Resident Thoughts

Sep252018

Pay It Forward

Sanjay Mohan, MD 2 Comments Resident Thoughts

“What’s your airway plan, Michelle?”

To be quite frank, I don’t think I actually listened to what my junior said in response. Without much thought, I promptly replied (in my big boy voice), “Awesome, I’m going to help you set up.”

Since July, I’ve been told that I’m a “senior resident.” I’ve also been told (by Uncle Ben), with great power comes great responsibility. Now that my co-residents and I have been tasked with supervising our juniors and running a team, I’ve encountered a new dimension to clinical medicine – the art of precepting. Suffice it to say, I have never been more tired as a resident. For ten to twelve hours, I am obsessively reviewing labs, looking at imaging, verifying that urine and cultures has been sent, leading resuscitations, and constantly running the triage board. It’s difficult evaluating critically ill patients; it’s even more challenging delegating responsibility and making sure things don’t fall through the cracks in a hectic ED setting when you aren’t always the primary provider.
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Nov172017

The Paradox

Sanjay Mohan, MD One Comment Resident Thoughts

The Paradox

“Go take a break.” “Let me quickly pick up these two patients.” “Go grab some food and come back.” “I’m fine, I’ll just…” “Sanjay, get the hell out and don’t come back for fifteen minutes.”

It was my sixth overnight in a row. After having struggled for over 15 minutes with trying to place an ultrasound guided IV in a sickle cell patient, my senior resident felt my exasperation. She had also probably seen me almost engage in a yelling match with a middle-aged man who was demanding a plain film for chronic muscular lower back pain and witnessed my frustration when dealing with several patients requesting medication refills for their metformin and insulin.

As second years in a four-year training program, my co-residents and I are now expected to master triage, volume, and efficiency – we are the workhorse of the program;
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Jun302017

Trust Me.

Sanjay Mohan, MD One Comment Resident Thoughts

“Just cut. He’s dead”, my senior resident calmly whispered behind me. I had walked through the crash chest tube hundreds of times in my head. I knew the steps like the back of my hand – fourth or fifth intercostal space, mid-to-anterior axillary line, cut above the rib, bluntly dissect with the Kellys, pop through the pleura, and keep your finger in the pleural space. In fact, my senior (who I shall now refer to as the Chest Tube Whisperer for the remainder of my time as a resident) talked me through the procedure just before our patient arrived to the trauma bay. I was ready – I was gowned, scalpel in hand, heart racing. But in that moment, all I could think was, “BUT WHERE IS THE BETADINE?!”

Truthfully, I might have blacked out for the next 10-15 seconds – for the next thing I remember was having my finger in this patient’s thoracic cavity.
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Mar312017

Dear Intern . . .

Sanjay Mohan, MD Leave a Comment Resident Thoughts

Dear Sanjay,

Hope you’re doing well. You’ve probably just settled into your first adult-sized Manhattan apartment. It may take a while, but you’ll eventually manage to find your stethoscope – it’s been gathering quite a bit of dust since Match Day. Your scrubs are free of bodily fluids – at least for now. And that shiny new badge with the letters M.D. probably feels a little heavy at the moment.

I write to you as your future self – almost a year older, hopefully a year wiser, and ever more confident that I made the right choice in devoting my life to this craft. I write to you in hopes that you heed at least some of my words, for the next twelve months will be some of the most challenging of your life thus far – physically, emotionally, and spiritually.

Much of intern year will be spent outside the walls of the emergency department. 
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Jan062017

Miles to Go

Sanjay Mohan, MD One Comment Resident Thoughts

I often joke about the first time I ran Side1 as the sole resident. It’s a rite of passage here in our program. During our adult Emergency Medicine months, every so often, one of the interns is responsible for holding down the fort on Side1 in the Bellevue ED during the weekend. To those who are unfamiliar, Side1 is a cozy little corner of our Emergency Department that has 6 patient slots and should hold 12 patients. Of course, on most days, it holds over 20.

A few hours into that first shift, after I began carrying eight patients (four of whom I had yet to write notes for and needed IVs placed and labs drawn), I half-jokingly told my attending that we should probably overhead page, “Side 1 is now on diversion.” Needless to say, she was not particularly pleased. Somehow, twelve hours came and went and I eventually made it back to my apartment beaten and downtrodden.
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