I Want to Be a Doctor
15- Passing Out
February 18, 2023
Today's question is from a first year medical student who asks "Did you ever pass out during a procedure?" Why yes, I did! And I'm here to tell you that you can have a tendency to pass out, overcome it, and no one will remember long term that it was you. https://podcasts.bcast.fm/i-want-to-be-a-doctor
Welcome to the I want to be a doctor podcast where insider information about what it takes to become a physician is available for anyone. I'm Dr. Robin Dickinson, a board-certified family physician and I will give honest answers to your questions. Today's question is from a first year medical student who asks "Did you ever pass out during a procedure?"

Why yes, I did! And I'm here to tell you that you can have a tendency to pass out, overcome it, and no one will remember long term that it was you. 

The time I actually passed out was completely unexpected for me. I was in a family physician's office watching a very small biopsy on someone's back. We had a really awesome program at my medical school where we got to be in a primary care office one afternoon a week every week for the first two years of medical school. The physician was about to cut into the skin and then I woke up lying on my back on the floor. I had my hair braided and pinned up on the back of my head so my landing was padded and the only part of me that was injured was my dignity. At the time, I thought I'd develop a reputation for being a weak person or something. But that same physician ended up scheduling all her toenail procedures for the afternoons I was there because she disliked them and I enjoyed them. I became quite adept at digital blocks (which means numbing up a finger or toe by injecting into the base of it) and at toenail procedures. Not only that, the same physician was one of the owners of the practice by the time I graduated from residency and she offered me a job. That was where I worked for the three years before I opened my own practice. The same staff were still there and after I'd been working there long enough to not have imposter syndrome anymore, I asked around and no one remembered me passing out. 

So remember, what's a huge deal in your life is a minor blip in someone else's. You are playing a lead role in your own life but you're only an extra in the lives of all the nurses and doctors you work with. In the credits, you'd be called something like "medical student with brown hair" or something. 

That physician gave me some tips before my surgery rotation so I wouldn't pass out again. By then I'd already done lots of toenail procedures but had never seen inside someone. And I used to be rather prone to getting lightheaded. And I'm going to share those tips with you. 

Most importantly, know the signs that you might pass out and get away from the surgical table before you do. Different people may have slightly different warnings but mine are that I get a flushed feeling in my face and my vision starts to grey out a bit. 

Have a plan for what to do if that happens. My sister's best friend is Jewish and very involved in her synagogue and she always says, "It's more embarrassing to pass out while holding a chuppa than to lie down on the floor." A chuppa is a wedding canopy that four people hold on poles. 

I actually told everyone for my first several surgeries that I'd passed out before and arranged ahead of time where I'd be allowed to sit down. I got some gentle teasing but I also found out just how many surgeons, anesthesiologists, surgical assistants, and nurses had also fainted. I didn't scrub in for my first couple surgeries until I was sure I wasn't going to pass out. Instead, I watched from a slight distance so I could walk away easily. The first time I scrubbed in, I made sure I was not standing too close for the same reason. It's hot in the surgical gown so the intern on my team grabbed me a couple cold packs from one of the floors for that first time and I slipped them inside my socks. That actually really helped. 

I made sure to eat a really good breakfast and lunch every day with lots of protein and didn't drink any caffeine. Before every surgery, I'd slip back to the resident break room and eat some salty crackers, a few pieces of cheese or a hard boiled egg, and drink some grape juice. I went through a quart of grape juice a day for the first week on surgery but after that I was fine. 

If you do pass out, don't worry. It won't happen forever and no one will remember it in the future. That's just one tiny episode in a very long career, and one you'll enjoy telling your students about someday! 

That's it for today. Subscribe, share with your friends and mentors; and remember to live the life that is right for you with your personality interests and values. 
Please send your questions to me at podcast@docrobinschool.com. That's podcast at d-o-c Robin like the bird school dot com.
Show notes are available on the podcast website linked below. 
This episode was sponsored by Dr. Robin's School, the first premedical curriculum for kids, and recorded and produced in beautiful, downtown Englewood, Colorado.