15 - Comedians: mordant humor and cynicism

Summary

CASE

“You killed one of our patients”

On my first night on call as a third year medical student on internal medicine rotation, a 52-yearold man was brought into the hospital by his son and daughter because of lumbar and bilateral hip pain so severe he could no longer get out of bed. Two months earlier he had gone to his local Emergency Department complaining of a seizurelike episode. His doctors had diagnosed lung cancer with metastasis to his brain and he had undergone surgery to remove his brain tumor.

We began to work to alleviate the pain and performed daily musculoskeletal and neurological exams. This went on for about one week; each morning arriving early to check on the vitals and physical. One morning, strangely enough, I could not locate the man's chart. When I walked into his room, he was no longer there. I was annoyed, believing that my patient had been moved to a different floor, thus wasting my preround minutes. When I approached a nurse to ask the whereabouts of my patient, I was shocked to hear that he had passed away overnight.

I felt strange. I kept thinking about my daily exams and how pointless they had been. I felt neglected; left out. Though only a student, I felt that I should have been there with the family. As I mulled over these thoughts, our team made our way to morning report.