Mile 24417 + 2710: Different Mindsets

Above: I ate this food 2 hours after taking this picture when the food was fresh. Oh ER...

"YOU AND I HAVE
DIFFERENT MINDSETS."

A seventeen hour drive was completed about two weeks ago. It brings me to the sunny shores of St. Petersburg, Florida. I am enjoying my time here so far as the mentality of the people of the city definitely feels midwestern, but of course, the weather is a side benefit to living here too. We're less than 7 weeks away from graduation...

During my days in the Emergency Room to date, I'll have to say that no day is ever the same. There are some shifts that'll have me waiting for a good case, other days I'll have loads of good cases. There are days that there will be no procedures, and other days where I'll be doing a million. There are days when my days are filled with a bunch of chest pain due to a cardiac cause, and other days where I get a bunch of chest pain from drug seekers.

I had an opportunity to work on a patient who came in with abdominal pain and urinary incontinence over several weeks, but was soon discovered to be pregnant via a urine screen. When presenting to my attending, my assessment started with the important stuff, the abdominal pain probably secondary to being pregnant, and then when I started on the urinary incontinence, my attending stopped me in a friendly manner, saying we're going to take care of the pregnancy first. However, although I knew that was very important, I thought that addressing the patient's concerns about her frequent urination and peeing would be important.

That's when my attending told me that we have different mindsets. I wanted to take care of the whole patient, or at least address everything, but the emergency room doctor needed to prioritize. I agree there should be priorities, but it seemed the patient's urinary complaints would go by the wayside if they weren't addressed further in the visit for follow-up.

I love taking care of the whole person as much as possible. It's a hard habit to break.

However, that doesn't mean Emergency Medicine has been a bust. It's been anything but. I've had opportunities to put stitches in people coming in from accidents (20 in one patient, and even learning the technique of the vertical mattress to add on to my skills), taking care of abscesses, and even yanking back dislocated hips (which taught me that I need to go to the gym). These types of procedures are seen frequently in the emergency room, but if I have my own practice, it's possible I'll be doing these same procedures too, so I'm glad that I have an opportunity to do these now.

Emergency Medicine at Bayfront here in St. Petersburg has also brought me to work along with the armed forces, as the ER here is a site of training for them. I had an opportunity to meet some of our folks who are learning to work on the field as medics, and some of them have taught me a pearl here or there. As tough as our armed forces are, they are real people and great at teamwork. Many of them are blunt and honest with each other, but each member took it on as constructive criticism. I really enjoyed working with them as they had a very good model for camaraderie.