- Posted by AMA (NSW) / ASMOF (NSW) Alliance
- On 22/01/2018
It was hour 12 of 15 for the day and my patient had just fallen over. I say my patient but I’d never met them before, they had just been admitted from ED and were just one of 100 that I was tasked with not killing for a few hours while all the real doctors were having dinner and going to bed. He had a shopping list of comorbidities, an even longer one of medications, and my pager was furiously interrupting my attempts to recall the pathophysiology and management of the severe hyponatraemia that I just discovered on checking the bloods from ED. There was no plan for what to do with that, and all I could think of was the horrible things that would happen if I corrected it too fast: central pontine myelinolysis. Aka badness.
I called the med reg, bracing for the sarcasm, passive aggression or general harried irritation, to be told that this was surely basic med school knowledge and I’d have to figure it out as they were dealing with much sicker patients. Instead, she thanked me for the call, asked a few extra questions, calmly suggested a list of follow up investigations, an initial fluid management plan that accounted for his co-morbidities, as well as a neat resource with more information and the calculations she would use to more precisely treat his problem safely. Oh, and she’d pop over to review him shortly, no bother at all. He sounded a bit un-sorted.
She almost certainly doesn’t remember that moment, it was no big deal to her. But that kindness came as sheer relief to me, an intern uncertain how to cross the bridge in front of me, and grateful for the encouragement of someone who had walked that way many times before. I knew then what kind of med reg I’d like to be one day.