In between Nernst equations and voltaic cells (three guesses who had an electrochemistry exam today) I managed to squeeze in some shadowing at the ER. One of the professors who works with our program (I’ll call him Dr. P* for the purposes of this blog) is an ER and internal medicine physician and has been offering us opportunities to follow him around his various jobs. These include stints at the ER, a primary care clinic, and rounds in palliative care

ERs are starting to be called EDs more and more (no, not erectile dysfunction, emergency department) which makes sense seeing how they tend to be made up of many rooms, corridors and mini-departments. There’s a separate section for children, and another section for minor injuries for people who would probably never be seen otherwise. (EDs work by triage; most serious cases first, everything else later. A sprained ankle, even on a slow day, just isn’t going to make it to the front of the line as long as there are car crashes and food poisonings to deal with.)

I absolutely love shadowing. I love getting to wear my silly white coat, I love getting to watch the residents explain their cases to Dr. P, I love meeting the patients. The only thing I don’t love about shadowing is vomit, which seemed to be the order of the day yesterday afternoon.

Everybody has their thing, right? That one thing that, for no good reason, makes them want to run as far and as fast as they can in the other direction? For me it’s people throwing up. Which, I know I know, is something I’m going to have to deal with as a doctor no matter what specialty I go into; it’s up there with pain and passing out as the major signs that something internal is not going the way it should.

So I’m trying to think of it as a good thing that during my first ED shadowing experience there were no less than four patients who all had vomiting as their major symptom. One of whom, a miserable looking gentleman who was in a room front and center for most of my time there, retched his way through his entire stay in the emergency department.

I’m sad to say that I didn’t acquit myself as well as I would have liked. I’ve watched surgeries, seen mangled hands, a piece of glass in someone’s eye, but twenty minutes of listening to that man vomit and I had to excuse myself to sit with my head between my knees. How embarrassing! If I’d had any blood left in my face at all I would have been blushing through the rest of the shift. Even telling myself that it was as much due to dehydration as phobia (two cups of coffee and no water is not the way to start any medical experience, which I really ought to know by now) didn’t help; I felt like I had “WIMP” stamped across my forehead in big block letters.

In my defense, I did stick out the rest of the shift (and then some; I think all told I was there for three hours rather than the scheduled two before heading back to review for the exam) and managed to thoroughly enjoy myself once I was steady on my feet again. Perhaps it wasn’t precisely how I would have liked my shadowing experience to go, but I’ll chalk it up to day one of aversion therapy and hope that next time I can at least remain upright in my disgust.

* Confidentiality laws, common decency and the desire to someday practice medicine without my patients/employers judging me based off of what I write here has led me to take a few steps to preserve anonymity. Most of them feel pretty silly to me right now since 90% of my readership is close friends and family, but I’m trying to think big. And also avoid getting sued.

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