The Before and After (Published in JGIM)

We sit at grouped desks, eyes on blinking green pagers then back to bright screens. It’s now the last year of my residency, and I’m admitting and cross-covering patients on night shift. Just as I finish putting in orders from a consultant, my pager buzzes with an admission. I call the Emergency Medicine resident.

“Room 631,” he says. “She’s a 67-year-old female with previous MI, diabetes, and tobacco use. Presented after a low-impact motor vehicle accident. It was a hit and run, those bastards. Anyway, Trauma cleared her, but she still has some chest pain. Needs a cardiac work-up. Her CT chest and abdomen are pending.”

I ask a few clarifying questions then start the familiar trek downstairs. The lights are dimmed, hallways empty. Soft tones alarm as I walk, signaling some minor derangement of vital sign or EKG lead displacement. Those tones persist, even in the silent stairwell.

I reach room 631 and introduce myself. Ms. Adams lies in bed, with starched blankets pulled to her chin. She has a stylish bob cut, her short bangs interspersed with wisps of gray. Her daughter Sarah sits at her bedside and launches into the events of the day. I ask about pain and associated symptoms. Other than mild pain at the seatbelt site, Ms. Adams feels fine.

I routinely ask about weight loss, and the answer catches me off guard.

Read the full essay here from the Journal of General Internal Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280425/