{"id":1590,"date":"2017-01-12T08:23:25","date_gmt":"2017-01-12T12:23:25","guid":{"rendered":"https:\/\/www.themspress.org\/blog\/?p=1590"},"modified":"2017-02-03T12:08:25","modified_gmt":"2017-02-03T16:08:25","slug":"lunch-chats","status":"publish","type":"post","link":"https:\/\/www.themspress.org\/blog\/lunch-chats\/","title":{"rendered":"Lunch Chats"},"content":{"rendered":"

It\u2019s 6:30 AM. I have one hour to see four patients before morning rounds. This seems like ample time, and it is\u2014it just isn\u2019t the best<\/em> time. My patients are still sleepy. They aren\u2019t in the mood to listen to me talk about meal planning or exercise regimens (at the crack of dawn, I wouldn\u2019t be either). Each morning, I wake my patients up, ask them pertinent questions, and perform a focused physical exam. Then, I let them get back to sleep. Yes, I would see them again during morning rounds, but no, seeing them twice is not enough. I realized early in my clinical education that if I really want to make a difference, I need to visit my patients after lunch<\/em>.<\/p>\n

I was motivated to visit my patients in the afternoon after hearing the following wise words from one of my attendings: \u201cthe patient you see at 7:00 AM is very different from the one you see at noon.\u201d<\/p><\/blockquote>\n

In the morning, sometimes as early as 6:00 AM, patients are sleepy. It\u2019s much harder to engage them in conversation. In the middle of the day, after they\u2019ve eaten lunch, they are often looking for an engaging visitor.<\/p>\n

When I started third year, I wanted to heal every issue on my patients\u2019 problem lists. Inpatient medicine is driven by a patient\u2019s \u201cchief complaint,\u201d and the management of long-term health issues is left for follow-up with a primary care provider. This is a practical system, but it is still unsettling. I was never convinced that Ms. B, who came in with a toe ulcer, would continue to manage her diabetes with a \u201clow carbohydrate diet\u201d and regular glucose checks.<\/p>\n

When Ms. B was on my team\u2019s service a few months ago, our daily visits to her room generally entailed checking the status of her toe. She received accuchecks every four hours, and her blood sugars were generally well-controlled, but would she really continue to eat this healthy at home? I wanted to find out. After I started visiting Ms. B multiple times a day, I learned so much more about her health obstacles. I learned that she often starved herself the entire day and binged on one \u201cfeast\u201d at night. She thought she was being healthy by only eating one meal! I explained that her eating pattern was messing with her body\u2019s metabolism, and I gave her a presentation I had made a few years ago about affordable healthy food choices available at the local supermarket.<\/p>\n

Attendings and residents work extremely hard, and they don\u2019t often have enough time to sit with every patient and discuss life choices. As a medical student, I have this time. I\u2019ll never know if Ms. B implemented my suggestions, but I do know she left the hospital with more than a healed toe. Since then, I\u2019ve been visiting my patients after lunch\u2026I\u2019m always surprised by how much I learn.<\/p>\n

 <\/p>\n

Photo courtesy of Am Kaiser<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s 6:30 AM. I have one hour to see four patients before morning rounds. This seems like ample time, and it is\u2014it just isn\u2019t the best time. My patients are still sleepy. They aren\u2019t in the mood to listen to me talk about meal planning or exercise regimens (at the crack of dawn, I wouldn\u2019t […]<\/p>\n","protected":false},"author":22,"featured_media":1591,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false},"categories":[1,9,409],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/1590"}],"collection":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/users\/22"}],"replies":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/comments?post=1590"}],"version-history":[{"count":1,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/1590\/revisions"}],"predecessor-version":[{"id":1592,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/1590\/revisions\/1592"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/media\/1591"}],"wp:attachment":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/media?parent=1590"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/categories?post=1590"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/tags?post=1590"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}