“We didn’t check it, sir,” I would say, squirming. I would be tempted to say that the patient’s creatinine was 0.9 and the urine was gushing and that we had brought the sugar from 500 to 100 with nary a bump. But explanation would be futile and could lead to a trip to the library to do penance by looking up articles.
“You could have precipitated a fatal arrythmia,” the chairman would say as he stared at me down the length of the table. “Also, next time, get a clean white coat.”
The only solace I would have is that all of the house staff faced similar inquisitions.
Tough but Invaluable Training
These experiences were not enjoyable, but I look at them with a certain appreciation and gratitude because I was learning my craft from people of knowledge and unyielding standards.
Medical training is changing as the work hours are plunging. We are now at 80 hours a week for interns and residents, and 65 hours is in the offing. In the next column, I will discuss the impact of the new training models on the coaching we do and, indeed, whether academic medical centers can provide coaching at all.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center in Durham, N.C.
