Saturday, March 12, 2011

Weekly Whine: Can't Remember Shit

Why does being a doctor require you to remember so much shit?

First, there's med school. You think that you just need your memory to hold out through anatomy and all those damn nerves and arteries and muscles. Except that's just the beginning.

As a med student in my clinical years, I was usually not responsible for more than a couple of inpatients at a time. It was actually sort of a struggle to remember things about these patients. And not just medical stuff. Sometimes I'd even forget their gender, which was a huge hazard when you're on peds, the patient is six months old, and you keep having to use gender-neutral statements when talking to the parents because you let this important piece of information slip your mind.

During residency, you take responsibility for more and more patients. The max was 12 inpatients at a time during my internship, and 17 during my residency. If on a given night of call, I admitted three or four chest pain patients, I was almost guaranteed to get them mixed up. Okay, I'll be honest: I'd get them mixed up if there were only two. That's why I used notes and checkboxes meticulously.

Now, post-residency, I follow anywhere from 20-30 patients at a time.

That's a lot of shit to remember.

It's hard. It's not like my memory has miraculously improved in the last ten years to the point where I can keep track of all the details of 30 people. And it's not realistic to carry around summaries of each patient's information like I did in residency. And you're not supposed to because it's dorky... you're just supposed to remember it.

I manage. Somehow. Actually, sometimes I surprise myself by somehow keeping track of random details of 30 different patients at once. But it really sucks when people working on the ward seemed surprised that I can't remember every fact about every patient. One thing that drives me crazy is that nurses refer to patients by their room numbers when asking questions... then when I ask the name of the patient, sometimes they don't know! I can't remember the room numbers of every patient too. I can't.

I don't know what I could do to improve my recall of all this information. More sleep might help, I guess.

I'll tell you this: I'm no longer impressed by teachers in high school who managed to remember all their students' names.


  1. This is where being an engineer is nice... 99/100 times the people I'm dealing with are male. Remembering names, yeah I suck at this, but I don't have to worry about my pronouns.

  2. I'm kind of reassured to know that the amount of stuff you need to know is just as crazy at the end of the tunnel as the beginning.

  3. Ack. I can't tell you the number of times I've called a doctor about a patient, been all like "I'm calling about Mr. Such and Such who was admitted with blah bblah are you familiar with him?" Get an enthusiastic "oh yeah!" from the doc, followed by totally confusing orders because they have no idea who I'm talking about. Then there's an awkward silence followed by "Oh, that's not Mr Such and Such is it?"

    Moral of the story: please ask me to clarify if you need it. I (nursing) only care for 4-5 patients at a time, see them for much longer periods of time than the docs do, and still get them confused.

  4. Hannah: I'm glad to know that nurses realize it's much harder for us to remember the details of 20+ patients than for them to keep track of their census.

    iamnothouse: Why is that *reassuring*??

  5. You've been blogging a lot about memory lately. Did you read all the reviews and Maureen Dowd's hilarious editorial and Joshua Foer's new book about memory - "Moonwalking with Einstien?" It makes me want to get it.

    What we learned in med school is true. If you tie enough banal crap you have to memorize to lurid, graphic sexual imagery, you can ace your boards.

  6. Giz: They were originally the same entry, then I decided to break them up. But it's definitely been a source of frustration for me lately. I've never had to keep track of so many patients at once!

  7. It wouldn't be so hard to remember the gender of those 6 month olds if their parents didn't name them things like XAIDEN. (Speaking from experience!)

  8. Reassuring in that people who have gone through the whole training still find the process a little daunting.