Farewells are always hard for me, to the point that I avoid them as much as possible. As we wrap up Telluride Napa 2018, I reflect on the lessons we have all been exposed to over the last four days and what I will bring back to my home institution. Some talks were so powerful that I feel that I cannot forget how they inspired me. I am glad to have made a new family, with whom I will be bonded and always be able to reach when I have issues undertaking the overwhelming obstacle of changing the healthcare culture. I also will not forget the happy moments and laughs we shared both within and outside of the classroom. This experience was incredible and I will recommend it to my junior residents when I return home.
I was asked to reflect and understand why I came to Telluride. This experience, while a great honor, took a lot of planning. Hearing opinions from prior alumni, composing a personal statement, obtaining leave from residency duties, planning the trip… Of course the opportunity to be exposed to such great lectures, experiences, and atmosphere speaks for itself and I am so grateful to be a part of this conference. But I also realize that the why I wanted to come here is the what I wanted to bring back.
I teach many of the patient safety education series to my emergency medicine residency program. Not only have I witnessed my fellow residents tune out, answer text messages or close their eyes, but they have also bluntly told me that the lecture was a ‘waste of time’ or ‘boring.’ While I hope this doesn’t reflect my teaching and engagement skills, I… Continue reading
This is the fifth time I have seen the film detailing the Michael Skolnik story and I still must fight back tears each time. It’s also amazing how much I learn with every viewing. Every bad outcome starts with an initial conversation and as an ER physician, many of the initial conversations occur on my turf. I wonder how many times I have told patients diagnoses that changed their lives and lost them to follow up, which is inherent in the emergency medicine profession.
I think back on times when I obtained “informed consent” from worried family members for patients on whom I really wanted to perform procedures. I remember my almost-first lumbar puncture, when the patient changed his mind and although verbally consenting, refused to sign the consent form in the end. I walked away so angry with the patient for not letting me perform the procedure, unable to… Continue reading
Here is the link to one of my stories from the ER about my first pediatric death. I hope it circulates some cortisol and oxytocin.
It is already a very emotional first day at Telluride as I re-watched Lewis Blackman’s story as a senior resident. Two years ago, prior to any patient encounters, I first watched it as an intern, incredulous at the turn of events. At that time it baffled me how health care professionals could diminish patient and parental concerns so callously, and how so many errors could pile up to lead to a tragic outcome. As an intern I vowed to never allow such reckless practice to occur under my watch. As a senior I reflect on how many vital sign abnormalities I let go, errors I let happen, and lives I let slip through my fingers.
As an ER resident, the acuity of illness is higher than other specialties and inherently the potential for medical errors. Two years ago, my naive intern-self entered residency with the goal of committing no preventable… Continue reading