Let’s do a thought exercise. TW medical experience.

Your kidneys are rapidly failing and you’re having a hard time breathing. Every minute it’s harder to breathe. Your back and head are pounding. You need an emergent femoral line for dialysis.
The resident is visibly nervous. His voice is shaking as he tries to consent you. You’re getting more and more overwhelmed because the kidney failure is making it hard to think. He is taking a long time to set up.
His first attempt fails. You’re starting to panic and he’s digging around hurting you. Do you put resident education above your needs in that moment, or do you ask someone who knows how to place a femoral line to do it?
Anyway this happened to me. I let the resident try twice while he asked the attending over and over how to do it. I regret that I even allowed the first try - it was so obvious he was too nervous and inexperienced. But medicine is a coercive environment. It’s hard to say no.
These experiences are some of the worst things that can happen to a person. They leave lasting scars, visibly and emotionally. I have three scars from that line placement. They remind me how fucking terrified I was.
Bonus points because I actually tried to get transferred out of this hospital (it was not where my primary oncology team was) but nowhere would take me 😅
For a DIY empathy building experience, next time you are sick or in pain, set an alarm for 12 AM, 4 AM, 6 AM, 8 AM, and 10 AM. At 12, 4, and 8 you have to take your temperature and lie flat on your back for a BP. At 6 and 10, give the history of your illness, last 24 hours, etc
These histories should take at least 10 mins. You also need a physical. Do you want to get rid of the 6 AM? lol
Bonus points for turning on all the lights for about half of these encounters. Also, don’t forget the 5 AM blood draw!
btw I know treatment coordination can be done well, which is why I want us to see it as possible and work toward it. I’ve had many doctors who took time and effort to make this less painful for me, but also many others who insisted this was the only way.

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More from @brookevitti

8 Apr
One of the most frustrating things about talking about patient difficulties on this app is that my point is frequently misconstrued to something it is not.

"There are times a patient may need a break from pre pre round ands pre rounds" ≠ "I refuse all trainee care"
Continually explain that I still usually invited trainees to participate!
Read 8 tweets
28 Mar
I will never understand how we normalized health insurance companies acting as a barrier between doctors and patients for no reason other than extracting money. They literally don’t even have a product.
Why does my doctor have to ask a business team whose sole goal is profit if I can have chemotherapy? If you told that to someone 200 years ago they would KNOW something is wrong with us.
Me: So your doctor has to ask permission before giving your treatment.

Them: oh like an advocate for the patient?

Me: No, like an advocate for these people who invested in the company. The company makes more money if they say no to your treatment.

Imagine. Lmao.
Read 4 tweets
27 Mar
Really excited to be part of this! Acute pain prior to my cancer diagnosis was ignored and even mocked. The opioid crisis is real, but so is chronic pain. We have to strike a balance without abandoning patients.
When I talk about balance here are some incidents that should not have happened 🥰

1. ED doc sending me home with no treatment/minimal exam telling me I’m lying to my face while I’m crying bc my ears hurt so bad. I can only think this was leukemia-related bc it was 3 mo pre-dx.
2. Calling a resident at 3 AM ~5 days post BMT begging for a morphine increase bc mucositis was so unbelievably painful and him telling me to wait for rounds at 10 AM and not even coming to see me.
Read 10 tweets
22 Jan
idk something about vaccinating caregivers but not the actual vulnerable disabled people doesn’t sit right with me. is there something im missing?
It seems like it rests on the assumption that disabled people are entirely home bound. I’m the most exposed person in my family BECAUSE I’m immune compromised and have constant dr appts
It also seems to assume that caregiver relationships are perfect - disabled people are actually very vulnerable to the power dynamic of needing a caregiver. A caregiver can be vaccinated but still not complete all errands that require leaving the house
Read 7 tweets
21 Jan
Finally summoned the courage to reapply for samfund after they threw out my app a couple years ago over a technicality. Now I'm ineligible bc my diagnosis was 6 months too early & I don't quality for SSDI. I swore off charities after that, why do I keep hurting myself like this.
The technicality was that they accepted my application and confirmed that it was complete, but then emailed me 2 hours before the deadline that a form was incorrect. I saw it 30 mins after the deadline and returned it immediately, but they refused to read the application
I cried for like 3 days lol I was so beyond the end of my rope, so so sick and it had taken every ounce of my energy to complete that extensive application.
Read 5 tweets
21 Jan
I watched CA’s vaccine advisory board meeting last night. They emphasized focus on age (might even remove farm workers currently eligible from 1b) and not disability. Didn’t evaluate data by disability. Just age. They estimate 20-22 weeks to get through people over 65.
50 minutes in a disability advocate brought up disabled people and he was told “thanks for your impassioned response” and then focus returned to age.
I literally feel like I should leave the state. And I know I’m really fortunate to even be able to consider that, even if it will be difficult and prob involve debt.
Read 8 tweets

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