Getting burned is another piece of non-medical medical lingo I will try to translate. To “get burned” is to do something incorrectly, interpret something incorrectly, forget to do something, or to generally “mess up” or miss something, generally leading to Badness. “Badness” is usually either a bad patient outcome, or one that is at least delayed or sub-optimal.

Every attending (translation: every doctor) has at least one or two areas where they have previously “gotten burned.” These are issues that they vow to never, ever get burned on again. Issues upon which they rise to their soapbox and emphasize to those listening where things have gone wrong for them, so that the mistake is never repeated again. I would imagine if you ask any doctor he or she can pretty instantly tell you their burn stories. They are usually tragic, sad, and preventable. There is usually an air to the stories of “if only X, Y never would have happened.” They are shocking, and their foreshadowing is horrifying; we the listeners all realize that we ourselves will get burned in our own careers. No matter how hard we try to be perfect, we will represent, and later resent, our humanity, our imperfection. We will do something that will greatly harm a patient.

Only those in positions of responsibility and supervision are able to truly experience getting burned, as I am starting to realize, given that I am starting to have some actual responsibility. I’m starting to see errors and mistakes in my judgment that have luckily always been pointed out to me by a resident or attending that is double-checking it all, and I’m sadly starting to learn something that may explain doctor behavior and frighteningly my own: trust nothing.

The quick anecdote is such: an intoxicated gentleman comes in, found down, complaining of generalized body weakness for which he has been seen on numerous occasions. Nurses know him by first name, and note that this is his typical course–he comes in, sobers up, leaves. Being astute medical student that I am, I want to rule out Other Badness. Sugar normal, exam normal. I draw labs. Just ’cause. Much later my attending decides we should also get an EKG. Just as it’s printing out and I’m noting the U waves and the long QT, the lab calls with his low potassium and calcium results. Ugh. Had I just decided to get the EKG to begin with, we could’ve caught this much quicker. But I decided, “No, he comes in like this all the time, the nurses see him like this all the time, he’s probably just drunk.” Now, nothing bad happened to the gentleman–we fixed him right up–but I can just barely see other versions of the story, and it’s scary.

I’m sure my paranoia and distrust will only get worse when I have my own medical students reporting to me, but hopefully by that time I’ll have most of my close calls under my belt, without a scratch to my soul.

Yeah.

Right.

Comments Off on Getting Burned