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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Boston Globe Health and Science staff:
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
Short White Coat blogger Ishani Ganguli
Short White Coat blogger Jennifer Srygley
Thursday, June 14, 2007
Short White Coat: Take a number
Short White Coat, our blog about medical school, has a new blogger: Jennifer Srygley, a third-year student at Harvard Medical School. Jennifer grew up in Tallahassee, FL, and attended the University of Georgia, where she majored in genetics and creative writing. As a medical student, she tries to remain aware of the strangeness and beauty of her surroundings on the hospital wards, all while taking good care of patients. Her posts will appear here as part of White Coat Notes. E-mail Jennifer at firstname.lastname@example.org.
My day starts and ends with numbers. As a medical student on the surgical service, my first task every morning is to go to every patientís room and record temperature, heart rate, blood pressure, fluid intake, and urine output.
With time, the numbers themselves have come to take on meaning. The number 102, for example, is alternately alarming or reassuring, depending on whether it is a temperature or a systolic blood pressure measurement. There are some patients that I have come to know not only by chief complaint or social history, but by their numbers: Mr. Lís heart usually beats between 70 and 80 times per minute. Knowing this detail is enough to recognize the earliest signs of dehydration when his heart rate climbs to the 90s.
And there is something else. I find it comforting to know exactly how fast the hearts of all my patients are beating. While my task of writing down the vital signs every morning and afternoon does not require any particular skill or training, I enjoy the sense of vigilance and duty that it provides.
The next step in medical training is to know what to do about each number, when to become concerned about the deviation of a particular number from normal, and when to act. The clinical skill of number interpretation will come with time, I hope. For now I am content to carry my patientís pulses on an index card in my pocket.