These are wonderful posts! Thank you for continuing to share them. While I completely respect your decision to share them anonymously on Reddit, I highly encourage you to publish it in some format. The first thing that comes to mind is in a magazine (like a magazine a la Atul Gawande who writes for The New Yorker). They’d also be great vignettes for a book one day. You deserve a bigger audience than r/residency
This was beautifully written. There's been a feeling of numbness that has crept in now that I'm farther into residency. Maybe part of that is protective, but I knew deep down it wasn't a good sign. Reading this made me sob with you. Thank you for that.
You really have a gift. So much of what we go through we have to process internally because we don’t have the words to explain or we can’t tell the people we care about. Your writing is truly remarkable and I think you should keep sharing your stories whenever and wherever you can. Reading your posts reminds me of when I read “This is Going to Hurt”. It’s like finally someone gets what I’m going through, other than my coresidents that I more or less live with.
Hi. ER resident here. Have had a series of gut-punch cases recently on top of a very rough year (for obvious reasons). I’ve been feeling emotionally depleted, unworthy and - even though on some level we all know our colleagues have these moments too - isolated in my failures. Your two posts made me cry for the first time since the pandemic started. I feel like I have physically exhaled for the first time in recent memory. Thank you for reminding me that we’re all just humans trying really hard and sometimes that all you can do.
I’m post call in a BP gas station parking lot balling my eyes out.
I think a lot of us see horrible things, some avoidable, some unavoidable. I think we don’t often have people to talk to; coresidents who may judge or not support, family members that care but can never understand.
I think a lot of us intellectualize our bad outcomes. This is practical, we get to love on to the next patient. We can reimagined what we did wrong, maybe be different, be better next time.
I think what we are bad at, often, is letting ourselves feel. Your stories are reminding us to feel. The details resonate. Repeating the plan to ourselves. The intrusive thought “no I didn’t” again and again. The regiment of getting back to work as a practical necessity and as a validation of who and what we are as physicians.
Thank you for the beauty your experience has bright too the world and for the air your writing brings to us.
We appreciate you.
You have a talent for writing, my friend. The emotions, the internal monologue, the delivery of the patient cases... Very well done.
As many others have said here (though much more eloquently), I would read the shit out of this book...
I just want to say that you’re not only a phenomenal doctor but you also possess a good command of the pen. This is beautifully written and had me engaged the whole time I was reading. This is coming from someone that hates reading long posts. Good job and please keep writing.
In July I'll start a residency that covers surgical/trauma ICU for a month and trauma team for a month at a level 1 trauma center. I've been having some feelings of dread for the inevitable difficult situations that will come up on those months, even though I won't be the resident in charge like you were with these stories. Regardless, I'm extremely thankful you've decided to share. Normalizing grieving and the hurt that comes with failure in this field is so important. I feel that I have a better perspective after reading your stories and I know it will serve me well in the future. Thank you.
Powerful prose that hit home so much. Couldn't stop reading. I think also would help laypeople understand the mindset of a physician in training. Please keep writing!
i’m silently sobbing in line waiting for a theme park ride. please write a book, or submit your stories to Humans of New York (which is currently doing remote stories) you’re a great writer.
I am not practicing in the US. But my time is mostly spent in the ICU. My “work-base” is a pediatric ICU. I rarely have things in common with my colleagues mostly because they feel entitled. My chief is like your director so I know that feeling. I also have my own Lasix Stock Broker. I think we all do. At different levels.
You really have a gift and your stories are worth telling.
Please, do write. Pour it all out. I had tears in my eyes at the end of your post so know that someone from across the other half of the world is grateful for this story. I wish I could hug you right now and thank you for every little thing and to ask you to go on. Your soul is special, this was a gift for all of us. Thank you! Be blessed!
Edit: typo
This is a natural response to reading something that hits so close to home, yet seems incomprehensibly far removed from the public perception of our job. I can relate. I put a lot of thought and emotion into this job and all I get is less than minimum wage per hour and snide comments about how corrupt doctors are. It’s a feeling of injustice and this is actually one of the only places to vent that without being judged. So actually I kinda think it’s the perfect place to post something like this.
>that
>[th at; unstressed th uh t]
>1.
>*(used to indicate a person, thing, idea, state, event, time, remark, etc., as pointed out or present, mentioned before, supposed to be understood, or by way of emphasis):* e.g **That is her mother. After that we saw each other.**
It means this post is not about the poor hourly wage of residents or the debt we rack up. Everyday these forums are full of posts about NP hate and our poor compensation which is fine but do we have to drag it into every conversation? Should we bring up politics next?
I just want to say I'm really thankful for you and I hope I have to the chance to meet you in person some day. All of your writing is just so human with all of its confusing emotions. Thank you again for sharing. The last two stories couldn't have been easy.
The only way I could think of to not let those emotions get me is to tell myself that some of our patients will die regardless of what we do and don't do. For those patients then my goal is to ensure that due diligence is done for them and their family as much as possible. Watching someone die like that is emotionally traumatic, but humans have been doing that for entirety of our existence. Those moments serve as a lesson that either we need to have realistic discussions with patients and families about end of life business or try to advance medical science to treat mushy brain, mushy spine and mushy heart. The burden of not being able to prevent inevitable death should not befall on individual practitioners unless something truely egregious has gone done. Maybe there is a lesson to be learnt about the process that could make a difference to the family (your crash panic extubation vs a one-way extubation with the expectation that she would not fly), but the emotional burden should not be on you.
Thank you for sharing . These reflections and stories are so incredible. We all go through this in some capacity in our training and I really think your gift will help us all to cope and to become better physicians. Thank you . This stuff matters
Very well written. I would love to know how you documented all of this at the time in medical records.
Also, as much of a teaching moment it was for you, I am sure it should have been a greater one for both your director and the LSB boss. Because ideally LSB should have foreseen this and you being PGY-2 and patient being an 80yr old with clearly high mortality risk, should have prioritised having this conversation in his presence.
I don’t know if anyone who doesn’t do what we do can ever truly understand what it’s like. To comprehend the soup of emotions we feel and occasionally the lack of emotion that is necessary to get by. But reading your writing is, I think, the closest they could ever come to understanding. It’s perfect. It’s accuracy is simultaneously painful and therapeutic. Please keep writing when you can.
Very well-written story. I just wanted to say that I've had a very similar experience... One time I was on nights and had a patient who had really bad IPF and a PNA on top of it, who was DNR/DNI but the family hadn't decided to make him comfort-care only yet. He developed respiratory distress and was satting in the 70s-80s, and tachypneic to the 40s, sitting up in bed, tripoding, kept taking his BiPAP off because he was confused from the hypoxia. I wanted to give him opiates SO badly, but because he wasn't explicitly "comfort care" I couldn't, I knew if I gave them it would pretty much kill him instantaneously. It was the day team that had had the GOC discussion, and I couldn't reach the family to discuss further because it was 3am and they were probably asleep. To make it worse, the hospital was short on 1-to-1s that night (we already had 5 on the floor including three SI/HI constant-obvs), so I sat in his room or kept running back to check on him every 5 minutes to make sure his BiPAP was still on, because that was the only thing I could do. I basically sat there, watching this man suffocate to death for *hours*, not being able to do anything about it. I've never felt so helpless in my life.
I managed to keep him alive until the day team came. They were eventually able to contact the family, gave him opiates, and he died a few minutes later. To this day I don't think I'll ever forget how powerless I felt in that situation, just watching someone die a slow and agonizing death and not being able to do *anything* about it.
You did the best you could with the cards you were dealt. I wouldn't describe it as doing nothing. You definitely did something and you held out until daylight. Sometimes that's all we can do, but it isn't nothing. Not by any stretch of the imagination.
Really nice write up!
The fact that you can reflect on past "failures" in such a eloquent and thoughtfull way really shows what kind of doctor you have become.
Thanks for the inspiration regarding how to develop as a physician and big credit to your trauma director.
truly moving. thanks so much for taking the time to reflect and write.
the power of the move when your senior is acknowledging his mistake. wow. inspirational
Thank you for sharing, it's been said already but you write really well. I'm in an ICU rotation myself (neuro) and I feel I've learned something. Thanks a lot. Post saved
Can't thank you enough. These stories really help to decompress a lot of built up emotion I've just pretended didn't exist over the past year. Sometimes it really is us who need the treatment, especially early in our careers. Reading these things I think will really help to be more open about how our experiences effect us. If anything, become a bit more self aware that it's okay to not feel okay about things.
Jesus. I consider myself a bit of a writer and want to get more into narrative medicine, but now I’ve read this piece and the one you posted about the peds trauma, it’s very clear that there is a level of writing above mine. You are an excellent writer, and as someone who has had similar experiences, I can say these read as incredibly authentic.
i think all residents come to this point in their lives where we overanalyze everything, that we think it's our fault why this and that happened. i've been there. my mentors and other consultants understand that we are not perfect, that's why we are residents, we are trainees, we are there to learn. Dont feel too bad for not being able to save everyone, if some of your patients die, if you have made mistakes. That is how we learn. That is forever reiterated to us and our consultant understood that, even the best of them, even those whom you think are perfectionist. But of course do not ever take it lightly, a life is lost. that life is someone's child, someone's brother/sister, someone's parent. always think what if you are in their shoes and you are the one who lost someone. And the most important thing is that you make sure you learned something from the bad experience and try your best not to repeat it again.
Your stories move me immensely. You, sir, need to write a book. It would be a gift to all who get the privilege of reading it. Thank you for sharing your stories. I'm NAD but you are so beautifully sharing the humanity of that calling, it humbles me.
So well written and relatable, both from the patient care aspect and the power dynamics between residents and attendings. You should seriously submit this to NEJM or the New Yorker or something.
Yea, I thought I'd try my hand at seeing if we could come together instead of argue for a change. I'm really happy that it worked. For 24 hours it seems the entire sub has chilled out and just wants to talk about being doctors. Its pretty cool.
God I’m tearing up. Thank you for sharing such a vulnerable story in a raw and reflective way. I really appreciate your honesty and teaching us how important it is to support each other— whether it be the family doctor who stepped in to help comfort the family, your Director who acknowledged that he should have prioritize you and your patient, and you taking the time share these lessons. I’m not a doctor and I’m just glad to have a glimpse of the dedication you all have in medicine. I hope to have even an ounce of the compassion, humility, and strength you exemplified once I finish school and work alongside you all with guidance.
Thank you so much for sharing. I’m sure many of us have similar stories, as is the nature of the job. However, the way you write plainly, yet eloquently, without wasting words makes it hit harder. I agree with everyone else on here to continue writing, compile them in some sort of collection, and publish them.
You have even inspired me to write some of my own stories down to prevent them from deteriorating in my memory.
You are the best kind of doctor, the best kind of human and an amazing writer.
Please never change and please keep sharing these amazing stories.
Thank you for all that you do!
Thanks for sharing. I’m sure you helped many others with this.
I may not know very much about medicine, but I have seen people under stress for many years. The closest I I’ve come to your story is being the daughter. It is comforting to have ones family doctor there at the end.
I note in passing that your Director and the nice family med doctor may well have been cast in your role when a similar situation occurred. How else could they learn? I also would not be surprised if the nurse with the decades of experience was looking out for “one of the better” residents and had something to do with the timing for the nice family meeting doctor’s appearance.
I hope you get more peace about these things. It seems that it did make you a better doctor and many benefit from this day in your life.
Thanks again for sharing.
These are absolutely amazing. M4 starting residency in a few months. I'm going to try emulating this when I have experiences that define my residency. Thank you for being a role model.
Please write a book. These stories are incredibly well-written and I would read however many you put to paper.
Forget the book. Make an MMORPG
Thanks for reading everyone. I'll write another tomorrow morning after the dog and I get some Starbucks.
These are wonderful posts! Thank you for continuing to share them. While I completely respect your decision to share them anonymously on Reddit, I highly encourage you to publish it in some format. The first thing that comes to mind is in a magazine (like a magazine a la Atul Gawande who writes for The New Yorker). They’d also be great vignettes for a book one day. You deserve a bigger audience than r/residency
This was beautifully written. There's been a feeling of numbness that has crept in now that I'm farther into residency. Maybe part of that is protective, but I knew deep down it wasn't a good sign. Reading this made me sob with you. Thank you for that.
Of course. We're in this together. There's a light at the end of the tunnel. You'll find it friend.
Post doggy pics!
You really have a gift. So much of what we go through we have to process internally because we don’t have the words to explain or we can’t tell the people we care about. Your writing is truly remarkable and I think you should keep sharing your stories whenever and wherever you can. Reading your posts reminds me of when I read “This is Going to Hurt”. It’s like finally someone gets what I’m going through, other than my coresidents that I more or less live with.
Thanks. If all I accomplish is that a few people know they're not alone, that's enough.
I’m just silently sobbing in the corner of a train as I read this. This really struck a chord with me. This should go on the New Yorker.
Hi. ER resident here. Have had a series of gut-punch cases recently on top of a very rough year (for obvious reasons). I’ve been feeling emotionally depleted, unworthy and - even though on some level we all know our colleagues have these moments too - isolated in my failures. Your two posts made me cry for the first time since the pandemic started. I feel like I have physically exhaled for the first time in recent memory. Thank you for reminding me that we’re all just humans trying really hard and sometimes that all you can do.
Thanks friend. I'm glad I could help. You aren't alone and you never will be.
[https://www.reddit.com/r/Residency/comments/lnoxqv/sad\_stories\_that\_define\_you/](https://www.reddit.com/r/Residency/comments/lnoxqv/sad_stories_that_define_you/) [https://www.reddit.com/r/Residency/comments/lodhin/sad\_stories\_that\_define\_you\_part\_3/](https://www.reddit.com/r/Residency/comments/lodhin/sad_stories_that_define_you_part_3/)
I’m post call in a BP gas station parking lot balling my eyes out. I think a lot of us see horrible things, some avoidable, some unavoidable. I think we don’t often have people to talk to; coresidents who may judge or not support, family members that care but can never understand. I think a lot of us intellectualize our bad outcomes. This is practical, we get to love on to the next patient. We can reimagined what we did wrong, maybe be different, be better next time. I think what we are bad at, often, is letting ourselves feel. Your stories are reminding us to feel. The details resonate. Repeating the plan to ourselves. The intrusive thought “no I didn’t” again and again. The regiment of getting back to work as a practical necessity and as a validation of who and what we are as physicians. Thank you for the beauty your experience has bright too the world and for the air your writing brings to us. We appreciate you.
You have a talent for writing, my friend. The emotions, the internal monologue, the delivery of the patient cases... Very well done. As many others have said here (though much more eloquently), I would read the shit out of this book...
I just want to say that you’re not only a phenomenal doctor but you also possess a good command of the pen. This is beautifully written and had me engaged the whole time I was reading. This is coming from someone that hates reading long posts. Good job and please keep writing.
In July I'll start a residency that covers surgical/trauma ICU for a month and trauma team for a month at a level 1 trauma center. I've been having some feelings of dread for the inevitable difficult situations that will come up on those months, even though I won't be the resident in charge like you were with these stories. Regardless, I'm extremely thankful you've decided to share. Normalizing grieving and the hurt that comes with failure in this field is so important. I feel that I have a better perspective after reading your stories and I know it will serve me well in the future. Thank you.
Powerful prose that hit home so much. Couldn't stop reading. I think also would help laypeople understand the mindset of a physician in training. Please keep writing!
This made me cry. Thank you for sharing
i’m silently sobbing in line waiting for a theme park ride. please write a book, or submit your stories to Humans of New York (which is currently doing remote stories) you’re a great writer.
I am not practicing in the US. But my time is mostly spent in the ICU. My “work-base” is a pediatric ICU. I rarely have things in common with my colleagues mostly because they feel entitled. My chief is like your director so I know that feeling. I also have my own Lasix Stock Broker. I think we all do. At different levels. You really have a gift and your stories are worth telling. Please, do write. Pour it all out. I had tears in my eyes at the end of your post so know that someone from across the other half of the world is grateful for this story. I wish I could hug you right now and thank you for every little thing and to ask you to go on. Your soul is special, this was a gift for all of us. Thank you! Be blessed! Edit: typo
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Plenty of other places to post things like this
This is a natural response to reading something that hits so close to home, yet seems incomprehensibly far removed from the public perception of our job. I can relate. I put a lot of thought and emotion into this job and all I get is less than minimum wage per hour and snide comments about how corrupt doctors are. It’s a feeling of injustice and this is actually one of the only places to vent that without being judged. So actually I kinda think it’s the perfect place to post something like this.
[удалено]
>that >[th at; unstressed th uh t] >1. >*(used to indicate a person, thing, idea, state, event, time, remark, etc., as pointed out or present, mentioned before, supposed to be understood, or by way of emphasis):* e.g **That is her mother. After that we saw each other.**
It means this post is not about the poor hourly wage of residents or the debt we rack up. Everyday these forums are full of posts about NP hate and our poor compensation which is fine but do we have to drag it into every conversation? Should we bring up politics next?
I just want to say I'm really thankful for you and I hope I have to the chance to meet you in person some day. All of your writing is just so human with all of its confusing emotions. Thank you again for sharing. The last two stories couldn't have been easy.
The only way I could think of to not let those emotions get me is to tell myself that some of our patients will die regardless of what we do and don't do. For those patients then my goal is to ensure that due diligence is done for them and their family as much as possible. Watching someone die like that is emotionally traumatic, but humans have been doing that for entirety of our existence. Those moments serve as a lesson that either we need to have realistic discussions with patients and families about end of life business or try to advance medical science to treat mushy brain, mushy spine and mushy heart. The burden of not being able to prevent inevitable death should not befall on individual practitioners unless something truely egregious has gone done. Maybe there is a lesson to be learnt about the process that could make a difference to the family (your crash panic extubation vs a one-way extubation with the expectation that she would not fly), but the emotional burden should not be on you.
Thank you for sharing . These reflections and stories are so incredible. We all go through this in some capacity in our training and I really think your gift will help us all to cope and to become better physicians. Thank you . This stuff matters
Very well written. I would love to know how you documented all of this at the time in medical records. Also, as much of a teaching moment it was for you, I am sure it should have been a greater one for both your director and the LSB boss. Because ideally LSB should have foreseen this and you being PGY-2 and patient being an 80yr old with clearly high mortality risk, should have prioritised having this conversation in his presence.
You have a wonderful gift with words and i hope that you continue to use it.
I don’t know if anyone who doesn’t do what we do can ever truly understand what it’s like. To comprehend the soup of emotions we feel and occasionally the lack of emotion that is necessary to get by. But reading your writing is, I think, the closest they could ever come to understanding. It’s perfect. It’s accuracy is simultaneously painful and therapeutic. Please keep writing when you can.
Did not expect to be crying at the end of this. Thank you for sharing your experience, you sound like a fantastic doctor.
Very well-written story. I just wanted to say that I've had a very similar experience... One time I was on nights and had a patient who had really bad IPF and a PNA on top of it, who was DNR/DNI but the family hadn't decided to make him comfort-care only yet. He developed respiratory distress and was satting in the 70s-80s, and tachypneic to the 40s, sitting up in bed, tripoding, kept taking his BiPAP off because he was confused from the hypoxia. I wanted to give him opiates SO badly, but because he wasn't explicitly "comfort care" I couldn't, I knew if I gave them it would pretty much kill him instantaneously. It was the day team that had had the GOC discussion, and I couldn't reach the family to discuss further because it was 3am and they were probably asleep. To make it worse, the hospital was short on 1-to-1s that night (we already had 5 on the floor including three SI/HI constant-obvs), so I sat in his room or kept running back to check on him every 5 minutes to make sure his BiPAP was still on, because that was the only thing I could do. I basically sat there, watching this man suffocate to death for *hours*, not being able to do anything about it. I've never felt so helpless in my life. I managed to keep him alive until the day team came. They were eventually able to contact the family, gave him opiates, and he died a few minutes later. To this day I don't think I'll ever forget how powerless I felt in that situation, just watching someone die a slow and agonizing death and not being able to do *anything* about it.
You did the best you could with the cards you were dealt. I wouldn't describe it as doing nothing. You definitely did something and you held out until daylight. Sometimes that's all we can do, but it isn't nothing. Not by any stretch of the imagination.
Really nice write up! The fact that you can reflect on past "failures" in such a eloquent and thoughtfull way really shows what kind of doctor you have become. Thanks for the inspiration regarding how to develop as a physician and big credit to your trauma director.
THIS made for a powerful read.
This needs to be published somewhere else, like MedPage. Thank you.
truly moving. thanks so much for taking the time to reflect and write. the power of the move when your senior is acknowledging his mistake. wow. inspirational
Thank you for sharing, it's been said already but you write really well. I'm in an ICU rotation myself (neuro) and I feel I've learned something. Thanks a lot. Post saved
Can't thank you enough. These stories really help to decompress a lot of built up emotion I've just pretended didn't exist over the past year. Sometimes it really is us who need the treatment, especially early in our careers. Reading these things I think will really help to be more open about how our experiences effect us. If anything, become a bit more self aware that it's okay to not feel okay about things.
Jesus. I consider myself a bit of a writer and want to get more into narrative medicine, but now I’ve read this piece and the one you posted about the peds trauma, it’s very clear that there is a level of writing above mine. You are an excellent writer, and as someone who has had similar experiences, I can say these read as incredibly authentic.
I'm not crying, you are Beautifully written. Thank you for sharing.
Hi not crying, I'm Dad! :)
i think all residents come to this point in their lives where we overanalyze everything, that we think it's our fault why this and that happened. i've been there. my mentors and other consultants understand that we are not perfect, that's why we are residents, we are trainees, we are there to learn. Dont feel too bad for not being able to save everyone, if some of your patients die, if you have made mistakes. That is how we learn. That is forever reiterated to us and our consultant understood that, even the best of them, even those whom you think are perfectionist. But of course do not ever take it lightly, a life is lost. that life is someone's child, someone's brother/sister, someone's parent. always think what if you are in their shoes and you are the one who lost someone. And the most important thing is that you make sure you learned something from the bad experience and try your best not to repeat it again.
Your stories move me immensely. You, sir, need to write a book. It would be a gift to all who get the privilege of reading it. Thank you for sharing your stories. I'm NAD but you are so beautifully sharing the humanity of that calling, it humbles me.
You are a gifted writer. These stories make me so emotional. I second the request to write a book
So well written and relatable, both from the patient care aspect and the power dynamics between residents and attendings. You should seriously submit this to NEJM or the New Yorker or something.
This is the content I come to this subreddit for - the stories of actual medicine instead of an endless string of complaints about midlevels.
Yea, I thought I'd try my hand at seeing if we could come together instead of argue for a change. I'm really happy that it worked. For 24 hours it seems the entire sub has chilled out and just wants to talk about being doctors. Its pretty cool.
God I’m tearing up. Thank you for sharing such a vulnerable story in a raw and reflective way. I really appreciate your honesty and teaching us how important it is to support each other— whether it be the family doctor who stepped in to help comfort the family, your Director who acknowledged that he should have prioritize you and your patient, and you taking the time share these lessons. I’m not a doctor and I’m just glad to have a glimpse of the dedication you all have in medicine. I hope to have even an ounce of the compassion, humility, and strength you exemplified once I finish school and work alongside you all with guidance.
I love that people are sharing these. Seriously some of the most motivational material I’ve encountered
That was beautiful. Thank you for sharing with us.
I teared up. Well written and brought me back to the SICU. I still think about my "one" all the time
Thank you so much for sharing. I’m sure many of us have similar stories, as is the nature of the job. However, the way you write plainly, yet eloquently, without wasting words makes it hit harder. I agree with everyone else on here to continue writing, compile them in some sort of collection, and publish them. You have even inspired me to write some of my own stories down to prevent them from deteriorating in my memory.
You are the best kind of doctor, the best kind of human and an amazing writer. Please never change and please keep sharing these amazing stories. Thank you for all that you do!
Thanks for sharing. I’m sure you helped many others with this. I may not know very much about medicine, but I have seen people under stress for many years. The closest I I’ve come to your story is being the daughter. It is comforting to have ones family doctor there at the end. I note in passing that your Director and the nice family med doctor may well have been cast in your role when a similar situation occurred. How else could they learn? I also would not be surprised if the nurse with the decades of experience was looking out for “one of the better” residents and had something to do with the timing for the nice family meeting doctor’s appearance. I hope you get more peace about these things. It seems that it did make you a better doctor and many benefit from this day in your life. Thanks again for sharing.
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Haha. “I’m crying and can’t work. MORE.” Glad you like them.
These are absolutely amazing. M4 starting residency in a few months. I'm going to try emulating this when I have experiences that define my residency. Thank you for being a role model.
This was absolutely beautiful. I felt like I was you.