Saturday, April 13, 2024

Moral of the Story: Don't Cause Gratuitous Pain

I have not been blogging much for several years because my other academic/scholarly activities have taken precedence. But now that I'm a PGY-26, I have accumulated in my mind a bevy of anecdotes that serve as lessons or stories with morals for me, and I'm going to start documenting these here as they occur to me.

When I was a 3rd year medical student on a surgical rotation in 1997 at Ohio State University, rotating at Grant Community Hospital, I was in the surgical intensive care unit (SICU) with a very good resident. A Swan-Ganz catheter was being placed for hemodynamic monitoring in an intubated and partially sedated man. I was eager to witness this procedure. It was a left subclavian insertion site, with a Cordis. The patient writhed in pain with each landmark-guided needle pass. There was no time urgency - for the patient anyway, it was an elective procedure, though the doctors were very busy - and I thought: "there is no need to rush this procedure, why don't we sedate him or give more local anesthesia?"

This experience - I recall it vividly as though it were yesterday - has been burned in my brain as an indelible stamp with the moral: don't cause gratuitous pain.