5/21/2023 0 Comments A surgeon's notes on performance![]() ![]() The senior resident, however, went back to check on her himself twice that morning. It is this little act that I have often thought about since. ![]() I made a silent plan to see her at midday, around lunchtime. Of course, I said, though nothing we’d seen seemed remarkably different from previous mornings. Keep a close eye on her, the senior resident told me. Her heart rate was running maybe slightly faster than before. She’d be fine. One morning on seven o’clock rounds, she complained of insomnia and having sweats overnight. We’d give her antibiotics and wait her out, I figured. Each day, she stayed more or less the same. I checked her vital signs, listened to her lungs, looked up her labs. I went to see her twice each day for the next several days. I took sputum and blood cultures and, following the internist’s instructions, started her on an antibiotic for this possible pneumonia. So her internist admitted her to the hospital, and now she was under my care. A chest X-ray showed a possible pneumonia-maybe it was, maybe it wasn’t. ![]() But some laboratory tests revealed her white blood cell count was abnormally high. One was a wrinkled, seventy-something-year-old Portuguese woman who had been admitted because-I’ll use the technical term here-she didn’t feel too good. The senior resident had assigned me primary responsibility for three or four patients. I was on an internal medicine rotation, my last rotation before graduating. Introduction Several years ago, in my final year of medical school, I took care of a patient who has stuck in my mind. ![]()
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