Fullmetal in the hospital

A few days ago while I was working in the ER, I was borrowing a nurse's computer to print out a patient's vitals when I spotted the name "Edward Elric" on the list of patients in that part of the ER. Almost immediately I burst out laughing. For anyone not familiar with anime, Edward Elric is the main character of a well known anime series called Fullmetal Alchemist. I've never seen FMA myself, but I've been to enough conventions to recognize the characters, not to mention I've seen Ed's voice actor Vic Mignogna at multiple cons and he's made no secret of the fact that Ed was one of his favorite characters to ever voice. I know the basic plot of the story, how Ed and his brother Al used alchemy to attempt to resurrect their dead mother, and in the process Ed lost an arm and leg and Al's soul got trapped in a suit of armor. I also know that there are a lot of themes in the series, i.e. the bond between brothers and how dangerous it is to play God with other's lives. One of these days I'll have to watch FMA, but for now, all that mattered was that there was someone calling himself Edward Elric in the ER, and apparently I was the only one who knew that name was a fake.

I saw "hallucinations" as the chief complaint, so it was entirely possible that this guy was psychotic and really did believe himself to be Edward Elric. However, he wasn't my patient and I wasn't about to violate any HIPAA laws by reading up on his file. So I did the next best thing and snagged one of the ER docs, telling him that the name "Edward Elric" was a fake one and that the ER social worker was going to have to try harder to learn his real identity. I even pulled up Ed's picture on my phone and showed it to him to prove that I wasn't crazy either. The ER doc laughed, saying that his patient didn't resemble Ed at all. He was also amused that it was thanks to my "inner nerd" that all this came to light. What can I say, it's not everyday that anime and medicine come together in my workplace. I later texted Kyle, a voice actor I befriended who'd also worked on FMA, to say that "Edward Elric" showed up in in the hospital (without going into too much detail); he thought that was pretty funny.

"Edward" was in the ER for at least 3 days waiting for a bed at a psych hospital, though by the second day, some of the ER docs had looked up FMA to learn about the real Edward Elric. "I heard you're the one who found out it wasn't his real name," said another doc. And apparently the ER docs were still talking about it over the weekend (I got those 2 days off) and my partners heard about it, too. I'm guessing he finally made it to a psych hospital; hopefully he'll get the help he needs and not fall into more delusions of grandeur.

Studer Training

Several months ago, my colleagues and I attended a mandatory meeting with a coach from the Studer Group, a group of physicians that educates other physicians about how to improve patient satisfaction and outcomes. It was four hours of teaching us how to demonstrate empathy toward our patients, ways of going "above and beyond" i.e. sitting down when talking to a patient, touching the patients, communicating, etc. Most of my colleagues thought it was a bunch of baloney; as for me, this was nothing that our med school hadn't already emphasized back in the day. I do try to sit down with my patients whenever I get the chance, I listen to their concerns, and I'm not afraid to lay a hand on their shoulder when they're crying. This I attribute to my med school training, not to the Studer Group.

Imagine my surprise (and dismay) today when the chief medical officer of the hospital poked his head into the physician's dictation room where I was writing my notes and asked if I had time to spare for him and a Studer coach (the same coach from above) to shadow me while I talk to my patients. I haven't had anyone shadow me since I was a med student, and I was sorry to say I couldn't recall much from the Studer training session. The CMO, Studer coach, and I saw 4 patients together: an osteomyelitis case, a chest pain, an A-flutter s/p ablation, and a new ESRD pt. I chose these patients b/c they were pretty straightforward and I had a pretty good relationship with them so the coach could see me at my best. The coach seemed pretty interested in where I trained, and asked where I thought my strengths were. I told him that I take time to listen to my patients, and that I make an effort to develop a relationship or rapport with them while they are under my care. I even gave some props to TCOM by saying our old motto, "Treat the patient, not the disease."

As for criticism, the coach said that I never once sat down while talking to my patients (the other chair was occupied and I didn't want to sit on the patients' beds), and he also commented that I rarely ever smiled. That's nothing new; I know my default facial expression is more of a frown than a smile. Still, I could see his point. One of the nephrologists at our hospital is extremely bubbly and friendly, and just seeing her makes me want to smile. Now I wonder what kind of disservice I've been giving my patients by not smiling when I walk through their door. And as for sitting down to talk to patients, they say sitting down gives patients the impression that our face-to-face time lasts longer than if we spoke with them while standing. That, thankfully, was one tidbit I remembered from the Studer training session, and the coach seemed pleased when I was able to recall it. Overall, he said I was doing pretty well, and that with a bit of tweaking, I can do even better.

Some of my partners wanted to hide when they heard that the Studer coach and CMO were walking around finding people to shadow, but I think everyone's going to get it eventually.