smcgaughey

Nov 02

ACE: I am just a medical student. -

cranquis:

wayfaringmd:

docedace:

She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried.  

She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach - a lumpectomy with axillary node biopsy without radiation.  She’s admitted, and gets a chest x-ray and a CT scan, which show a pleural effusion with what looks like nodules in both lungs.  ’Likely represents metastatic disease,’ reads the official radiology report. She knows, so I don’t bring it up again.

'I am just a medical student,' I think. 

On the second day, she undergoes surgery to evacuate the effusion, and her lung is biopsied.  Now, we wait for the pathology report.  I visit her everyday as we wait, sometimes two or three times. I’ve met her husband, and we know each other by first names.  Her daughter and son are also beautiful people, just like her.  They ask me questions, and I keep my answers limited to what I’ve read in the chart. They never ask me about the cancer. They know what the radiology report said, so I don’t bring it up again.

'I am just a medical student,' I think.

She never complains. Not from post-operative pain, not from shortness of breath, not from coughing, not from anything.  I take my time with my physical exam, ensuring that I don’t miss any tenderness.  I don’t want her to suffer unnecessarily.  ”Surgery is painful,” I tell her, “make sure you let us know if you are in pain.”  She agrees, but never complains.  

The nurse corners me one afternoon, and asks me, “Is there any way to put in an order for morphine PRN for her?” 

'I am just a medical student,' I think.

"Why?", I ask.  

"Because when her family isn’t here, when she’s alone, she cries.  She’s in pain, she’s scared, but she’s a silent sufferer."

Oh.

I am the first person she sees every morning, and I try to make sure she’s comfortable.  I offer extra blankets, water, anything I can do just to make sure she is as happy as she can be.  She appears more and more cheerful, and I spend what seems like hours holding her hand and chatting about life, the weather, her family, my family, my future goals, my girlfriend.  I show her pictures.  We laugh. We smile. But her eyes remain anxious and worried. 

She says she likes my bowties, so I make sure to wear one everyday for her.  And I tell her, “I thought of you when I put this one on this morning.”  She smiles through those tearful, anxious, worried eyes.  I smile back. And that is enough to make my day.

I walk in with my bowtie and smile around 6:30pm. She just got back from the CT scanner, and her family is around her bed, as per usual.  I visited, just to say good-bye for the day.  The sun dips a few degrees further West, just enough to peak through the curtains, and her husband turns to me and says, “Edwin, thanks for bringing the sunshine.”

I stand there, in a loss for words, armed with little more than a bowtie and a smile.

'I am just a medical student,' I think.

"There’s something of yourself that you leave with every meeting with another person…" — Fred Rogers

Med students, take your cue from this guy. You make a difference too. 

Magnificent writing, inspiring story.

Jul 27

Clueless:
I had often heard that being an intern was a far more enjoyable experience than being a med student. Hearing stories of long hours, stressful decisions, and overworked interns, I found that hard to believe. Granted, as a pediatric intern, my experience is different than a surgical or even internal medicine intern— yet I now understand the benefits of transitioning to a resident. 
Our rapidly digitized and regulated medical system has the unfortunate side effect of cutting medical students out of patient care. My former med school used a robust EMR system. It disallowed easy entry of student orders. Furthermore radiology prelim reads went directly to interns, and daily lectures usually cut into crucial patient care. However med students are, in my opinion, unfairly tasked with following and presenting a patient’s hospital course. They round, gather numbers, read results, and review radiology studies. Unfortunately this is a practice, more of reading of the day’s events, than a recap of an experience they were involved in. The system is designed to handicap their ability to truly assume an autonomous role in a patient’s care. 
In theory residents should keep their students updated in the latest events and involve them in the decision making process. This is a practice easier said then done. Despite these hurdles, I had wonderfully talented and caring residents during med school. Many of them overcame barriers in the system to actively engage me in patient care. They recapped their orders, filled me in on radiology studies, and “ran the list” with me to make sure I was up to date. Certainly having these residents in the past has pushed me to pay back this educational debt. While medical students may face logistical hurdles– they are bright, eager, and resourceful. It is worth the extra time and energy to involve them in every facet of medical care. I as find the balance between efficient patient care and medical student teaching, I hope that the many hurdles our system fade. 

Clueless:

I had often heard that being an intern was a far more enjoyable experience than being a med student. Hearing stories of long hours, stressful decisions, and overworked interns, I found that hard to believe. Granted, as a pediatric intern, my experience is different than a surgical or even internal medicine intern— yet I now understand the benefits of transitioning to a resident. 

Our rapidly digitized and regulated medical system has the unfortunate side effect of cutting medical students out of patient care. My former med school used a robust EMR system. It disallowed easy entry of student orders. Furthermore radiology prelim reads went directly to interns, and daily lectures usually cut into crucial patient care. However med students are, in my opinion, unfairly tasked with following and presenting a patient’s hospital course. They round, gather numbers, read results, and review radiology studies. Unfortunately this is a practice, more of reading of the day’s events, than a recap of an experience they were involved in. The system is designed to handicap their ability to truly assume an autonomous role in a patient’s care. 

In theory residents should keep their students updated in the latest events and involve them in the decision making process. This is a practice easier said then done. Despite these hurdles, I had wonderfully talented and caring residents during med school. Many of them overcame barriers in the system to actively engage me in patient care. They recapped their orders, filled me in on radiology studies, and “ran the list” with me to make sure I was up to date. Certainly having these residents in the past has pushed me to pay back this educational debt. While medical students may face logistical hurdles– they are bright, eager, and resourceful. It is worth the extra time and energy to involve them in every facet of medical care. I as find the balance between efficient patient care and medical student teaching, I hope that the many hurdles our system fade. 

Jun 23

Day #1
Well my first day of officially being a resident-physician starts tomorrow. I hope to post intermittently throughout the year about my experience.

Day #1

Well my first day of officially being a resident-physician starts tomorrow. I hope to post intermittently throughout the year about my experience.

Jun 12

The Road to Residency: 
A New Website to Help Guide Medical Students Through the Residency Application Process.
My fiancee and I worked over the last several months to craft a website to make the residency application process easier. As we went through the many steps ourselves, we found that there was a gap in information— between sites with too little information and those with every detail covered. Our goal was to take the best websites and pull their advice then inject our own suggestions. Hopefully our site will help reduce the complexity of the entire process as well as evolve as we get more feedback. Please contact me if you have any suggestions. (steven.mcgaughey@gmail.com)
http://theroadtoresidency.com/

The Road to Residency:

A New Website to Help Guide Medical Students Through the Residency Application Process.

My fiancee and I worked over the last several months to craft a website to make the residency application process easier. As we went through the many steps ourselves, we found that there was a gap in information— between sites with too little information and those with every detail covered. Our goal was to take the best websites and pull their advice then inject our own suggestions. Hopefully our site will help reduce the complexity of the entire process as well as evolve as we get more feedback. Please contact me if you have any suggestions. (steven.mcgaughey@gmail.com)

http://theroadtoresidency.com/

Apr 12

Here’s a quick set of pictograms I did for an app a team of us are submitting for a competition. The app deals with Personal Protective Equipment (PPE) and pesticide safety in agricultural areas. We didn’t have enough time for our app developer to code it but we’re throwing together an animated mockup. 

Here’s a quick set of pictograms I did for an app a team of us are submitting for a competition. The app deals with Personal Protective Equipment (PPE) and pesticide safety in agricultural areas. We didn’t have enough time for our app developer to code it but we’re throwing together an animated mockup. 

Mar 15

Wash U!
So my girlfriend and I are heading to Washington University in St. Louis for pediatrics and neurology. We’re excited to call St. Louis home soon.

Wash U!

So my girlfriend and I are heading to Washington University in St. Louis for pediatrics and neurology. We’re excited to call St. Louis home soon.

Mar 04

For some reason I can never remember what ferritin does. So to remind myself that ferritin binds iron and releases in a controlled fashion I made a Ferret pumping iron. I could’ve easily memorized this instead of spending hours making this icon…oh well.

For some reason I can never remember what ferritin does. So to remind myself that ferritin binds iron and releases in a controlled fashion I made a Ferret pumping iron. I could’ve easily memorized this instead of spending hours making this icon…oh well.

Mar 02

Brain
Part of a larger project that I need to finish up. In the meantime I thought I’d post this.

Brain

Part of a larger project that I need to finish up. In the meantime I thought I’d post this.

Feb 27

Crafting Letters
Just doodling around with lettering. 

Crafting Letters

Just doodling around with lettering. 

Feb 09

Something a Little Different
After letting my Wacom tablet collect dust for the last several months, tonight I finally decided to start drawing agin.
I’ve been following Shane Burcaw of LAMN for a little while and I wanted to make a small tribute piece. Shane is a 20 year old with SMA (spinal muscular atrophy) who has a wonderfully lighthearted outlook on life. He also happens to be an active member in the muscular dystrophy world. He just launched his nonprofit laughingatmynightmare and is showing no signs of slowing down.
Though I don’t know Shane personally, he reminds me of the many wonderful patients and families I had the pleasure of seeing as part of my neuromuscular fellowship last year. 
So here’s a drawing I put together tonight of Shane looking tough in a pretend cape—something I wouldn’t be surprised to see him post on his own tumblr site. 

Something a Little Different

After letting my Wacom tablet collect dust for the last several months, tonight I finally decided to start drawing agin.

I’ve been following Shane Burcaw of LAMN for a little while and I wanted to make a small tribute piece. Shane is a 20 year old with SMA (spinal muscular atrophy) who has a wonderfully lighthearted outlook on life. He also happens to be an active member in the muscular dystrophy world. He just launched his nonprofit laughingatmynightmare and is showing no signs of slowing down.

Though I don’t know Shane personally, he reminds me of the many wonderful patients and families I had the pleasure of seeing as part of my neuromuscular fellowship last year. 

So here’s a drawing I put together tonight of Shane looking tough in a pretend cape—something I wouldn’t be surprised to see him post on his own tumblr site. 

Dec 28

Shine Brighter.
I’m not one for inspirational text prints but I thought I’d post a little re-do of one of my more popular pieces (Gemfibrozil). 

Shine Brighter.

I’m not one for inspirational text prints but I thought I’d post a little re-do of one of my more popular pieces (Gemfibrozil)

Dec 27

I’m sure most of us have experienced the painful sensation in our ears when flying, but why do our ears hurt and why do you feel them pop? 
It all boils down to unequal pressure between our external auditory canal (arrow) and middle ear (#2)—and the membrane that is caught in the middle—the tympanic membrane or eardrum (#1).
Rapid changes in altitude change the pressure the outside of the eardrum, but the middle ear doesn’t respond as quickly. The eardrum is a highly innervated (by cranial nerves V, IX, X) and thus is highly sensitive membrane. Differences in pressure cause the membrane to distort either in or out and subsequently cause pain. 
So what about the popping sensation? The middle ear is connected to the nasopharynx (#4) (i.e. the back of the nose/upper throat) by the eustachian tube (#3). This tube is usually closed—however when we swallow it opens briefly which allows the pressure to equalize and your hear and sense the pressure dropping in your middle ear.

I’m sure most of us have experienced the painful sensation in our ears when flying, but why do our ears hurt and why do you feel them pop? 

It all boils down to unequal pressure between our external auditory canal (arrow) and middle ear (#2)—and the membrane that is caught in the middle—the tympanic membrane or eardrum (#1).

Rapid changes in altitude change the pressure the outside of the eardrum, but the middle ear doesn’t respond as quickly. The eardrum is a highly innervated (by cranial nerves V, IX, X) and thus is highly sensitive membrane. Differences in pressure cause the membrane to distort either in or out and subsequently cause pain. 

So what about the popping sensation? The middle ear is connected to the nasopharynx (#4) (i.e. the back of the nose/upper throat) by the eustachian tube (#3). This tube is usually closed—however when we swallow it opens briefly which allows the pressure to equalize and your hear and sense the pressure dropping in your middle ear.

New Project

I’ve been quite absent on tumblr since I’ve been running around the country interviewing. Since I’m now done with boards (at least until step 3) I thought I’d start up a new project to kick start my drawing again. Though I know many of your are medical students, I wanted to focus on a project explaining more mundane medical phenomena. Perhaps once a week I’ll try to post a small drawing and explanation of a simple medical problem or condition. I’ve always been interested in medical education, especially how medical professionals educate patients. Since my one year research year in focusing on neuromuscular diseases, I’ve thought a good deal about how to best represent complex medical ideas. Hopefully this project will get me thinking more about this concept. 

Anonymous said: Hi Steve, First of all, your art work is great. I really wanted access to that lipoprotein graphic that you did; the gastric subway is very useful of course. I'd really like high-resolution versions of these and the rest of your work if you are interested to monetize them or share in anyother way. I hope you'll nourish and nurture your talents further in life and share them with the world. Thanks.

Thanks! Shoot me an email and we can chat. I can’t post links in tumblr mail but you can head over to my website—my email is listed there in the about section. 

Dec 05

Help Wanted!

Sorry I’ve been MIA but I’ve been wrapped up in some projects. One of the really exciting project is working with a medical boards review book series to oversee a revamp of their medical illustrations. I’m trying to find individuals who are interested in medicine and illustration. Preferrably I’m looking for medical students with an eye for design, or medical illustrator students with a strong science background. If you know anyone I’d love to talk with them further.

Hope to hear from you.