ndab Ah Yes, Medical School: Failure

Sunday, August 06, 2006

Failure

Amid the constant flashing lights, the shrill beeps, the moans, and the persistent alarms, there was one other event that I could always count on every single morning of my three weeks in the medical intensive care unit (MICU): that my first patient (we’ll call her O) would spike a fever, and that no one would have any clue as to why. I picked her up on my first day of the rotation, but O had already been in the MICU for over a week after having had a bleed in her brain, in the hospital for over two months after surviving a severe case of necrotizing fasciitis (that’s flesh-eating bacteria to you). When I first met O, she tried to speak to me but could not do so, the ventilator tube obstructing any and all attempts at verbal communication. Instead, she mouthed the words “take it out” and motioned weakly to the tube with her hand. I explained to her why we could not do so, that she was too weak and would die if she tried to breath only on her own, before walking away to do my work.

The first few days were rough for me, mostly because I had a hard time figuring out what was going on with just about everything. The MICU is a scary place for newcomers, lots of machines beeping, lots of sirens, special tests, sickness. Which is why my daily routine with O was so calming, if only because I could count on nothing drastic changing with her. For an MICU patient, she was, so gloriously, routine. I would check her overnight data, find that she spiked a fever, checked all the labs to confirm that there was still no source, and promise to her that we would try our best and keep looking. The comfort of this routine was made more so because it was just about the only routine thing that would happen in the MICU. After all, these are the sickest of the sick, people teetering on the precipice of life and death on a second by second basis, relying on countless machines, drips, and manpower to keep them alive. But O and I , we were a team, soothed by each other’s routine, reassured by each other’s presence.

Halfway through my rotation, I admitted a 32 year old gentleman with a type of leukemia that was refractory to treatment. He was having difficulty breathing for multiple days, but was well enough one morning to tell me that he was ok, save the sensation that he needed to urinate. I walked away from him, poked my head in to look at O, and proceeded to team rounds. Within five minutes, the nurse ran out of the gentleman’s room and said “He’s not breathing.” Code blue. Chest compressions. Shock. Intubation. He made it through the code, but only after having no pulse for almost eight minutes. The last thing I said to him was, “Do you feel like you need to pee?” A little later I walked by O, noticed that she was more lethargic than previously, and continued searching for the cause of her fevers. I found nothing.

Later that same day, at about the time the wife and two young daughters were saying goodbye to their 32 year old husband and father right before he stopped breathing for good, the team was down in the ER, there to greet a 29 year old gentleman, also with leukemia, and also having difficulty breathing. His girlfriend, a nurse, was at his side, pleading with him to be calm as he tried desperately to express what he did and did not want done to him. Yes to help with breathing, no to invasive breathing tube. Yes to pain medications, no to blood pressure drips. We left the bedside at about the time he defecated on the bed, because we had to go back to the MICU and declare the 32 year old to be dead.

Later in my rotation, I checked up on O. Sure enough, she’d spiked a fever the night before, we still had no clue what was going on, but now she was barely arousable. Sure enough, the 29 year old’s heart, which had been pumping furiously to keep up with his thrashing, eventually gave out. His girlfriend and his family were all at his side. His mother, who surely never expected to outlive her son, was screaming, moaning. Family members poured in, more shrieks. We sat by our computers, which are situated by the bedside for central access, while this young man’s family cried for four hours. Four hours. There was nothing to do but listen.

On the second to last day of my rotation, I peeked in on O, who was at this point almost entirely comatose but who was about to go down for more surgery, because the plastic surgery team that removed the original flaps of infested skin felt they could possibly remove more that might be infected and might be the cause of her fevers. I knew this was going to go well, a success story, one where she’d defeat the fevers, reawaken to life, and no longer need that breathing tube. About an hour later we received a frantic call from the plastic surgeons, who noted that she had a new infection of flesh-eating bacteria, one that probably started as a smidgen the night before but had now melted away much of her left arm. Her arm was going to have to come off if she had any chance of surviving.

Finally, on my last day, I showed up especially early to check up on Ms. O. She was not there. She no longer had a fever. She no longer had a bed. Or a tube down her throat. I never discovered the infection that had been giving her fevers for over a month, only the new infection that took her life, and even that discovery came too late. It ended up being her time to go, as much as it was mine. I did not get a chance to say goodbye, and apparently my arrival missed her departure by a mere 20 minutes.

There is nothing routine about the MICU routine, but I know that it has left me more numb than I would ever care to be, more distraught and afraid of the thought of dying, and more riddled with nightmares of family members weeping, screaming, howling, hugging, and leaving while their sick move onto something else.

78 Comments:

Blogger Susan said...

This comment has been removed by a blog administrator.

11:12 PM  
Blogger Susan said...

Wow...posts like this one make me wonder if I will be strong enough to be a good doctor.
However, when you say that experiences like this one make you more afraid of dying, I'm know I'm probably not the only one.

I don't know if you would mind answering these questions on my website (leave a comment somewhere), or just here on your own blog...they are questions that have come up as I go through medical school application process, and I'm sure other people have them as well.

Is being around the sick helping you be less or more afraid of sickness??? ( I have clinical and volunteering experience but I've never had anyone die during that time, and the sickest person I have seen was already ver old)

Did you feel afraid, before going on to medical school, that it was going to be too hard, emotionally?

How do you deal with your own fears when treating terminal patients?

Is it true what I hear about the "student doctor syndrome"? Do people go through a phase of sds during medical school? What about after?

I hope you have the time or energy to answer these questions, I would love to know what your thoughts are on them. Any advice would be appreciated by all of us, your readers.

11:20 PM  
Blogger Dr. Wannabe said...

First off, this experience should by no means be considered a "failure." It was simply something that you were going to encounter at one point or another. The idea of death is not something that's easy to accept, understand or live with. But it's undeniably a reality. Congratulations don't seem to be appropriate, but I'm impressed that you got through it. I would say that was a big step towards becoming The Real Doctor.

11:20 PM  
Anonymous Laura said...

I have been a nurse for 34 years and "Failure" is not the correct title for this "Blog". I can hear in your Blogs how you are growing.You will be a great Dr. the day you stop feeling is when you have failed.

12:18 AM  
Blogger adventures in disaster said...

I am a critical care nurse. I have only worked in an ICU. I have made it a rule to work in the CVICU.
I tried working trauma but alas people kept dying and dying and dying some more.
In the CVICU I have the comfort of knowing my patients for the most part consented to their treatment. They were told the risks, watched a badly made video on heart surgery and their families were prepared.

Trauma or MICU can be soul destroying because so many of the patients are end stage everything.
That means you can be the bestest nurse or doctor and it doesn't matter. You can be the fastest and terrifyingly smart and it still doesn't matter. The disease or trauma is so advanced it cannot be stopped.
It's not failure , it's life and then death.
The trick to working in the ICU is to stop seeing death as an enemy to be destroyed. If you view death as evil and "saving" someone as noble you set yourself up for disaster.
You must step back and see the whole picture. You list the things you can do to give your patient every advantage and then you keep your fingers crossed and hope for the best.
It's not about winning or losing patients..that thinking leads to burnout.
Working in the ICu is about the relationships you create with your coworkers. Your patients will barely remember you so it's your coworkers who will carry you everyday.
ICU work isn't all doom and gloom, some days it's really cool.
You just need to step back a little and find perspective......sometimes death is a good thing and that is a painful thing to realize.

12:38 AM  
Anonymous Adam Cheng said...

Adventure in disaster's reply is touching.

Keep going, remember what your goal is.

1:11 AM  
Blogger Sarah said...

wow, fd, ur post was very moving. i don't know what to say.....thank you for sharing your experience. ur def. not a failure. you can only do what you can do, the rest is in God's hands.

1:50 AM  
Anonymous christine said...

this post was incredible. beautiful, touching, raw. i loved everything about it. it leaves me feeling more convinced that you should definitely get published and share this with the world. i am so grateful for this glimpse into the work you guys do.

4:06 AM  
Blogger :) Jenna said...

Great post... Wrong title...

No matter how good of a doctor you are and no matter how far technology advances, no one gets out of life alive...

No one...

Some of us just leave more peacfully than others.

For those of us who will die in a hospital in the care of the surrounding strangers, thank you. I am sure your time with O meant more to her than you know.

I wasn't smart enough to stay in college and after a 15-year-career in radio news, I am a dialysis technician of three months.

I am not used to our patients coding while on treatment (I've seen only one so far, and it was enough) nor am I used to them slipping into the light at home, but I still want to be there for them every other day when they walk or roll through the door to spend three to five hours with us.

I still want it... So do you...

5:04 AM  
Blogger kt said...

as the common theme seems to be to change the title of your post. i do know the feeling of failure. however..as you get deeper into this career, i hope you to see that death is not always a failure but the next natural step sometimes...even after all our searching for answers as to why one is ill.

5:21 AM  
Blogger genderist said...

I started out my nursing career in the ICU working nights... and your description of the relentless beeps is on target. I remember going to sleep hearing the beeping serenade of the vents, the humidifiers on the vents, the drips, the heart monitors, the phones... One minute people are talking to you, the next you're coding them... It's a hard place for anybody to be, I think.

You're not a failure; you're human.

5:41 AM  
Blogger Rachel said...

Working in the healthcare field and in the critical care field specifically, we need to remind ourselves that the death of a patient is not a failure. People dies, and there IS such a thing as a good death. If you provided sensitive and consistent care, as you did with O, you did something incredibly important for her.

To have a familiar face who comes to your bedside consistently, who acknowledges you as another human and not just an extension of equipment is so important to prevent suffering in someone who is so sick, intubated, and scared. Take that with you, along with all of those feelings and fears about life. This is what will ground you and keep you human and effective in your career.

7:15 AM  
Blogger psychgrad said...

I'm not sure if I could take an experience like that. Thank you for sharing your experiences and I hope your next rotation isn't as rough.

7:24 AM  
Blogger FUNKYBROWNCHICK said...

Wow, thanks for being so honest and raw. But, then again, after reading your blog for almost a year now -- I can't really say that I'm surprised. I'd expect nothing less. :)

About this whole "failure" thing ... don't listen to the others, you *SHOULD* indeed carry the weight of the world of your shoulders. I mean, come on, you are God aren't you? And, as such, you should completely feel 100% responsible for all unexplained and uncontrollable factors of life and death. Hell, maybe I should even blame *YOU* for the recent heatwave here in New York City. It was really hot here for a long time. So, damn you, Fake Doctor ... DAMN YOU!!! :)

Anyway, on a more serious note, I have nothing to add to what has already been said (i.e. listen to adventures in disaster and the others, you're certainly *not* a failure).

7:26 AM  
Blogger Tanya said...

Wow.... this is pretty hectic stuff, man. I read your blog all the time and I am constantly amazed how you manage to keep your sense of humour.

Your post title: failure. No. You are not a failure. What you do isn't failed.

What you do every day is an act of strength.

7:34 AM  
Blogger Kate said...

It's amazing how you make us laugh one instant, and then come out with something like this the next.

Just remember to take care of yourself, too.

9:57 AM  
Blogger jali said...

Beautiful post - wonderful, caring person. wish you wer MY doctor.

11:37 AM  
Blogger Sid Schwab said...

If a doctor doesn't at some level feel she/he can cure any illness, there's a problem. But it also follows that failure to do so feels like, well, failure. Can't have one without the other. It's both the glory and the bane of a career in medicine. What others have said here is correct: it's not a failure. But that it feels like it is, is part of the deal. It should always remain so, sort of. You also have to be able to tell yourself -- when it's true -- that you did everything you could.

11:38 AM  
Anonymous Troy said...

IV. THE PATIENT IS THE ONE WITH THE DISEASE.

On that note, I can't wait for that rotation.

12:57 PM  
Anonymous Anon said...

Your compassion and determination is admirable.

1:19 PM  
Anonymous canmedclerk said...

wow there are a lot of nurses who read this blog....
i'm doing this rotation too, albeit it will be my last one before interviews. I hope I will be ready..

1:56 PM  
Anonymous Debs said...

And this is why you will make a superb doctor; you will remember every minute spent in that department and use the negative experience to form a positive one. Despite what you may want you cannot save everybody but you can make their crossing a more personable experience for the patient and their family, a crossing that the family will be grateful.

3:10 PM  
Blogger Gadzilla said...

We're here for you.

Your a stronger man than I. I freak out at the sight of my own blood being drawn. Emotional detachment is never an easy process. It is a step that will insure your sanity though.

Good luck my friend.

6:31 PM  
Blogger Heather, S.N. said...

Why is death always considered a medical failure?

Yeah, it blows, especially when it's sudden or when it happens to someone young. But dying is a part of living, too.

Just a thought.

9:28 PM  
Anonymous Anonymous said...

Really moving.. scares me.. glad i have a long time before I am going to be in that situation.

Love your blog.

2:39 AM  
Anonymous Anonymous said...

I have only spent time in the PICU and CICU of the Children's Hospital with my youngest daughter. But your description brought back haunting memories. The constant beeps and a world that never stops.

Luckily, I wasn't one of those families who had to say good-bye to their child in the ICU, but I was with my best friend when she and her husband said good-bye to their three-year-old daughter there.

Someone said that the patients will never remember you. That may be right, but the families will. Every little kindness is magnified and remembered.

ICU to a family is what living in a foxhole in war must be like. The emotions are extreme, the relationships that develop are intense. On behalf of O's family, thank you for caring.

4:50 AM  
Blogger Abby said...

I have been reading your blog for a while now and usually it is quite funny. But all along I have had a large respect for you. Reading today has brought forth another great respect because I could never even attempt the situation you lived. I can't imagine being around strangers, trying to help them, knowing they were about to die and there was very little you could do. You can't call it failure... you were not the only person in charge of O, and if the hospital did leave the entirity of care up to one person it would be the hospital's fault. It is a team effort so you can never blame yourself for missing something, or not finding something that was probably not even there until soon before it was found. Keep writing, I look forward to your posts and keep going, I think you will make a great Doctor!

5:17 AM  
Blogger beajerry said...

Very good post.

7:28 AM  
Blogger GP said...

I'm a 4th year med student and yet to be in MICU but what you've blogged scares me a little to what I foresee through you.
I have to say this though - Do not take it as a failure or discouraged.

8:21 AM  
Blogger Heather said...

Not the best name for this particular entry.

Medicine is still a work in progress (isn't that why they call it practice?). There are no guarantees...unless it is death.

Keep the faith, FD. Critical care is hard area to work in. You're not going to save them all. You can only do your best, but at the end of the day, it's all really out of your hands anyway.

9:56 AM  
Blogger A. said...

This post reminded me of my rotation as a hospital chaplain while in divinity school. Those on-calls were hard. I admire anyone who can do hospital work, of any nature, for an extended period of time.

12:31 PM  
Blogger sadielady said...

I've only rarely heard my dad talk about losing patients, I think he talks more to my mom about that than to his children (since we've become adults), but I do remember one particular conversation with him. I had just had a failure of a kind in my own career, as a lawyer, which I was reeling from. And I was talking to my dad about it late one night at my parents' house. He ended up talking to me about some of his early experiences as a young doctor. And in that converation, he told me about some of the first experiences he ever had with a real patient who died while under his care. How tough it was, how he couldn't shake it, not at the end of the day, not when he went home, not for a while. But he said, you have to go on, continue, because there are other cases out there you can help, there is good work you can do, and unfortunately this just comes with the territory, you've got to realize that you're going to have to deal with it. He's telling me this as he tells me how he went home to his small apartment at the end of a shift and cried and cried the first time he ever lost a patient. I personally believe people like this, people with the knowledge and intelligence and skill of being a doctor, who so take to heart a patient's loss, these are the best doctors. In my humble opinion, anyway. The kind of doctor I would want to have. The kind of doctor I see my dad to be, even if he maintains for the most part a cool professionalism when he's actually in the hospital or in his office seeing his patients.

Anyway. That was a moving post. Very moving.

4:52 PM  
Blogger Boomer said...

Once again the seriousness of your posts have left me speechless.

Take care of yourself.

4:55 PM  
Blogger sadielady said...

and p.s., the part about the story where i said my dad and i were talking b/c i had just had a setback in my own job - - i didn't mean to imply by that that what i was talking about to my dad was actually comparable to losing a patient, nor did i mean to imply that losing a patient is ever a failure; rather, it's going to be a part of your life, unfortunately, if you're a doctor, because you're working to save lives that are on the brink of being lost; as wonderful as modern medicine is, it cannot save everyone from everything. It takes a strong person to continue to work in medicine, realizing that to be true.

4:58 PM  
Blogger Anna said...

I spent alot of time in the NICU with my youngest son just after he was born. It was the most moving time of my life. I got to know many of the nurses quite well, and the burnout rate for nurses working in that area was pretty high. I could never do the type of job they or the doctors did. Truly amazing.

8:05 PM  
Blogger Kim said...

On behalf of the patients you helped care for during their last days, thank you. I'm sure they were incredibly greatful for your hard work even if you didn't get the results you were hoping for.

10:07 PM  
Blogger trail_grrl said...

FD, I have been following your blog for the past few months. I'm not in the healthcare field, but have worked with nurses in the past. I have not so far had the misfortune to have a family member admitted to the MICU.

I have lost a family friend to a motorcycle accident in the past month. She was admitted to our regional trauma center, but there was never any hope at all that her shattered body would recover.

The nurse that posted who said that people who are admitted to MICU are endstage, worst of the worst is correct. These are peple who in many cases have no hope of recovery.

My friend ran her Harley into the back of a car at a high velocity and was then thrown 350 feet. On her way to work on a Wednesday morning. At this point the only harm you can do is to show no compassion.

Just remember that Death is not a failure, it is a fact of life. I firmly believe that everyone's time is preordained and you can't escape your fate.

I wouldn't have believed my friends fate was to die at 47 and that frightens me that I could die a similar painful death. But it doesn't stop me from living my life and it doesn't stop me from riding either.

Death and Dying happen a lot in the medical field. Not being able to stop it does not make you a failure, it simply means you're fallible. As long as you recognize that you're human and will make mistakes on occasion, you'll be an amazing REAL DOCTOR someday.

12:40 AM  
Blogger Krupo said...

I choose to interpret "failure" a different way, meaning the body's end - it's death, that sort of failure, rather than anything personal - because you certainly shouldn't ascribe it to yourself!

Keep up the good work.

1:14 AM  
Blogger P. Curtin said...

I grew up in a doctor's house. I've had to deal with doctors treating friends and relatives, it seems forever. This post alone tells me that you will be a great one, but it's going to hurt alot.
Please stick with it. We need you.

3:40 PM  
Blogger Bean said...

Grief is painful.
But caring is worth it.
You cared.
And thank G*d for that.

6:30 PM  
Anonymous Med student in canada said...

These are the experiences that make medicine worthwhile. I don't think being a medical student is overly challenging academically, but the art/philosophy/humanity of medicine is incredibly challenging. Any patient encounter that leaves me thinking about quality of life, access to care and end of life issues is a reinforces for me why I'm here doing what I do.

Keep up the great work...love your blog!

12:27 PM  
Anonymous karen said...

haunting and vivid. that is hard to write secondaries to.

6:41 PM  
Blogger Febrifuge said...

Good stuff, FD. Thoughtful, and melancoly, but without being morose. In response, I'll just quote a couple wise men you've reminded me of here: the playwright Samuel Beckett, and then the comics writer Neil Gaiman.

1) "I can't go on... I must go on... I'll go on."

2) "You get what anyone gets. You get a lifetime."

8:51 PM  
Anonymous Nicole said...

You have such a great heart- You are going to be an amazing doctor.

10:44 PM  
Anonymous Crystal said...

Oh, Honey....

Sometimes life is a cruel-ass bitch. What can I say.

Wow. You brought Mama Bear out with that one. Yeesh. Lord save my kids if they decide to be doctors, I'll be the nutsy Mom dropping by with pasta and cookies and a nice, nourishing salad and trying to hug all the tired looking house staff.....

4:18 PM  
Blogger kdoctor said...

that is very moving. you are excellent at conveying your experiences to us readers.. i feel fortunate to get a glimpse of what lies ahead for me through your words.

Thanks alot for keeping up with your blog. I am sorry you are going through a harder period. it means alot to all of us that read it that you want to share your journey

6:37 PM  
Blogger B said...

I'm sitting in my office at paediatrics right now... The waiting room is empty, for two afternoons now. Maybe it is the weekend or maybe the children just do not feel like stepping on bees in cold, rainy weather:). Or getting serious allergic reactions anyway (what I've been seeing a lot lately).
Your post reminded me of a little boy. His mother noticed his belly just isn't symmetrical. On physical his spleen was residing over half of his abdominal cavity and filling half of his pelvis... Lab was disastrous. Ad paediatric haematology, right away. Though chances are I will never see the boy again I will remember his big blue eyes that questionned and his unwillingnes to cooperate in examination. His mother knowing something just isn't right. Me being unable to give answers instantly. But above all, I will remember the feeling of grabbing sand in my hands and how it is running away no matter how hard I try. (A cheap comparison, I know.) What the hell am I trying to say here? Any of my colleagues that are anywhere near *sane* (my judgment anyway and I am arrogant enough to count me in) are a bit emotionally masochistic. To be able to cope with amounts of garbage after the masochism cynicism kicks in. Why the hell not? It's fun. Fun makes it all worth. And that sometimes diseases can actually be cured, not just treated.

11:13 AM  
Blogger mysterio said...

It's much more bearable when I take God with me each day.

12:48 PM  
Blogger MICU RN said...

Wonderfully written.

3:17 PM  
Blogger amanda said...

wow. makes me really scared to start picu in a few weeks.

1:18 PM  
Blogger FASHIONABLYSLIM said...

You are not a failure. You helped those people in their last hours, made them as comfortable as possible. Hats off for having had the guts to survive it! I know i couldn't have handled it. You're going to be a great doctor.
This was a beautiful post.

3:11 PM  
Blogger FASHIONABLYSLIM said...

And just as a side note. MICUs are not only about death. My mother was in one and was cured and is healthy now. You will have some victories. Perhaps, since they're from less favorable odds, you may feel more proud at bringing someone back.

3:14 PM  
Blogger SPC said...

I have worked in ICU for 30 yrs as a nurse. You just have to grow Hope. It keeps you going when the docs don't give up and you see the patient suffer. You just do all you can to help and know that you are doing that.This is life and death at it's rawest form and when you figure out how you can help, you love it. The caretakers who have the most knowledge and control are the ones who enjoy it the most. It is difficult to work there if you don't understand the process and the egos that keep people and families going after it is much too late.

6:45 AM  
Blogger searching4path said...

All I can say is "thanks" to all those of you that have ever worked or still working in MICU. Reading the post is sobering, and I don't ever wish to step in MICU. At least the patients didn't die alone.

3:42 PM  
Blogger Regina said...

For anyone in Chicago: come to a living will workshop next week 8/30/06. Having a legal document saying what you do and don't want done to you medically will spare your family/friends a lot of pain if you're ever unable to make your own decisions. As a nurse friend says, EVERYONE SHOULD HAVE A LIVING WILL. See my blog for details on the workshop.

10:49 AM  
Blogger The Leaf Ninja said...

wow this blog is GOLD. I'm having lots of laughs and serious thoughts as I read your posts. I know you say it's supposed to turn people away from medical school, but these experiences are so interesting that it makes me want to become a doctor even more. Anyways, with that said, you've inspired me to start a blog as well.

peace fake doc.

8:21 PM  
Anonymous C A D said...

Another ICU nurse here.

Sometimes, we have to take the rough with the smooth. Sometimes, we have done all that we can do.

Sometimes, we have the chance to do a little more. You did that. You took the time to stop in each day. She wouldn't have been able to recall your name or indeed probably not why you were there... but she would have known you became a friendly face, who cared.

That's a quality that I for one, like to see in the Doctors I worked with.

And sometimes, we come across patients who can teach us about ourselves as human beings as well as practitioners... those patients shape our practice and our professionalism. Those patients, although on their way from this life, they leave one last gift... the memory of what impact they had and how strong that is.

As others have said, you'll be a fine Doctor.

5:14 PM  
Anonymous JABonk said...

I know this feeling. I hated it when I first had it, but after reviewing the comments of ICU nurses who've added here, I know it's normal.

The Byrd's had it. There is a time to die. Goddamn it.

The lesson I've taken from my time in the ICU? This is your last day - pretend it is so and act accordingly. You did so FD and you did very well.

Be at peace.

1:17 AM  
Anonymous am said...

as i read your story, it's funny. it tickled something inside of me. lots of old feelings and emotions that i have forgotten in the past 3 months of my intern year.
my first reaction, in my bitterness, apathy, and tired-ness, was 'jeebs, of course this is the MICU...it's where people go to die.' i hated the micu. 15 medications, comorbidities galore, and people who seemed to take forever to get better. sometimes, just sometimes, they did get better. and those days were great. but it didn't happen often enough for me.
i spent the first month of my intern in the sicu. man, i love it. it's like, you've got the people who you know will die, but then you've got the people who will definitely get well. because most traumas are relatively young and healthy. and the post-op ones, for the most part, also younger and healthier because otherwise they wouldn't have been in the OR.

but in any case, there was no point to my post. just keep it going, keep it going, you're almost done. 4th year is fabulous. enjoy it, take out that extra loan to go on a trip!

7:19 AM  
Anonymous RaTu said...

I'm an Indonesian medical student actually... somewhere Central Java. I'm currently doing my junior clerkship, and it's only my first week in the hospital; mostly working on routine physical exam. anyway... if all of you guys wanna know what's the story in a teaching hospital in a south east asian country like mine, be sure to check my blog,, yesterday was the first time I watched dying patients. they're in neurology ward. and already, I was emotionless. I don't know if I'm always gonna be like this, maybe not. but again, who knows...

8:54 AM  
Anonymous diya said...

Hi fake docter I have been reading your blog for quite some time now,I think you are someone who has a wonderfull sense of humour but this blog of yours finally made me write to you,though I have been enjoying your blog for a long time now.I think the feild you have choosen for you makes you numb in many ways to so many things,I myself started this venture 14 years ago when I was fresh just out of high school so called normal person wtih such high minded ideas of being a docter and helping people live and get well,but 14 years down the line though not a veteran yet I have become wiser (i am not sure) or more numb to death..yet more and more afraid of it at the same time.I have come to reaslise one thing for sure, no matter how much you think you can help, you still cant do enough,so whats the use?I ask why try to help when most of the times when help is really required we hardly can do anything.

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