John Lawrence was born in New York, grew up England, and attended Georgetown University where he told his career advisor that the only thing he did not want to be was a doctor. He subsequently survived medical school and residency training in Utah.
John was not the typical medical student, sneaking out of the hospital whilst on-call to audition for television shows; writing film scripts (also available on Amazon!) and overcoming imposter syndrome. He went on to work as a doctor for 20 years in both traditional western medicine and functional medicine.
John’s varied non-medical resume includes river rafting guide, ski race coach, bagel baker, screenwriter, film director, and expedition doctor climbing Kilimanjaro with Olympic Hall of Fame athlete Chris Waddell.
Visit the author’s website: https://johnlawrencewriter.com/