Preceptorship

We had a single preceptorship session for learning about the "Care of the Critically Ill Patient." I was assigned to the Highland Hospital Emergency Department, the main trauma center for Oakland (others were assigned to chaplains, hospitalists, palliative care physicians, oncologists). I had a great experience. The preceptor was a UCSF residency graduate, super receptive to us coming and gave us a fabulous introduction to emergency medicine and tour of the department. We then split up and saw several different patients. The first patient I saw was fascinating and challenging and is described here. I then saw a classic presentation of an MI (left sided chest pain radiating up left neck and down left arm, diaphoresis, weakness, past history of heart disease, etc.). Although it would seem like a great case for learning about the "critically ill patient," the guy was comfortable and chatting to me pretty easily. The last patient I saw was a strange one. A mother, high on pot, brought in her four year old daughter because she was "tweaking." I didn't know what that word meant. It turned out the child was acting very strangely, with something that looked like absence seizures along with nystagmus and decreased awareness. They thought that she had accidentally ingested some sort of medication, and luckily, the child is fine now. I really enjoyed my experience there, seeing a good variety of patients, learning more about emergency medicine, and discussing how doctors deal with cases of great severity.