Monday, September 29, 2014


This is basically what you may be facing if you visit an E.R. at a teaching hospital in the upcoming months. Stay healthy!

I'm putting everyone here on notice. In the immediate future, my colleagues and I are taking a few hours' worth of workshops on vital signs, after which they (the ubiquitous superpower THEY, never to be identified) are sending my colleagues and me into the emergency room of a hospital somewhere in the northern half of California. The same thing is probably happening in teaching hospitals all over the nation. If you know what is good for you, I would advise you to stay the hell away from teaching hospitals in general and mine in particular if you're feeling not quite up to par and think you may be in need of medical treatment at an emergency room. 

I'm not quite so much worried about myself.  I've watched enough House, MD episodes that I could basically diagnose anyone. I've been doing it for years (much to my father's chagrin) with remarkable accuracy. ( Rule #1: It's NOT lupus.) It's my less-enlightened colleagues for whom I fear. Most of them could not differentiate a case of full-term labor from the measles. 

We won't be actually responsible for your treatment, although our beady eyes will be on you the entire time you receive said treatment.  We will process your intake. If we really screw up a blood pressure or pulse reading, the odds  are that someone will catch it.  Sometimes things don't happen in the manner that is statistically probable, though. Perhaps you will be the one in ten who will NOT be caught by someone smarter and more capable than we are.

Again, it is not I about whom  you really need to be worried. I've been able to take a blood pressure reading with a sphygmomanometer and stethoscope (I even know how to spell them correctly and have known how since elementary school, unlike more than half of my colleagues) since I was nine years old. I won't kill you off before you even see a real doctor.  I cannot, however, make the same guarantee in regard to many if not most of my peers. 

Just to be on the safe side, if you fail to heed my admonition and do find yourself in a northern California E.R. in the next month or two, and you find that your intake is being processed by a medical student who looks greener than Ireland in the month of June, ask for Alexis. It may not be my hospital, and even if it is, I may not be on duty, but it's probably still in your best interests to at least ask. Maybe they'll page me.

P.S. In a real pinch, ask for Matthew. I know that you must be reluctant to do so after some of the stories that I've shared about him, but he does at least know how to take an accurate blood pressure and pulse. I know this because I taught him personally.

P.S.S. I'm praying for the continued good health of readers everywhere, but particularly for those of you who wander through the northern half of California. From what I hear of southern California's medical students, they're even stupider as a group than we are, so you might want to be very careful if you're spending any time there.


  1. There's a first time for everything. I am sure you and your colleagues will be fine. And I am sure you will be very well supervised.

    That being said, I stay away from doctors anyway.

  2. That is wise. Unless I'm likely to die or lose a limb if I don't see one, I try to avoid it, which has sometimes meant locking myself in my bedroom.

  3. I was in the ER Tuesday. My now 2 year old central line broke before school while I was using it, which earned me a trip to Philly (3rd time in about 10 days.) I called ahead of time so the ER had everything reserved, and I skipped right over triage. I still had an intern, though under the circumstances he wasn't doing anything, to me anyway.

    I've had 1st year residents unable to properly differentiate between liver and spleen. You guys should get a little bit of slack.

  4. Missed that you have begun your journey as I was on a long journey-Oz to the northern hemisphere. Your apprehensions are to be expected and continue to question yourself. Self knowledge is an important part of attaining competence.

    Good luck for the next and all steps.

  5. Very good. Laughed out loud at Lupus comment - I once wrote something along those lines about House in my UK TV column and was inundated with complaints from the Lupus society, saying I was laughing about them, which I wasn't, of course. But it WAS always coming up on House!!

  6. I live in the northern half of California. But as much as I would like to meet you in real life, I hope it's not in the ER.