One of the teaching activities I am involved with is a Rural Preceptorship for medical students from one of the major medical schools.
Looking through some of the materials I received a while back, I saw a list of objectives that caught my attention. Students are expected, through their different experiences, to specifically advance in the areas of “talking like a doctor” (giving oral case presentations), “writing like a doctor” (recording chart notes), “thinking like a doctor” (applying clinical knowledge) and “acting like a doctor” (showing professionalism).
I was reminded of my experience when a Hollywood movie crew came to our area many years ago to film a horror movie with a doctor in one of the main roles. I did an insurance physical on the child star, helped the prop man get the medical items he needed and I took care of the film crew’s accidents and illnesses. I also met with the actor who played the young doctor.
Although I had never heard of him, he carried himself like someone who was used to fame and attention. He was casually dressed and looked like he could have been from downstate or even around here if it weren’t for his alligator boots.
The one question I remember him asking me was how disturbed he should be as a young physician when suddenly faced with an accident victim who has had his head partially crushed.
I thought for a while.
The closest I had come to that was early in my first residency, back in Sweden. The first night of the county fair a pretty, seventeen-year-old girl was brought in by ambulance in cardiorespiratory arrest. She was reported to have fallen off a merry-go-round. Ambulance protocols weren’t as advanced then as they are now. She arrived on a stretcher without a back board or rigid neck collar. The chief surgical resident was the doctor in charge of all things surgical in the emergency room at our community hospital. I assisted him as we relieved the ambulance crew giving chest compressions and ventilating her with a bag and mask.
Her pupils were unresponsive and her chest didn’t move with our efforts to ventilate her. As I leaned close and smelled the strange blend of blood and alcohol I have since come to associate with violent deaths, I noticed the swelling around her neck. I knew her windpipe was torn and we were pumping air into the soft tissues of her neck. The surgeon saw it, too, and ordered the resuscitation halted. Carefully, he moved her head, and we both cringed as her neck just continued to move to the side. She must have broken her neck falling off the merry-go-round.
All of it seemed surreal – the beautiful young face with unresponsive blue eyes, the swollen, limp neck and the smell of death and alcohol.
The surgeon called off the code and we covered up her face. Neither one of us said anything, but I could tell he felt as sick about it as I did.
“How disturbed do you think I should be?”
The Hollywood actor repeated his question. His earnest expression came back into focus as I cleared my mind of the images I had carried with me all these years.
“Ummm…….”, I answered, “quite disturbed”.