Medical Dummies
I hadn't heard about the new medical dummies until I saw it in The New Yorker. I have to say that I think it's a wonderful thing, mainly for medical emergencies. There is nothing wrong with American medical education - best in the world - but the fact is that when you graduate, and it's your first night covering a NYC emergency room as an intern, you do see things you've never seen before, and you don't have time to think.
I'll never forget one night in my first month when I was the only medical intern on duty in the ER. I had 17 patients in there. One acute MI who coded and didn't make it, one respiratory failure who didn't make it, a rule-out MI who didn't have one (we didn't do the enzymes then), a bad asthmatic who finally did well, a total-body disintegration from a nursing home, a drunk with acute pancreatitis, a diabetic with an acute hyperglycemia who we got under control but later died of aspiration pneumonia, various gomers here and there trying to either die or to fall off their gurneys ("Gomers go to ground", remember House of God? Good book), an arrhythmia or two - can't remember, an upper GI bleed vomiting blood, and who knows what else. With time to think, I could have taken care of any one of them fine. After a year of that, everything became routine.
In the ER, it's about rapid, accurate diagnosis. What is surgical, what is medical, and what can wait. Diagnosis is easy in books, tough in real life. Not only do I wish I had had a week to be challenged by one of these new dummies, I wouldn't even mind it now, even though it's been decades since I've done ER work. I've heard that aviation simulators can almost give pilots heart attacks, so I'm sure that a few hours with the dummy would be quite an adventure. Worth paying for.
Read the piece about medical simulation. Written with The New Yorker's usual craftsmanship.
