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Unofficial Prognosis

Unofficial Prognosis

Perceptions and prescriptions of a medical student
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    Ilana Yurkiewicz Ilana Yurkiewicz is a fourth-year student at Harvard Medical School who graduated from Yale University with a B.S. in biology. She was an AAAS Mass Media Fellow, and her work has appeared in the New England Journal of Medicine, Aeon Magazine, Science Progress, The News & Observer, and The Best Science Writing Online 2013. She has an academic interest in bioethics, currently conducting ethics research at Harvard after previously interning at the Presidential Commission for the Study of Bioethical Issues. She is going into internal medicine and is also interested in quality and systems improvement. Follow on Twitter @ilanayurkiewicz.
  • These agents prevent disease. Why aren’t we using them?

    When red cells "sickle," oxygen delivery is impaired

    The life cycle of a medical advance usually goes something like this: from discovery at the research bench and replication of findings, to translational research and clinical trials, to implementation. The bottleneck can be at any one of these stages, and often it is in the discovery one; we just haven’t yet found the thing [...]

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    What’s so healthy about skepticism?

    He was known to the hospital as someone who would try to manipulate his caregivers. And I fell for it anyway. Frequently admitted for pain crises associated with a chronic illness, he spent most of his hospital course avoiding eye contact with the team. So, too, were avoided answers that involved more than a few [...]

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    Strange bedfellows

    “You wanna talk? Let’s talk.” The 42-year-old man sits up straighter in the hospital bed and grins a toothless grin. “Those other doctors, they don’t understand. They don’t get what I’m going through, you know?” I know only what they told me. A few minutes earlier, our team had gathered outside the door, where the senior [...]

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    It’s a simple question – isn’t it?

    “So, is this the sickest list you’ve ever had?” the resident asked me at 2 AM, after I finally finished checking off all my boxes for the night. I nodded. I agreed. I was also shaking. I had been covering nine patients that night. Almost none were stable. In the span of one shift, we [...]

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    Reflections of a fourth year medical student

    “We pass through the present with our eyes blindfolded. We are permitted merely to sense and guess at what we are actually experiencing. Only later when the cloth is untied can we glance at the past and find out what we have experienced and what meaning it has.” – Milan Kundera Two weeks ago, I [...]

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    Taking sides

    The page comes from the psychiatry intern on call. “There’s a situation with patient RB on the unit. Please advise.” We gather in the hall outside the patient’s room. There are already three – no, four – security guards standing several feet away with their arms folded. Backup. Ready. Ready for what? We whisper in [...]

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    Disrespect in hospitals isn’t just unpleasant. It’s unsafe.

    Read the full piece here Hospital bullies: they’re a minority, but they’re sizable enough that they can unfortunately set the tone for everyone else. Most health care providers have in their arsenal some juicy tales of mistreatment to tell, but most is far less glamorous. It’s micro-aggressions; and this is what creates a culture. There are [...]

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    Talking shop: when doctors forget to fill in the blanks

    “Ms. M,” the resident says, “I saw in your chart that the last time you had surgery you had a pulmonary embolism.” She nods with recognition: “I felt like I couldn’t breathe. It was really scary.” Then: “I sure don’t want that again.” The resident lifts up the covers and sees that the patient’s calves [...]

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    Because I work in a hospital, I can’t help you

    Had I met her anywhere but the hospital, I would have gone to her side. I would have asked her what was wrong. I would have offered to help. She was 99 years old and about to undergo surgery. Pre-operative holding is generally a busy place. Patients lie in gurneys, spending some last moments with loved [...]

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    But I remember you

    You may not remember me, but when I asked how you were you said “Alive.” A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone [...]

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