Anamnesis is a podcast from 乌鸦传媒 where health professionals share stories reveling in intangible lessons beyond EMRs and ICD codes. We honor and highlight the humanity and soul of caring for people -- patients and one another. Each episode features two or three contributors who share their stories around a particular theme with musical interludes from musician doctors and clinicians. In-between-isodes report from recent medical conferences about stories shared there and a brief rundown of top studies and developments. For season one, we have five feature episodes lined up!
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Here, on our first episode of Anamnesis, we open with the theme of "First Time." The path to becoming a clinician is filled with firsts – there is no more obvious time for that than July, when medical students become interns, who then become residents, who then become attendings.
We're not only talking about the obvious milestones – first patient, first procedure, first death. Medicine is a journey of lifelong learning. Your firsts don't end with your formal training, they continue on no matter what phase of your career you are in.
So, for our "First Time" here at Anamnesis, we lead in with a series of firsts from three brave physicians who have shared their stories with us:
Chapter One, A Ziploc Bag of Brains: Judy arrives at her first death scene only to find the dead body has disappeared. Story told by Judy Melinek, MD, a forensic pathologist.
Chapter Two, Gut Punch: Edwin wrestles with the roller-coaster of his first time embroiled in a malpractice suit. Story told by Edwin Leap, MD, an emergency medicine physician.
Chapter Three, All Eyes: Ajay steps up to the podium, performs a live case for the first time at a medical conference. Story told by , an interventional cardiologist.
Episode produced by
Hosted by Amy Ho, MD
Sound engineering by
Music by , a.k.a.
Theme music by Palomar
Note: We produce Anamnesis for the ear. If at all possible, we strongly suggest listening to the audio. Much as we love the written word, voices convey nuanced intonation and emotion. We provide a transcript below, but these are generated with speech recognition software and light human editing, and there may be minor errors. Please double check the actual audio before any quotation or reference.
Judy: When we got there, all that was left was a helmet and there was some brain material there and some skull fragments, but there was no body. The first thing was what happened to the body? Where did it go?
Amy: Hi, everyone. This is Amy with the first episode of 乌鸦传媒 Anamnesis, a podcast dedicated to the stories that make us the clinicians we are today. Anamnesis is a really interesting word, loaded with meaning for us as physicians. It comes from a Greek word meaning remembrance and it's now used in medical terminology meaning a patient's account of a medical history, something we are all familiar with. However, it also means the remembering of things from a supposed previous existence. This last definition of anamnesis is what speaks to me as the soul of our mission here
As physicians, every patient interaction we have become a part of our personal and professional lives. They impact us in ways that are not always foreseen or predictable, and they can be subtle, but also remarkably profound and transformative. So much so that we really do morph into a new existence because our very understanding of the world of medicine and of humanness can be colored in a new light. This podcast is about showing these transformative moments, those that we hold for our lives and remembrance, that change who you are as a clinician. We open here on our first episode with a series of firsts from three brave physicians who have shared their story with us today. Here's Judy, a pathologist, who finds life and death on her very first death scene.
Judy: The first death scene I ever went on we had gotten called out to the middle of an intersection in Manhattan. I really don't remember where the intersection was. I just remember it being right in midtown with skyscrapers and buildings, and there was a huge construction site. This crane had fallen over on to someone. What had happened was there was a hurricane warning the day before and they had strapped it down because of high winds. Then the following morning, the crane operator either didn't know that it was strapped down or had forgotten, and he started the engine and pulled the motor and then the crane didn't budge, so he gunned it. At that point, the crane went up and then bent up over itself backwards and collapsed. People had scattered, but there was one person who was hit by it. It was a construction worker.
The crowd was actually not interested. It was a typical New York day. They were going about their own business. It's different from when someone is gunned down in their neighborhood, for instance. It was anonymous in some ways. Then there were looky-loos. There were people who were looking, who stopped and looked for a little while and then moved on, but mostly they were fascinated by the equipment because they were too far away to actually see what we were doing.
I was a resident in pathology and I was rotating through the New York City medical examiner's office. It was my first time doing a forensics rotation, so I didn't really know what to expect. I had spent the past few years just working in a hospital under fluorescent lights and in scrubs and white coats. Now, I was expected to, in addition to performing autopsies, going out to death scenes. During this part of the rotation, I was shadowing the medical, legal death investigators, who are the medical examiner's office first responders to any death scene. I had been assigned to spend the week with them.
We got a call. I was in the office space that we share and we went out to the scene. Unfortunately, because of the way the crane had gone through the intersection, they blocked off traffic in all directions. Even our ability to get to the scene was impeded because of the traffic. We don't have lights and sirens on the morgue van, so we can't go past anything. At a certain point, we just pulled over, parked, and just walked the remaining three or four blocks to the scene and showed them our badges. I didn't have a badge or a jacket at that point, so everybody kind of looked askew at me, but the investigators vouched for me. They let me go underneath the cord and line which said, "Police line. Do not cross." That was the first time I'd ever been able to do something like that before. It feels weird. It feels like you're breaking the law, like you're breaking the rules, but I knew I was there for a reason. I was there both to document what we saw and also to learn.
We were called out because of the death scene, but when we got there, all there was left was a helmet, his hardhat, some brain material, and skull fragments, but there was no body. The first thing was what happened to the body? Where did it go? In a panic, we went over to the police and said, "What happened? Why did you even call us out here? The body is not here. Where did he go?" and they said that they had taken it to the emergency room to get it out of public view, which they were not supposed to do. Then the next five minutes was me listening to the death investigator berate the police officer for allowing the paramedics to remove the body just because they didn't want it in public view -- when it's really the job of the medical examiner's office to investigate the death -- and we couldn't do that without the body. All we did was we scooped up the skull and brains into a Ziploc bag that they had, and then we went in search of the body.
The lesson I learned at that point was that we had jurisdiction of the body and no amount of convenience or horror is a reason to remove a dead body from a scene without having the coroner or medical examiner evaluate it first to make sure that there's been no foul play or disruption of the evidence. We need to photograph it. We need to document it, so that is what I had learned that day. I remember that because it wasn't something I'd ever thought of before. It's only when you start doing death scene investigation that you realize how important it is to preserve evidence, to photograph it, to look at it again, to have a set of eyes on it that are experienced and know what they're looking for. Because if you don't pick up on the fact that there is injury in a particular place or that there are drugs at the scene, you could potentially put other people at risk. You have a responsibility to the public to make sure that the environment is safe. When someone dies, a thorough death investigation uncovers safety aspects that impact everyone. Even today, I occasionally get to scenes where bodies have been declared dead, but moved anyway for whatever reason because people are not familiar with the law and familiar with the functions of the medical examiner. It compromises cases. It compromises evidence. It raises questions after the fact.
What we did is we got back into our morgue van with the Ziploc bag of brains and skull, and then we drove to the nearest trauma center, which hadn't heard of him and didn't know what we were talking about. Then, I think the medical, legal investigator called dispatch and said, "Where did they take him to?" and finally got information that he had been taken to another hospital that was close by, but second choice. What was amazing is the next day I got to see his autopsy. I didn't do the autopsy. A colleague of mine did, but he was so healthy otherwise. It's just that his brain was damaged and his skull was fractured in a way that we refer to as an "eggshell skull fracture."
I went home and I was on the playground with my son and my husband. We started chatting on the bench, and of course, he wanted to know, "What did you do today?" I told him about going to the death scene. When I described the autopsy findings that his head looked like an egg that you'd smashed on the counter, it's called an eggshell skull fracture. "Isn't that cool?" and there was just this long gap as he waited and goes, "No, that's not cool. That's not cool at all." That's when I realized that I had already started to transition from person to a forensic pathologist. I think you lose a certain amount of your humanity when you go out and see these incredibly traumatic things. I learned at that moment that I couldn't necessarily speak about my excitement without understandably horrifying some people because it is a really exciting job. It is really fun to go out to a death scene or a crime scene and figure out what happened and do an investigation such as what we do, but at the same time, we have to be sensitive to the incredible pain that people have experienced, the trauma that people who saw the death may have experienced, and obviously, to the grief of the family.
I think we are generally a little bit more open with our colleagues about our day-to-day experiences and we maybe sometimes one-on-one use humor or be dismissive of things in ways that if anybody was listening in they would think that we were horribly callous or uncaring. I think it's a coping strategy. I think all physicians do it. I've heard it from surgeons. I've heard it from emergency room physicians that we use terminologies that dehumanizes patients such as the kidney in room 354. He's not a kidney. He's a human being who had a kidney transplant, but he's not a kidney. There have been many times since then that I've gone to death scenes and it's very difficult because you have family members who are yelling, "Why aren't you doing anything?" and you are doing what you're doing. It's just you can't save them anymore and the best you can do is document the evidence.
The importance of the medical examiner responding to a death scene where it's in a place where people work -- and it's things like in an industry or an industrial accident, things like that -- is because our investigation may play an important role in assessing safety for other people. This is where the public health aspect of our job kicks in figuring out, for instance, whether the employee was on drugs or whether the employee was doing something that put themselves at risk, whether they were wearing safety equipment or not. Those can all play into our autopsy examination and we can discover certain things that can help elucidate why the incident occurred. In this particular case, obviously, he wasn't doing anything, but just drinking his coffee. The real investigation had to do with the crane operator, not with the victim.
But in other cases that I've done since then that involve industrial incidents, sometimes it's the victim who's made an error or who is intoxicated or who has a heart attack on the job and gets injured because they're having a cardiac event. All of these are factors that need to be assessed in doing an autopsy on someone who dies on the job. My entire fellowship was a learning process, but this was the first time I ever went to a death scene and it was dramatic and scary, and really hit home about how important it is to have experienced investigators at a death scene to prevent injury to other people.
Amy: Wow! What an incredible story from an unusual perspective. First, death is a milestone in every physician's medical training, but first death scene? This story just felt like something straight out of CSI. What Judy said, though, about the callousness we develop witnessing some of the atrocities that we witness could not have rung more true with me. Even from behind the safety of hospital walls where I think we're a bit sheltered from the rawness of some of these tragedies, I think we're still all guilty of using our crassness as a defense mechanism.
When you think about it, compared to our corporate 9 to 5 friends, we have very unusual work lives. We touch people on a daily basis, usually literally. We see in full force the things others only see as news clips, and patients confide in us private details that would be unheard of to tell a complete stranger. At times, it can be unnerving. It can be grotesque and we don't always have time to process it like normal human beings, so we swallow it quickly and shovel it down with a swig of academic discussion and a bite of intellectualism. But remember, it's okay to process and unpack and chew thoughtfully and with empathy because that's the longevity that we all need in this field. But speaking of longevity, we turn our sights on to something else that can be unnerving and certainly cut a medical career short. I'm pleased to introduce here Edwin, an emergency physician, with a very honest and at times cringeworthy story of his very first lawsuit.
Edwin: My name is Edwin Leap and I'm an emergency medicine physician and columnist, and I practice in a small hospital in rural South Carolina. I've been in practice for 26 years since residency and I want to talk to you today about the first time I faced malpractice litigation.
Edwin: I hadn't been out of residency very long when I received notification of a patient that unfortunately had passed away. The thing is these lawsuits come up over things we don't expect, and they tend to ambush us, so I had no idea this was coming. But there I was looking at the paper and realizing that I had a lawsuit pending. Honestly, it's like a punch in the gut. It's hard to describe to someone who hasn't been sued before, but you pull the paper out and you look at it and you try to make sure that it's actually you and actually someone you saw. You go to the computer in the hospital or back in those days that it happened ask for the records and the chart. You pour over it to see what you did or didn't do, what you've been accused of, or what you could have done differently. It's really disruptive and terrifying.
The reason is, for most of our educational process in medicine, we're taught to be terrified of malpractice. We're taught that it's something that's looming everywhere and that we should try not to practice defensive medicine, but we should make sure we practice defensive medicine. We order and test and document and look in the hopes that we'll never face litigation, and yet, there it was. The paper was in my hand. The attorney's name, the patient's name, the family's name, and all of it pointing to the suggestion that I had done something really wrong.
Not to bore you with the details -- which, of course, you can find in the National Practitioners Databank if you choose to look -- but I'd seen a patient with pneumonia, not realized they had pneumonia, apparently, because it just wasn't evident to me on the exam. They came back and were diagnosed with pneumonia and unfortunately passed away later. I'm not going to try to go into details of what did or didn't happen or defend or not defend. The case was ultimately settled -- as so many cases are -- but the process of going through it is just so hard because, in the end, it really strikes at the essence of who we are as physicians.
That's what happened to me. I'm asking, "Wow! Did I do that? Am I bad? Am I a bad person? Am I not trained well? Am I a bad physician?" At that point, I'd passed my board or education exams for the American Board of Emergency Medicine. I'd been in practice a few years. I thought I was doing a good job. I'd come from a good medical school and a good training program, and yet, here I was being sued.
I remember talking to people about it. The attorneys and the hospital risk management people are all fairly nonchalant about it. "Did you get the paperwork?" "Yeah, it's a lawsuit." Yet, they weren't being sued. I was being sued. They weren't the ones who were questioning the very essence of who they were and what they did for a living. That was me. That's what lawsuits do. They cause us to really look at our identity because unfortunately our identity as physicians is often just that. It's easy to lose who we are as individuals and replace all that with physician. After years of doing that in premed, med school, and residency, when someone says, "Maybe you did a bad job. Maybe you just really messed up," it just strikes at the chord of who we are. It's hard to avoid that reality.
I think that probably has to do with the fact that many physicians who are sued have suicidal thoughts. Now mind you I didn't and I was very anchored in my faith and in my love of my family and the support of my wife and friends and partners. I never felt that badly about it to the point that I would actually consider harming myself, but it was no fun. I remember going through the discovery process and answering questions. I remember going to the deposition and answering more questions. I also remember being in the deposition and having my attorney, who was appointed by the state, sit across the table from me and fall asleep in the deposition. That was very reassuring. I remember going back over and over again and looking at the chart and wondering, as we always do, "What could I have done differently?" More than once I did that because that's what we do. We question, reflect, wonder and reconstruct in our heads, and we reimagine and we re-envision the whole situation. That's what it does to you.
Edwin: It was a very unpleasant experience to me, but it wasn't a horrifying experience. I have to say that, because in the end, I decided that it was simply a transaction. I decided that medical malpractice was simply part of doing business as a physician and that it wasn't personal. Sure, it was personal to the people who were suing me, to the family members, but it wasn't really personal to me in that sense because they weren't attacking me as an individual. I realized eventually they were just upset and trying to recover losses for what they thought was an error. Yeah, I was the physician, but it didn't, in the end, change who I was. However, it's not quite that simple because even though that was my first lawsuit and since then, my only malpractice lawsuit, I still have to report that story over and over and over again. Any time I apply for a medical staff application, any time I have to talk about my medical history, for any reason whatsoever as a physician, I end up having to reprint and revisit that as if it were some badge or some mark that I had to carry around, like Jean Valjean's paperwork after his release from prison. "Yes, this is me. I'm Dr. Leap. Yes, I was sued. It's who I am."
It's an annoyance because everything is constructed to make it seem as if that defines you, but it doesn't define me. It didn't define me and it won't define me. I would say to all those people out there who have been or are being or will be sued in malpractice litigation, this is not the thing that defines you and you cannot let it be that. You have to recognize that there are other things in your life that matter more: the people you love, the things you love, the job you love, the patients you love. Anchor yourself in those things and don't be caught up in asking yourself if you actually are good or worthy, or asking yourself if maybe you're really a bad person because you really aren't.
Ultimately, I think it's important to remember this. This is very key. Over the course of a career, many physicians will have malpractice litigation. Lawsuits are part of the process, as I said earlier. But over the course of the same career in which one is sued, physicians will cause so much more good, will help so many more people than they'll ever harm that it's okay. Sometimes we just get sued, but think of the thousands upon thousands you helped, though. Think of the good you did and let the error, that error, whether it was real or not, whether you win the suit or don't, let that thing slip into the background and not be the thing you focus on. I reminded myself malpractice, even if we commit an error, is simply that. It's an error. It's not a sin. It's not a mortal sin and it's not the end of the world. We will go on and we will do good things and we will help people and make a difference. That was what I learned from my first lawsuit. I didn't enjoy it. I would not recommend it if you're given the option to be sued or not sued, but it did not change my life dramatically. It did give me perspective.
Amy: I relate so much to this story. I'm an emergency physician as well, and I think we take such pride in never batting an eye in the face of really crazy situations. I can code a patient with complete calm. I can get a difficult airway in without a sweat, but wow, you mention the L-word, lawsuit, and I can't think of a single physician whose heart doesn't skip a few beats. I think this just further shows how the firsts don't end after training. Hopefully, this will never happen to you, but if it does, I find Edwin's words actually surprisingly comforting.
We train so hard to be physicians, not to be in depositions or respond to subpoenas, but here is someone who lived through it, survived to tell the tale, and still is able to find joy in medicine. It's just an incredible story of vulnerability, fear, distress, and recovery, in a way, probably the same emotional stages our patients go through when they present to the ER. Now, lawsuits and litigation are undoubtedly a great fear of many physicians, but to move into something that is a great fear of many people, we have Ajay, a cardiologist here with a story on his first time with public speaking.
Ajay: This is Ajay Kirtane at Columbia University Irving Medical Center and NewYork-Presbyterian Hospital in New York. I thought I would talk today a little bit about first-time experiences at medical meetings because I think a lot of people ask whether medical meetings still need to exist. With everything that you can do digitally now, you might think there's so many ways to replicate that experience. But having been through this through the years, I can tell you I vividly remember various first experiences that I've had at medical meetings that honestly I don't think you can re-create any other way than being there.
Maybe starting off, the first medical meeting I attended was I think the American Heart Association. It might have been in California in Anaheim quite some time back. I remember after registering I got this big book of what all the sessions were because in those days they didn't have apps, and certainly I couldn't see everything. But it was amazing, like to be a kid in a candy store of all these various different sessions you could go to.
You can fast-forward a year or so. I think I remember my first late-breaking trial or first big-trial presentation. This was the first presentation of data on drug-eluting stents. I always thought I wanted to do interventional cardiology, but I wasn't sure. I remember being in the way back of a room with standing room only, and there was all this excitement for the trial to be presented. It seemed like this device would be somewhat of a breakthrough. When the data was presented that showed the rate of restenosis was zero, there was an audible gasp. You could feel the excitement in the room. It was amazing.
As a trainee to experience that, I didn't really even know how that would affect patients that I would care for subsequently, but it felt like such a big deal and I was just witnessing it. I felt honored to be part of that. Now, we do know that nothing in medicine or in life has a 0% rate of recurrence, and so clearly that wasn't true. After that, there were potential issues identified with drug-eluting stents and now iterations and iterations in technique. But I still remember being there and it was super exciting.
Ajay: The first time I had to present, I did not bring family members of mine or any close relatives. My mentor was certainly there and there were probably a few colleagues there as well. You try to avoid looking at them because you worry that you're going to stumble even though they're trying to give you support. There's a lot of practice that goes into it. I practiced in front of a mirror. I practiced with a timer. It was funny. I think I might have asked my wife, at the time, to critique what I was saying, but she's not in medicine, so she really couldn't understand very much. She just told me, "You were talking really fast," which is something that I do, and so I try to slow down and then that set my timer stuff off a little bit. But I thought overall it was a good experience. I didn't feel, at the time, like anybody was being malignant. Certainly, having gotten through it, it felt like I had almost earned a badge and that I belonged because I got through it without anything untoward occurring to me.
I just remember being so nervous because I was going to be in this room and it really didn't matter how many people there were. I just felt exposed, that I would have to go up there and present something, and then people could critique it and ask questions and that sort of thing. Someone gave me advice that basically said, "This is something you worked on. You worked really hard on it, and because you've worked really hard on it and you know all the data inside and out," which I did. I wasn't just somebody who was going to write a paper that I didn't know anything about. "You're the expert. Even if you're nervous, you're the expert. Just remember that when you get up there." That gave me confidence and I got through it.
Typically, when you're a trainee and you go up there, oftentimes people are benign. I think sometimes in certain systems, perhaps the U.K. and others, there's this history of essentially asking tough questions just to bring the mettle out of the person up there, but thankfully nobody really did that. There were a couple of questions that I had to answer somewhat thoughtfully, but because I knew the data, I got through it and I can't tell you the rush I felt after that that I'd gotten through it. I felt like I actually belonged in a field that I ultimately joined.
I still remember the first live case that I transmitted by myself to a major meeting, and live cases, there's always some trepidation about it because the patient always comes first. You want the patient to do well, and you're willing, if needed, to cut off the transmission feed. But at the same time, you also recognize that if you have specific expertise in something and other people don't, then this is a great medium by which to convey how you might do a procedure. It's not just about technical wizardry. It's about being thoughtful and considering the complications, and being able to preempt those from happening through your preparation. I find that's a really, really compelling force of live cases.
This live case that I had to do was a carotid stent procedure. That's a procedure for patients that have plaque buildup in their carotid arteries. If it gets to be sufficient severity or if the patient has a TIA or a stroke, a threatened stroke or a stroke, then at some point, there's a consideration of either doing surgery -- which is the gold standard procedure to remove the plaque -- or a stent procedure, which can be equivalent to surgery in terms of the long-term outcomes as long as it's done safely with an experienced operator. In this particular case, the patient was too high risk to have the surgery done because of severe other heart artery disease. That's why the patient was selected for a carotid stent procedure.
What happened is the first case, which was going to be done primarily by the senior operator, got a little bit more complex. Not complicated, but just more complex. He was stuck in that room and then we had to go live from my room. It was basically me by myself. There were several extenuating features about this case. First, was that this was a friend of a colleague of mine at the hospital. The colleague of mine asked if they could be in the control room to watch the live case. Ordinarily, you really don't want colleagues or family members from a policy standpoint to be watching a case, not for any other reason other than if something were to happen to their loved one or their friend, it's unpredictable in terms of how they might react. For the nursing staff and for everybody else involved, we often do not permit that. But the point that was obvious here is this was a live case transmission, and so there were going to be other physicians watching. There's no way, really, legitimately that I could have said no. That was one aspect of it.
The other aspect is that my dad, who is a retired cardiologist and internist, happened to be visiting D.C., which is where the meeting was, and so he said, "I'd love to go and watch." There was a little bit of added nervousness because my dad was in the audience. This colleague of mine was going to be in the control room, but I knew I was going to be fine because the senior operator was going to come in. We went live and I went on. I still remember we had prepped one device, and unfortunately while talking and prepping the device, I prepped the device incorrectly. I immediately noticed that and I'm certainly not going to use an incorrectly prepped device in a patient, and I didn't make light of it, but I came clean and I said, "Sometimes I think in every case there can be one thing that goes wrong. Fortunately, this happened outside the body. I prepped this incorrectly, so I'm just going to prep it again, and then we're going to proceed." I remember looking up at my colleague in the control room hoping that they hadn't heard it and got more nervous for their friend. But after that, everything was smooth sailing. The case went great. The patient did great. I still follow this patient to this day almost 10 years later. I'm good friends with that colleague. My dad was proud, so I guess all is well that ends well.
People often ask, "Why would you do live cases? What benefit could there possibly be to the patient?" I will tell you that not only having done many of them, but also moderating, there are plenty of times when suggestions are made by the panelists and/or moderator that are really, really good suggestions and actually help the procedure and the care of the patient. Sometimes we particularly pick cases where we know there's a little bit of controversy and actually ask the moderator and the panel, "We could use your help. What do you think ought to be done?" We could certainly make that decision on our own, but it is helpful to have a panel of experts in that way. Most of the times when we ask patients afterwards, "Did you have any untoward experiences or what did you think about it?" most patients, they're somewhat sedated, but they can kind of hear things. They don't really report any different type of experience, but that's something we want to be sure that we monitor prospectively going forward.
I think from the attendee perspective, the benefits are that you can get exposed to things that you otherwise wouldn't do. For instance, in the case that I was talking about, your carotid stenting case, there are many people who don't do those cases. Having seen how it gets done sometimes with cutting-edge technology that they might not otherwise have, they can appreciate how it could be done and that might be something that they would want to get trained on or something that they feel, "No way. I can't get trained on because this is not for me." Those are some benefits.
The other benefits are to watch how a theoretically expert operator gets through and troubleshoots situations because not everything is a walk in the park. Sometimes procedures can get complex and there are specific decisions that need to be made. There are certain preemptive strategies that have to be undertaken to prevent complications. Watching a good operator do that, I've learned a lot. They're techniques that I incorporate into my own practice after having seen an expert do them. I think it's important, though, that many safeguards have to be taken. Patients do need to have appropriate consent. The case selection has to be appropriate. The conversation must always be respectful at all times. There are, as I said, safeguards where one person is the primary operator. The other person is the primary commentary person, so there's a lot of sophistication that has to go into it. It's not so easy to just say, "I'm going to do a live case," and action upon that, but I think if they're done right, they can be an extremely valuable teaching tool for procedural specialties.
I think those are some basic impressions of firsts at meetings. I would summarize by saying I've been fortunate enough to have those experiences -- many others, including doing live cases at meetings -- and I just find it something that really can't be replaced by any other medium. I really hope that these meetings continue in a variety of ways, not just because I need to be featured -- I don't -- but just for the networking, the collegiality, and all of that. I'm more than happy to sit and watch my colleagues, fellows, and other people present so I don't have to be presenting, but I think that live activity portion of it really is irreplaceable.
Amy: I'm really reminded here of the Shakespeare quote, "All the world is a stage and all the men and women merely players," because there is the literal stage, like Ajay's presentations. But in a way, it's all a stage. The deposition is a stage. The death scene a stage and your local practice, whether it be exam room or office or operating room or emergency room, we are all just players. It's humbling. Just like these stories of firsts are humbling and reminding us that no matter how long we're on this stage that we call medicine, we will always continue to have firsts.
Thank you all, again, for sharing your time with us today and listening to our First Time episode of Anamnesis on our first time. Special thanks, also, to our team at 乌鸦传媒 and our producer, Nicole Lou. We look forward to sharing stories like this and more with you all this season. If you like what you heard, subscribe on , , and , or wherever you get your podcasts. If you have a story you'd like to share, please email us at anamnesis@medpagetoday.com. We'll include links in the show notes and we will see you all next time.
Physician Storytellers
Judy Melinek, MD, is a forensic pathologist and CEO of PathologyExpert, Inc. Her New York Times bestselling memoir, co-authored with her husband, writer T.J. Mitchell, is . They've also embarked on a medical-examiner detective novel series with , now available from Hanover Square Press.
Edwin Leap, MD, is an emergency physician. He practices full-time in a rural community hospital in South Carolina. He is a writer and blogger and has spent many years practicing in rural and critical access facilities, including locum tenens work for Weatherby Healthcare. He and his wife have four children.
, is Associate Professor of Medicine at Columbia University Irving Medical Center (CUIMC) and Director of the Cardiac Catheterization Laboratories at NewYork-Presbyterian Hospital/CUIMC. Kirtane is a leader in interventional cardiology, specializing in the care of patients with complex coronary and peripheral vascular disease.