Short White Coat: Lessons from Patients on Becoming a Doctor
I was told by a resident who graciously woke me from my coma at 3 in the morning, that I could go see the next patient. The patient was a year-old girl who came with her mother because of an upper respiratory illness, also known as a cold. My first inclination was to wonder why a year-old needed to come in the middle of the night for a cold and disturb my sleep. Was this simply convenience for her and inconvenience for me? Then, just before I might have said something highly inappropriate and regrettable, I realized that no patient ever set an alarm clock for the middle of the night to wake a doctor he or she has never met.
My responsibility and challenge was not to chide her for coming to the Emergency Room, but to understand why and what problem created the impetus to do so. As it turned out, she was scheduled to have cardiac surgery in two weeks and was having palpitations and had an irregular and abnormal heart beat. On another evening in the Emergency Room I saw an infant with fever and irritability and what I thought might be an ear infection.
It was good practice for me as a pediatrician, where everything you do not understand with an irritable infant could be an ear infection. I was not sure what he really had or whether the treatment would be helpful, and the thought of not knowing was really gnawing at me. I soon realized the only way I would figure out was to call his parents the next day and ask how their child was. This was a game changing experience for me.
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I, of course, wanted to know whether I had been close to correct in my diagnosis or management and this was my only hope of learning. Most patients get better independent of the doctor, so I am not so sure I was going to learn precisely what I wanted to know. However, what I really learned is how important it was to show a family that I cared.
I was assigned a patient with a complex history and one who, regrettably, had drained the emotions of everyone around him including his family. He was being seen by a consulting neurosurgeon to discuss a possible operation that everyone thought was necessary. However, after asking a few questions of the surgeon, he turned to me and asked what I thought.
I was no sage, no expert, and certainly not even headed towards neurosurgery.
However, I had spent time with the patient, perhaps much more than others could afford. For this fleeting moment, I no longer felt like a fifth wheel, I was his doctor. His question stopped me in my tracks. It also showed me that responsibility, not grades, is the most compelling driver for education, which is the very basis of the Yale system. Perhaps my most humbling moment occurred during my first rotation on surgery.
Short White Coat | Medical School | Physician
I apparently was not a stellar student there. When I received my evaluation from the chief of the service, he let me know in a cordial way that perhaps this was not the field for me. I said you mean surgery? No, his look made me think he meant medicine. I was demoralized. My confidence and spirits were at their lowest. However, I was fortunately assigned to pediatrics next and in short order found my home. I helped care for an infant with severe congenital heart disease and watched a cardiac catheterization to figure out the nature of her abnormality.
She had a tragic outcome, but I was mesmerized by the utter challenge to understand the complexities of oxygenating her tissues that were created by her abnormal anatomy.
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I then approached one of the cardiologists shortly after the tragic death of the infant with a barrage of questions to learn if I could find a means to quantify the circulatory disturbances. I regret my utter insensitivity in failing to realize the inappropriateness of my timing, but for reasons that mystified me at the time, my questions were welcomed. I was told that they could not be readily answered but they might be the basis for a study. I was told I might want to pursue this then two of the pediatric cardiologists, who became lifelong friends, proposed me for a research project and fellowship at another institution, which I was fortunate to receive.
When I arrived one day in the research laboratory of a renowned investigator, he handed a stack of papers and equations concerning a method to measure metabolism in infants, a key to the questions I asked. I was fascinated by the problem given to me, stayed up all night, proposed a possible solution, and started to build equipment to test the solution while my mentor headed to a research meeting.
I was hooked forever.
This actually became my thesis, my first publication. Suddenly, my career had challenge, momentum and direction. I discovered my path here, not by deliberation or deliberate planning but by serendipity, because of the generosity of spirit from those around me and the unrelenting expectation that I would find my way given the freedom to explore.
White coats are about communicating an ideal
I am driven in my field of critical care pediatrics by an intense pursuit of the basis for illnesses that afflict my patients. The seeds for this drive were planted through my experiences here at medical school. It is this pursuit that helps me bond to my patients and their families, invigorates me and keeps me from tiring and becoming complacent. I feel extraordinarily fortunate to have found this source of fuel so that I look forward to coming to work every day and do not find it tedious even 40 years after graduating.
This is your opportunity to do that. I do not expect you to leave here today with a lasting memory of my stories, but I have tried to prime you for what is to come. I hope that you can reflect someday on the opportunities here that opened the door for your exploration and on the many experiences with your patients that forged the way you practice medicine.
You are the next generation of this field and our best hope for shaping medicine and health care in the future. Your vast talents brought you to this point. We are counting on you. While numerous memoirs recount physicians' grueling experiences during residency, few focus on the even more formative portion of medical training: the third year of medical school-the clinical year. Short White Coat: Lessons from Patients on Becoming a Doctor is the disarmingly honest, yet endearing and sometimes funny account of a medical student's humbling initiation into the world of patient care.
Written during his third year of medical school at the University of Pennsylvania, James Feinstein's Short White Coat uses a series of engaging narrative essays to illustrate the universal life lessons that his very first patients teach him. He gracefully examines some of the most common issues and feelings that medical students encounter while learning how to meet, talk with, touch, and care for their patients.
Along the way, he learns from his own mistakes before discovering the answer to the question that plagues every medical student: "Do I have what it takes to become a doctor? James A. Feinstein, MD survived medical school and is now an attending physician at the Children's Hospital Colorado. After graduating from Dartmouth College with a degree in biochemistry and molecular biology, he earned his medical degree from the University of Pennsylvania School of Medicine.
His short stories have been published in multiple journals. Memoirs are almost a dime a dozen Not so [with] "Short White Coat," by Dr. Feinstein, about his third year as a medical student at the University of Pennsylvania. Medicine remains a universally fascinating topic The work is lively, honest, alternately funny and sad. Ranging from frankly scary to truly uplifting, each of the stories teaches a lesson about listening, learning and growing.
Convert currency. Add to Basket. Compare all 18 new copies. Book Description iUniverse, United States, Condition: New. Language: English. While numerous memoirs recount physicians grueling experiences during residency, few focus on the even more formative portion of medical training: the third year of medical school-the clinical year.
Short White Coat: Lessons from Patients on Becoming a Doctor is the disarmingly honest, yet endearing and sometimes funny account of a medical student s humbling initiation into the world of patient care. Written during his third year of medical school at the University of Pennsylvania, James Feinstein s Short White Coat uses a series of engaging narrative essays to illustrate the universal life lessons that his very first patients teach him. Along the way, he learns from his own mistakes before discovering the answer to the question that plagues every medical student: Do I have what it takes to become a doctor?.
Seller Inventory AAV More information about this seller Contact this seller. Book Description iUniverse, New Book. Shipped from UK within 10 to 14 business days. Established seller since Seller Inventory LQ Paperback or Softback.