In an ever changing world, medicine is filled with complex, fascinating, memorable, and unique stories. Podiatry residents especially see some life changing and rare cases thought their learning experience. With this in mind “The Residents – Vol 2” seek to answer one simple question:
What is the SCARIEST thing you have seen in residency?
Here we present just a few stories. You’ll meet a first year resident diagnose a rare disease. A second year resident receive a page in the middle of the night. A young resident unveil a scary image after a dressing change. This is just a few collection of stories submitted by residents on their unforgettable and SCARY experiences. All of our authors names have been kept private and anonymous for their protection. We hope you enjoy this collection of stories for the theme of Halloween in October, Hallux Magazine would like to bring you “The Residents – Vol 2“.
All our authors names have been kept anonymous for this special edition. We hope you enjoy these great stories by podiatry residents.
“It was a dark night three years ago, during the first year of my residency”
It was a dark night three years ago, during the first year of my residency. Myself and my co-resident, Dr. L, were alone in the resident room. It had been a quiet day and a suspiciously quiet evening. In the midst of the deafening silence, the pager went off.
We called the number back to realize it was a new floor consult. The strange part was that they couldn’t give us a proper consult because they couldn’t explain what was going on. We grabbed any and all supplies available; ready for anything. We were optimistic and new but so self-assured that we could handle anything.
We marched down to the floor to into the room to find the patient in bed with his feet … covered.
The suspense killed us, but we were immediately hit with a smell quite unlike anything we had experienced before. We drew the sheets back and we saw what appeared to be something we could only describe as paws!
It was two feet completely and totally covered in…
We thought to ourselves, we hit the jackpot; it must be a case of hypertrichosis, also known as werewolf syndrome!
Following further inspection, we began to realize something was a little…off.
We tried to wade through the thick fur and began to realize that the fur was not his.
He had continued stepping on his carpet which was covered in his animals’ fur over the previous weeks. He continued to do so, and the hair began getting matted to his skin. It was our responsibility to clean it all off. This revealed interdigital macerations, which was holding all the hair on his foot. We each grabbed a foot and went to work.
To this day, it was the scariest task I had ever performed as a resident.
Story by Dr. BS
“I was covering my first wound care clinic without senior assistance”
During my second month of residency in my PGY1, I was covering my first wound care clinic without senior assistance. Toward the end of the clinic, a patient who had been under the care of my attending for about one year for the same ulcer presented for follow-up care.
The treatment had been largely the same, using a collagen dressing, absorbent foam, and total contact cast (TCC) throughout the majority of his treatment course. The attending was in a rush as he was leaving to catch a flight, and he briefly looked at the patient’s foot, told me it was stable, and ordered the same treatment (including a TCC).
I had never seen the patient before,
but I could tell something did not look right.
The attending insisted the ulcer was stable and I could modify the treatment if needed. He promptly left the facility after seeing this patient. During one of my first encounters as a resident in wound care clinic, I had to make a decision:
do I listen to my attending, or do I listen to my gut?
Without hesitation, I began examining a plantar ulcer that was mostly callus covered. After debriding the thick layer of callus, I noted a small ulcer, measuring 0.5cm x 0.5cm x 0.2cm, that was dusky-red in appearance at the level of the second metatarsal head. The patient was elderly and did not speak much that day. I asked the nurse to check his vitals: his blood pressure was 90/60 and his heart rate was 120 beats/min. I noticed he was diaphoretic, and I sensed he may be shivering. I did not know exactly what was going on at the time, but I knew something was going on.
I informed the wound care staff that I would like the patient to be admitted, and I called my attending to inform him. He did not seem happy as he was out of the state, and he told me to ask another attending if he could cover for him. The emergency department noted the patient’s vitals were unstable, so he was admitted with a diabetic foot infection with possible septicemia. His X-rays did not show any signs of any gas gangrene.
The next day was a weekend,
and I went to round early in the morning on the patient.
As I unwrapped the dressing, I noted a horrific appearing foot.
I gently introduced my finger at the plantar ulcer site and did not feel any resistance: my finger went directly through all fascial planes, and the seemingly liquified skin and soft tissue dripped out of the foot. There was about 10 mL of dishwater pus in the ulcer site, and my finger probed all the way through to the level of bone. I quickly sent a clinical picture and called the attending covering and told him I suspect necrotizing fasciitis, but he doubted my assessment.
“Give me an LRINEC score and let’s go from there. I do not think the OR wants to come in for a wound debridement on a Saturday”.
I went back into the patient’s room, and in the 20 minutes I was away, the foot was even worse, and the toes were turning purple, black with hemorrhagic blisters forming. I sent another clinical picture to my attending. This time, I sent the picture to the senior resident as well, who supported my assessment and contacted the OR and my attending to come for immediate surgical intervention. By the time everything was set up for surgery, the patient’s infection spread more proximal than the point where a trans-metatarsal amputation would be effective. We performed an immediate guillotine amputation.
At the conclusion of the surgery, the remaining bases of the metatarsals, dorsal and plantar tendons and neurovasculature remained exposed without adequate viable skin and soft tissue for wound coverage.
Shortly after surgery, I received a phone call from the patient’s original attending who said “good thing we didn’t send him home in a TCC doc; he had quite a scary infection.” Without a doubt, this patient would have likely passed away if he went home in a cast that day with flesh-eating bacteria in his foot.
Story by Dr. MJK
“My residency started out in the Emergency Department”
My residency started out in the Emergency Department.
It consisted of a lot of night shifts and saw some of the scariest things I’ve ever seen.
I think it was my second or third day when I experienced a big case. I remember an ambulance brought in a 28-year-old (my age) patient with a Lucas CPR machine attached into the Emergency Room.
I will never forget…
the machine pumping in his chest to try and save his life.
Seeing death firsthand is incredibly scary no matter what specialty you are in.
But that wasn’t my only experience seeing something memorable.
In addition, the main hospital has a big psychiatry department. I remember one night the emergency doctor picked up a patient in one of the psychiatry rooms. The patient was very physical with the staff that the patient actually had to be put into an isolated room. The patient had to be placed in a room with an outside door lock because he was being so aggressive. I can still vividly remember see him banging on the door with multiple nurses and medical personnel just watching. I had honestly never seen anything like it, and it was terrifying.
I think residency is all around scary. Transitioning from a student to doctor is terrifying. You are trying to take care of patients, but at the same time trying to avoid getting nervous so you don’t mess up. You are always wondering…
“Am I going to be a good enough as a doctor?”.
It’s scary learning about yourself and your actual strengths and weaknesses, not just ones you made up for interviews.
Residency is a scary and rewarding experience, and I think each situation has made me a more empathic, hardworking doctor.
Story by Dr. KD
“the phone call we received during my 2nd year…”
The scariest moment of my residency career was the phone call we received during my second year to be deployed to the COVID-19 units in March of 2020.
I was placed on night shifts.
When I arrived, I was given a list of about 30 patients and was told to…
keep everyone stable till the morning shift.
I was advised to call the senior resident if a patient was close to coding or the oxygen saturation level dropped below 85%.
As a podiatric surgery resident, I could have counted the number of times I had performed CPR on a human being/plastic model on one hand. However, all that changed during my first night shift.
We had approximately 15 codes throughout the first night.
Each code, each death, each tragic middle-of-the-night phone call to family members was a reminder of how fragile human life truly is.
I was scared of contracting the virus and spreading it to my family at home. We had such little information on its transmission and its effects.
It was also difficult to comfort patients while wearing :
a plastic shield,
multiple gowns and
The quiet, empty hallways of the hospital in the middle of the night felt eerie. It was hard to see patients struggling to breathe, searching our eyes for answers to their unfortunate condition. It was even more difficult to deny families permission to come see their loved ones in person.
This experience transformed my spiritual vision and made me more grateful for each breath that my body takes effortlessly. Although those months felt like a clip from a horror movie, I am grateful for the life lessons that were bestowed upon me.
Story by Dr. S.V.