Internal Medicine Sub-I – Day 4

The theme today was “goals-of-care.” With really sick patients who are nearing the end of their life or for whom are treatment options are limited, we have a discussion with the patients and their families regarding what the goals of care are and through shared decision-making, figure out how we are going to proceed in light of the present limitations. Fortunately I wasn’t leading any of these discussions today, but was able to be a witness to my senior residents having these kinds of discussions under multiple circumstances, including during a patient’s acute decompensation. This event was a whole experience in itself. Perhaps surprisingly, this is the first time I can think of where I was present and involved in a code. It wasn’t a code blue, it was a code sepsis, but it was still exciting, not in a fun way, but in a “spring-into-action-I’m-not-sure-if-I’m-being-helpful-but-I-want-to-make-myself-available-and-also-I’m-a-little-scared” kind of way.