Excellent story and we need more of these. Every physician understands the intuition that comes from experience. Even more so, we appreciate that as a learner, we can sometimes quash that passion. Appreciate the effort to advocate for your patient.
It's great that you had the where with all to listen to your gut. I kind of wonder about his previous visits. Were his symptoms ignored? Maybe he was experiencing something that medical staff didn't detect.
I have worked in Respiratory Care for my entire life, encountering many acute, life threatening, episodes in countless patients in the ER and critical care units. I know first hand the gestalt of medicine! It is an intuitive feeling that tugs at you in moments of chaos and complete medical discomfort, but it always gives you the clarity on what to do! I love reading your posts, to remember the world in which I toiled for so long. Thank you for writing as you do!
Not every doctor has this high level of prescience. Good that you do — don’t ever lose that. I suffered a uterine rupture while in active labor and my exact words were “it’s ripping, it’s ripping.” My unastute doctor claimed they were contractions and I didn’t know what they felt like. Luckily a very seasoned nurse caught the fetal distress hours later and the new doctor on duty performed an emergency c-section. I’ve written the entire story here: https://maryannrollano.substack.com/p/uterine-rupture
Critical care medicine for 39 years has given me the gestalt gift.
I’ve taken care of hundreds of patients each with their own trajectories. I’ve learned a little of “something ain’t right” with a variety of patients.
Our intuition as healthcare providers can sometimes completely change the game for some patients. If we fail to listen to that voice in our heads we fail by omission.
My father died of a ruptured aortic aneurysm. He was 46. I was 11. It was 1973. He knew he was dying, but not physician gestalt was available that night. Bless you.
Your writing is superb and the subject matter is riveting.
Excellent story and we need more of these. Every physician understands the intuition that comes from experience. Even more so, we appreciate that as a learner, we can sometimes quash that passion. Appreciate the effort to advocate for your patient.
It's great that you had the where with all to listen to your gut. I kind of wonder about his previous visits. Were his symptoms ignored? Maybe he was experiencing something that medical staff didn't detect.
I have worked in Respiratory Care for my entire life, encountering many acute, life threatening, episodes in countless patients in the ER and critical care units. I know first hand the gestalt of medicine! It is an intuitive feeling that tugs at you in moments of chaos and complete medical discomfort, but it always gives you the clarity on what to do! I love reading your posts, to remember the world in which I toiled for so long. Thank you for writing as you do!
Bravo! Brilliant writing and such a vital topic in this challenging time. Thank you.
Not every doctor has this high level of prescience. Good that you do — don’t ever lose that. I suffered a uterine rupture while in active labor and my exact words were “it’s ripping, it’s ripping.” My unastute doctor claimed they were contractions and I didn’t know what they felt like. Luckily a very seasoned nurse caught the fetal distress hours later and the new doctor on duty performed an emergency c-section. I’ve written the entire story here: https://maryannrollano.substack.com/p/uterine-rupture
Always follow your gut — it’s rarely wrong.
Loved this post, Mike.
I worked with a doc who intuitively knew when to make house calls. He pulled more than one patient out of CHF in the late evening.
It's interesting how if you work long enough and trust in your medical "knowing", you can nip potential medical emergencies.
From a former ED/trauma unit manager. Thank you for your exquisite descriptions of how expert clinicians make a difference in patients’ lives.
Mike, Thank you so much for sharing your stories. I anticipate my inbox notification each time you share a new one. Cheers :)
You're my hero! Thanks for being a stand up guy!
I wish many more my colleagues in tertiary care hospitals were gifted with gestalt
The life would be much easier for all of us😊
It can be learned!
Critical care medicine for 39 years has given me the gestalt gift.
I’ve taken care of hundreds of patients each with their own trajectories. I’ve learned a little of “something ain’t right” with a variety of patients.
Our intuition as healthcare providers can sometimes completely change the game for some patients. If we fail to listen to that voice in our heads we fail by omission.
To me, it sounds like very much of the Spirit informing the man. You must be a very good doctor. Thank you for sharing.
My father died of a ruptured aortic aneurysm. He was 46. I was 11. It was 1973. He knew he was dying, but not physician gestalt was available that night. Bless you.
Do you think it’s more difficult for very complex patients with multiple diagnoses? Or the same? Thanks for sharing.
When you know you know.