This May Hurt a Bit: Harvard medical student's blog | Hacker News Reader

This May Hurt a Bit: Harvard medical student's blog

blogs.scientificamerican.com

91 pointspapermashea24 comments

This article puts a human touch on a human situation, from their point of view. As a volunteer firefighter I see more stuff than you normally would on average and it gives you a different perspective. For instance:

Before I got into this field, I always thought of firefighters, paramedics and doctors as magical superheroes that can fix anything. As long as you make it to their doorstep you'll be fine. This is not not always the case. the amount of people who are unsaveable would shock you. Even in the very best of care.

That's not a slight on firefighters, paramedics or doctors in the least bit, I'm just saying from statistics perspective there are way too many things out there that will kill you no matter what. They really are superheroes in the sense that they do extraordinary things every day and they always bring their A game. They do things you just wouldn't think possible because of how much they push themselves.

I've also seen what is described in the top article of this blog. When you see someone pass and you see just how much was done to save them. Even a 90+ year old person who at best would have a good year or two left, and I've seen doctors pull out all the stops and work just as hard as they would anyone else. The only difference is the patient is even more fragile at this stage. Life is life and they get it.

I've seen people work and struggle when it was very clear things are over. CPR that goes on long after the patient is past the point of no return. I've never seen anyone "throw in the towel" too early and I've seen people push and fight when everyone in the room knows what the outcome will be.

In short, everyone should read things like this and get a glimpse of this perspective. I don't know what you can take from it, but it sure will make you appreciate first responders and ER personnel more. At best it will make you appreciate life more.

The odds of resuscitation from ACLS(advanced cardiac life support) if you suffer cardiac arrest in a hospital setting is somewhere between 1-4% IIRC. The chances of a successful revival are already low. Once you pass the 10min mark you are really just hoping for a miracle...but it happens. Rarely, but it does.

I'm not sure what the exact medical events were that transpired in this case, but the rescue team who found this person performed CPR for 4 hours continuously, and she made a full recovery: http://www.huffingtonpost.ca/2014/04/06/skier-tree-well-mira...

Thats exactly why they keep going with CPR long after the point of calling it. If the patient presents even the slightest of signs they'll keep going and it resets the clock. I've never been involved in a 4 hour instance of this, but an hour or more is not uncommon if there is any sign of revival.

We'll probably never meet, but thanks. If something happens to me, I'd want someone to perform CPR as long as possible on me. I'm fond of existence.

My longest stint of CPR was 1h50m. The patient didn't make it out the door - but did get to say goodbye to their wife.

Hugely depends on the type of arrest.

In the Puget Sound area, and around Rochester MN, your survival rate for 'witnessed, shockable arrest' can approach the high 40s.

In some areas of the country that number is 2-3%

I'm a biomedical engineer and have been working with surgeons for a few years. I'm always impressed with their perspective given the situation of surgery. To the surgical team, its just another day in the office. To the person on the table, it is one of the most important days in the life.

I have been fortunate enough to be invited into the OR to observe a few surgeries. The first time, I was shocked at how casual the situation was to the people involved. The atmosphere is more like a workshop than you see on TV dramas involving surgeons (music playing, people chatting about what their kids and weekends, etc. like told in the article).

But after thinking about it some more, this is the atmosphere that's needed. Everyone is calm and collected, and not going to make a mistake from being stressed out. Being stressed out at work every day simply isn't sustainable. Some of these surgeries are tough jobs too, involving standing for hours in awkward positions (which can lead to long-term injuries). These men and women are true professionals - even on routine work they sacrifice their own comfort and well-being for the welfare of their patients.

Agree that it is good to make the perspectives of the original article more widely seen to appreciate what they do!

    The first time, I was shocked at how casual the situation was to the people involved. The atmosphere is more like a workshop than you see on TV dramas involving surgeons (music playing, people chatting about what their kids and weekends, etc. like told in the article).

This is part of what made MASH so great. Many of the best scenes took place with the characters in the OR talking, teasing, and generally going about their routine.

I've sat in on two caesarians as a father. One 'emergency' and one EMERGENCY!!!. The way I could tell the difference was that the first was as you describe and the second was disturbingly like a TV hospital drama. Both ended well, but it still makes me upset thinking about it years later.

You're absolutely right, that is what's needed. It's the same with the fire service, you'll notice most firefighters are pretty calm but fast. This is because of countless hours of training and building to make the men and women involved think in a very calm, procedural fashion. It doesn't reduce the gravitas of the situation but it's a situation where you know what you should do because you've trained and/or done it so many times. I imagine with a surgeon this is magnified many times over.

In Fire Academy they say "We want to train you so you there are so many things you'll do automatically and not even think about. That way you don't panic and also you can use the available thought power for the exceptions in the situation, not the basics"

Also they want you prepared. "You never see a garbage man pull into a neighborhood and say OH SH*T LOOK AT ALL THESE CANS!! HOW AM I GOING TO DO THIS? because they're prepared for it and have a plan".

Nice to meet a fellow firefighter here.

Nice! yeah it's a bit rare. Is it just me are there a lot of parallels between software and the fire service? haha.

Doctors understand that they aren't miracle workers, and as such, prefer much less medical intervention at the end of their own lives than the general public.

http://www.radiolab.org/story/262588-bitter-end/

http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...

The first article about the guy who died during a hip replacement surgery (?). It's terribly sad for everyone else, but when I go, that's one of the best ways I can imagine it happening. You go down optimistic for a better future where your hip is working again and just . . . never come back up. Dramatically preferable to years of battling with cancer or a gradual dip into dementia, at least for the victim. Especially if you've led a full life and are only going to be here for a short time more anyway, as is often the case with people who start breaking bones in old age. For the family, my heartfelt condolences.

I agree, everyone has to go and this way is preferable to suffering.

My dad had some health problems, and a few close calls in his last years. In the end he fell asleep in his favorite spot in his chair watching television and didn't come back. While it was one of the most heartbreaking things in our lives, but I'm glad his final departure was peaceful and painless.

Wow, this is a really moving blog. It shows you their point of view.

Based on her writing style, it is a good thing she is going into medicine and not journalism.

Are you fucking kidding me? Her writing is outstanding. Sorry it has some emotion, some reflection, some substance.

Would you prefer a log file of events?

Get real.

Med students don't know shit. And don't do shit. But I suppose it's still an interesting perspective.

> Med students don't know shit. And don't do shit

That seems like a fairly blanket statement? Care to explain?

I wish I could come up with an appropriate analogy. But basically, as a med student rotating at a hospital, you are simply there. It's beneath an internship, because that's essentially what you do the _next_ year when the real work begins, the long hours, etc. So any insights are going to be about being a med student or bedside manner. Boring. And probably a little pretentious.

    Shara Yurkiewicz is a fourth-year student at Harvard
    Medical School. She was an AAAS Mass Media Fellow, and
    her work has been published in the Los Angeles Times,
    Discover, and The Best Science Writing Online 2012. She
    is interested in medical ethics and has served as guest
    editor for the American Medical Association's ethics
    journal Virtual Mentor. She conducted ethics research
    at Harvard, Yale, and the Hastings Center and received
    a B.S. in biology from Yale.

4th year at Harvard Medical School, guest editor for AMA's ethics journal, undergrad at Yale, I think she's qualified to write a reflective / opinion-based blog.

http://well.blogs.nytimes.com/2014/04/24/are-med-school-grad...

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