Zone 1

Getting to the San Francisco General Hospital on a Sunday requires taking one MUNI train followed by another bus transfer. The bus ride is quite long, especially the final ascent up this massive hill to get close to the hospital.

From the hill, you have to climb down and cross a foot path over some sort of highway and traverse a labyrinth of buildings to the hospital enterance. Getting to Zone 1 takes a little more work.

Once I got out of the rain and into the main hospital, I enlisted the assistance of a white coated resident. He politely guided me to the Zone 1. As I ventured forth, I could hear the seasoned resident say, "Wear gloves and have fun."

After making a few turns down a corridor, I finally made it to Zone 1, the area in the Emergency Room where all initial traumas are assessed. Today was my first day in the Emergency Room.

When I arrived, I was directed to the white board, where a group of doctors where quickly debriefing each other about the patients (it was time to switch shifts). I stood and listened and once the speaking was over, I introduced myself to the attending, who I would follow for the next few hours.

Within minutes, we had our first motor vehical accident patient. He was rushed to an exam room, where the initial assessement was made: he was connected to a monitor, his pulses were felt, lights were shined in his eyes, he was asked to move his legs, his lungs were checked, he was asked he if felt pain, etc. His presentation reminded me of Mr. Danovich, our first case in medical school. Very uncanny.

I assisted with moving the patient to his side. With one hand on his shoulder and one hand on his hip and on the count of three, we rotated him over to his side so the doctor could feel his back, while asking if he felt pain.

When the gel was squeezed on his abdomen for the ultrasound, the patient jokingly said through gritted teeth,"tell me if it's a girl or boy." Despite his humor, he was in severe pain and looked scared.

Today seemed like a slow day. Perhaps, it was the Superbowl. After we sent our patient off for further testing, my attending got reports about the patients on the floor from the residents. I stood and listened. After the second round of debriefing, we visited our patients.

The ER is an impersonal place; it is the first stop a patient makes before being transferred. My first experience gave me a better idea about what goes into admitting a patient into the ER and how the initial assessment is made. I will likely return to Zone 1 (and know I know the way).