Two More Weeks

And I’m freaked out.

In about two weeks I transition into the role of a senior resident. I will be charged, on certain in-patient months, with leading a team with two interns. It’ll be my responsibility to teach, guide, and correct.

There are days when I feel like I am starting to come around — that I’m becoming the doctor I want to be. Then there are other days — days when my first and foremost goal is making a decision that will not negatively impact a patient.

I was recently charged with a patient who came in with a heart attack. He received multiple stents. I first saw him the day after the stents were placed. He was full of energy. He even wanted to go home! I examined him — all was well. His angiogram site looked good — no bleeding or hematoma.

A little after noon the patient’s nurse came up to me and let me know the patient was having some chest pain and that she was getting an EKG. I nodded and went on my way.

A few minutes later she came to me with the EKG. Knowing the patient had come in the day before with a heart attack and had multiple stents placed, I stood up and walked towards the chart rack so I could compare the EKG with old ones.

Comparing the EKG with the one taken hours earlier, I froze. There were significant — at least to me — differences. I stared some more.

I called my senior and showed him the EKGs. He thought the differences were significant too.

My senior called the fellow, who told us that the changes were significant and to call the attending.

Within an hour the patient was being wheeled back to the cath lab to undergo a repeat angiogram. The attending had agreed. The changes he saw in the EKGs were concerning to him as well.

I was right this time. I noticed something important and pushed it up the chain. But I realize things could have easily gone south. What if the nurse did not bring me the EKG? What if I looked at it and didn’t recognize that the small differences were something to pay attention to?

In just two weeks I won’t be able to hide behind the fact that I’m “just the intern.” When other services call and ask, “who’s the senior?” That’ll be me.

And I’m freaked out.