My Family Medicine Story
Elene Brandt, MD
It was during internship in 1983 that I realized that family doctor training was different than other specialties.
My second rotation was internal medicine at the VA. Usually the interns had seven or eight patients each but we were managing 15. We had two residents but one was helping out in the overwhelmed ER and the other was so swamped supervising admissions that we were on our own. I did not get well-educated in medical school and was always scared.
I got a homeless man with pneumonia in the ICU. I am humiliated to say that I did not get a blood gas or realize how acidotic he was. The nurses called me when he was seizing and he died.
The whole team was called on the carpet but the attending did support the team as not having enough help or supervision.
Two days later we were on call again. I got an admission, a man with cardiac issues, not in the ICU. I could not think. I was in total panic.
I called my advisor at home at 2 am. I told her to get me out of there, that I was going to kill somebody. She woke up and talked me down, setting priorities (Is anybody going to die if you don’t get to them in the next hour?) and making a plan for the new patient.
I knew that no internal medicine would dare to call an attending at home. I don’t know if they even have advisors.
I went on to become a family physician with much better knowledge and judgement. My advisor did not remonstrate or further humiliate me. She just grounded me and got me thinking again. It matters that the well-being of the physicians matter and that we learned that as part of our training.