Tomorrow morning I begin my second clinical rotation – internal medicine. I thought this would be a good time to share an amusing anecdote from my first month as a third year student during my hematology/oncology elective rotation.
On my very first day of third year, I spent most of the morning going through the orientation process at the hospital. I got security clearance, my ID badge, a tour of the building, and introductions to the important staff members I’d be interacting with. After the tour, I was on the floor being introduced to one of the doctor’s I’d be following for the month. His first consult that morning was a patient that needed a bone marrow biopsy, and I was asked to watch.
Bone marrow biopsies are usually performed when there is a problem with the body’s blood cell count. The marrow inside of your bones is responsible for creating platelets and red & white blood cells. To perform the biopsy, a region of the back is anesthetized, and a needle is driven into the pelvic bone to aspirate a sample of bone marrow. If done properly, the patient feels an intense pressure in their back, but no pain.
So, on the first day of my first clinical rotation of my third year of medical school, I was asked to watch a bone marrow biopsy. I should note a few things here. First, I have seen this procedure done before. My father is an oncologist, and I’ve watched him work. Second, I had just gotten back from my honeymoon the night before. Because I was nervous about starting my third year, finding a hospital I’d never been to before, and making a good first impression, I hadn’t slept well the previous night. I also hadn’t had anything to eat or drink since getting home that day.
I was fine throughout most of the procedure. The doctor was finished and began putting away his equipment when I started feeling dizzy. I excused myself and sat down for a few minutes, thinking I was OK to leave the room when the medical team was done. When I got into the hallway, my vision started to go black from the outside in. I remember telling a nearby nurse that I couldn’t see. The next thing I knew, it was a few minutes later and I was laying on the floor of the hospital hallway. The doctor who had performed the biopsy and the nurse who I told I couldn’t see were holding my legs in the air, trying to get some blood back into my head.
So everyone had a good laugh at my expense. The nurse sat me at her station and gave me some orange juice and crackers. Two minutes later, I was fine. It wasn’t for another 3 weeks that I got the opportunity to prove I could make it through another bone marrow. A couple of days before the rotation ended, I was with a different doctor for the same procedure. As it turns out, sleeping and eating breakfast are pretty good prophylaxis against passing out.