Tuesday, May 22, 2018

A Stroke Of Magic

Staying true to the source material while trying to recreate the same emotional response in the reader is to me the biggest challenge of writing a new blog.

Sometimes it is easy and sometimes it takes exploitation of the infamous 'Creative License' to accomplish this task.

On rare occasions though, something so remarkable happens that all I need to do is recount the exact sequence of events, with no added spice whatsoever to justify why the story needed to be told.
I spent the month of April working at the University of Chicago.

Established first in 1890, UChicago or UChi as it is sometimes referred to is a premier educational institute that ranks among the best in the world.

The list of famous alumni to be associated with the university is enviable, and the medical center by no means lag behind the competition.

Home to the latest in cutting-edge research and some of the best doctors in the country UCM is certainly living up to its mission to be 'At the forefront' of medicine.
I didn't sleep a wink the night before I was scheduled to start, but my energy levels were still at an all time high the next morning.

Even the 1-hour 45-minute journey entailing 2 buses and a train did nothing to deter my enthusiasm.

Things looked promising and it helped that for once I looked pretty handsome in the picture on my ID:)

The university campus is huge, and for a first-time visitor, it can be very confusing to navigate through the 4 units that comprise the medical center.

It is easy to spot someone new to the university complex.

These individuals usually have the same expression on their faces, a mixture of wonder and confusion and more often than not, they would stop you to ask for directions, especially on how to get to the 'Au Bon Pain' on the second floor of the Mitchell building.

In case you were wondering, the 'Au Bon Pain' on the second floor of Mitchell is the most commonly used reference point while being directed to a particular location at the hospital.

I know this because I played the role of the confused visitor nearly every day to perfection for almost 2 weeks.

Not to discount the fact that I mis-led quite a few patrons into believing that I actually knew where the 'Au Bon Pain' on the second floor of Mitchell was.

More often than not I would run into these individuals a few moments later on at another floor and pretend that the person who misdirected them earlier was an estranged twin brother of mine.
Getting used to the layout of the hospital was only a small thing.

On two separate occasions, I walked through alarmed doors inconveniencing a whole bunch of busy people, I often got locked out on stairs without re-entry, ending up walking down several flights just to get back on the ground floor, once I took the wrong bus and ended up travelling 16 miles in the opposite direction and then there was an incident when I thought all my stuff had been stolen, only to find it on another level a few hours of anxious frantic searching later.

It is not that I was clumsy, which I am, the truth is, I was pretty overwhelmed.
Something that defines medical education globally is an emphasis on developing good bedside manners.

'A doctors hands must possess a healing touch' one of my favorite professors in India would say from time to time.

She hated it when we used gloves to examine patients except when it was obvious that they had a contagious process going on.

'The palm of your hand can be more efficient than a thermometer to gauge how your patient is feeling'.

My life as a doctor so far is a testament to what she said.

When sincere, all it takes to make a lasting connection with a patient is a gesture as simple as holding their hand.

Lying in a hospital bed puts you in a very vulnerable position, and I did not understand the full extent of it till I ended up in the ER about the same time a year ago.

That experience taught me that ordering all the right tests and medications are important, but making sure the patient feels comfortable and supported is equally important, if not more so.
A stroke can manifest in many different ways.

It is one of those conditions that can confuse a clinician with weird presentations and we are constantly reminded on a day to day basis to have a high index of suspicion for strokes in patients with unexplained mental symptoms.

When Ms.J was brought to the emergency room at the university with a sudden onset of unexplained confusion, her doctors were spot-on with ordering a CT scan of her head.

A large cerebellar stroke adequately explained all of her symptoms.

She was the first patient assigned to me during my rotation.

On my way to see her, I did my best to not walk through any alarmed doors, for the most parts of the 10-minute walk I made the right turns and the fact that I passed by elusive Au Bon Pain (you know, the one on the second floor of Mitchell) served as a reassurance that I was slowly settling in.

I double checked the door before entering the room to make sure that I was abiding by all necessary precautions.

It was only me and the patient.

Ms.J still appeared confused.

I tried explaining to her who I was and what I was there to offer, but my words didn't seem to register.

I moved closer so that she could hear me better and unknowingly pressed down a little too hard on the side rails of the bed.

A loud alarm went off from the bed alerting the nurses outside who rushed into the room.

'Doctor, you should know better than this, one of them said before turning off the bed alarm'.

I was mad at myself, the nurse was right, they were busy enough already to have to run around turning off false alarms all day.

My shoulders slumped and my head drooped, I was disappointed.

Now aware that I wouldn't get much of a history from my patient, I turned to take my stethoscope out of my white coat pocket.

As I fumbled around Ms. J gently held my hand.

I turned to look at her and for a moment the confusion was gone.

She continued to hold on to my hand without letting go, nodding her head slowly, it was as though she was saying to me - 'I know you are overwhelmed, but hang in there a little longer, you're going to be ok'.

I smiled and stood there a while.
Those 30 seconds were the saving grace for the rest of my rotation.

I don't mean to say that everything went on smoothly from that point onwards, I took my time to understand how the system worked, but just like Ms. J's path to recovery from the stroke, I slowly and surely got better.

My attendings at medical school always focussed on how important it was to make the patient feel supported in a time of illness, I wish I could share with them this story of how my patient did the same for me.

Until Next Time.