Fever is rising.
Now 38 Celsius.
Patient is Stable.
Heart Rate is Tachy.
Above 90 per minute.
Patient is Stable.
Breathing is labored.
Less than three seconds between.
Patient is Stable.
Patient ambulates
at speeds that are not quite safe.
Patient is Stable.
There is no doctor,
no IVF or pressors.
The patient is me.
I am running fast.
My altered mental status
Is Euphoria.
As I stay in SIRS,
it provides me the mental
clarity to heal.
These haikus represent the situational dependency in medicine. Many times, we use clinical criteria, calculators and guidelines to label and diagnose patients. However, these calculators can mislead providers to formulate incorrect plans by forcing patients into a “cookie cutter/one size fits all” model. In this poem, I use objective data to illustrate a patient in sepsis according to the systemic inflammatory response syndrome (SIRS) criteria. This criteria takes into account specific criteria to include heart rate which many times can be elevated or more commonly described as tachycardic which I refer to as “tachy.” Additionally, we often treat sick patients that meet SIRS criteria with intravenous fluids and vasopressor medications. These common treatments are symbolized by the terms “IVF” and “pressors” respectively. Introducing these terms as common medical colloquialisms further entrenches the reader in the culture of medicine as a whole. Embedding these phrases also helps to create a feeling of authenticity for how I would personally describe these treatment options when talking to other medical providers.
However, this is actually representative of my baseline during longer runs, workout sessions or even after a few flights of stairs in the hospital. I offset these concerning vital signs with the paradoxical statement of “patient is stable” to bring the reader’s attention to an otherwise sick and concerning clinical picture. This poem helps to articulate the notion that just because a patient meets certain criteria does not mean we have to immediately treat them; taking in the full clinical context is important. This is a difficult lesson that I have learned multiple times as a medical student and I anticipate that I will continue to learn as a practicing physician.
Another theme that this poem accentuates is the idea of pursuing our passions despite our commitment to a career in medicine. For me, running has always given me euphoria I get from the “runner’s high.” This steady state allows me to have balance in life. This is something that was emphasized heavily at my medical school but seemed to become less of a priority while on clerkships and clinical rotations. This poem serves as a reminder to its readers that it is okay (and highly encouraged) to maintain wellness as we provide the best care when we are our best selves.
Image credit: running by Seán Venn is licensed under CC BY-NC-SA 2.0.
Resident Physician Contributing Writer
Walter Reed National Military Medical Center
Ervin (Erv) is beginning his general intern year at Walter Reed National Military Medical Center and recently graduated from the Uniformed Services Univerity of the Health Sciences in May 2022. While in medical school, he was the co-director for the on-campus peer-led curriculum aimed to foster conversations about diversity, bias, discrimination, and inclusion in both medicine and the military. His interests include medical education, promoting diversity, and utilizing the arts to augment the healing nature of medicine.