The Admission Note – Joshua Smith

Josh Smith is one of the amazing house officers joining the blog this year. Based in Palmerston North, he’s passionate about medical education, and emergency medicine.

The Admission Note

A twenty-something year old male
Presents, tachycardic and pale
On a Monday morning in mid-November
For a reason he can’t quite remember.

He says the last thing he can recall
Is drinking beer from a funnel in a University hall
He admits to some loss of consciousness
But denies anything else on his problem list.

A difficult historian, he has some vague recollection
Of auscultation, percussion, or was it inspection?
Of pressures, oncotic and hydrostatic
And something about beta-blockers and the asthmatic.

He is previously fit and well
Any history of other masochistic decisions?
None, as far as I can tell
Except for a habit of last minute revision…

Family history is also unremarkable
The pedigree chart and punnett square
Offer no indication of why he’d embark upon
A career likely to cost so much hair.

On physical examination
His abdomen is tender to palpatio-
End of bed first, please!
Ah, yes.. how could I forget those ritual initial decrees!

He is but a youth, evidently in some distress
In the fledgling doctor’s typical dress:
Checked shirt, trimmed beard, pager at waist like a sword
With tremulous gait, he walks onto the ward.

At last we must consider our top Differential
For this lad and his peers, awash with potential
Aspiring physician? Surgeon? Saviour of lives?
For now, a purveyor of docusate and sennosides.

The Impression is of an adventure, about to commence
Five hundred new doctors apnoeic in suspense
Deep down, though, they know that survive they can,
As long as they stick to the following Plan:

1. Admit under Medicine
2. Recall Mum’s advice again:
3. “Don’t forget to hydrate!”
4. Now hurry, rounds start at Eight…