Island Med Student

If you’re reading this right now, chances are that you read a lot of blogs, and hence have heard of Twitter, a social networking and micro-blogging site. I must admit that I am not the hugest fan of social networking sites, in general. My friends had to force me, kicking and screaming, to join Facebook. Getting me to join Twitter was an even more difficult venture. But eventually, I joined both. I still have mixed opinions on them, but I’m starting to like Twitter a little bit more. (Probably has something to do with the fact that I can’t stand all those stupid applications on Facebook. You threw a turkey at me? Great!)

Many medically related blogs have begun posting “tweets” from a variety of sources. Some people even go as far to say that Twitter micro-blogging might eventually replace the conventional blogs entirely. I’m not so sure about that.

In the news recently, surgeons at Henry Ford Hospital in Detroit have been “twittering” surgeries live. Surgeons have twittered kidney surgery, brain surgery, and are posting more and more every day. Several other hospitals have also started twittering surgeries and other procedures.

There are obviously a lot of issues here. Some people are all for this new trend, and think that Twitter has created a new, and possibly better way of teaching medical students. Even if you’re not inside the OR, you can still follow the steps of a surgery, and you get to hear about the decisions that the surgeons have to make, and what goes through their minds during surgery. It provides a whole new perspective.

In addition to teaching, it provides the family with real-time feedback during the surgery. No longer is it necessary for the family to sit anxiously in the waiting room for the surgeon to come out and update them on the status of their loved one.

Some people are very against this new trend, however. One of the criticisms is that surgeons should be more focused on the surgery, rather than the twittering. But from what I’ve read, there is always a senior surgeon with the patient at all times, and they trade off on who actually does the updating.

There are also patient confidentiality issues. Patients always have to give permission to allow the surgeons to publish the surgery. But other types of medical twittering bring up more confidentiality issues.

Inspired by this concept, I recently decided to twitter my entire 12-hour night call on my family medicine rotation. Obviously, when I was busy with patients, I was unable to update. But I tried to update afterwards as soon as I could. So, here is a Twitter snapshot of my shift (there are a lot of random thoughts, so feel free to skip to the end if you get bored):

6:30 p.m. – On my way to hospital for night call. Yippee!
7:00 p.m. – In rounds now. Always find your surgeon!
7:32 p.m. – Patient died and came back!
7:46 p.m. – 71-year-old mean man presents to ED…
8:00 p.m. – One hour down, only 11 more to go, and no admissions yet.
8:34 p.m. – Admitted a patient with chest pain and nausea… I’m thinking ACS, costochondritis or GERD…
9:36 p.m. – SWAMPED! Just admitted 3 patients back to back… did a stool guiac.
10:20 p.m. – Patient has rales, pitting edema and positive Babinski… what’s wrong?
12:08 a.m. – I haven’t eaten in over 12 hours. I’m starting to feel the effects.
12:47 a.m. – Just helped stop a patient from attacking the resident because she was Muslim.
2:30 a.m. – Sustenance, finally!
3:00 a.m. – There’s nothing like hanging out at Dunkin Donuts at 3 in the morning!
3:40 a.m. – Brain is showing signs of sleep deprivation… if only I had slept last night.
3:45 a.m. – My nose has elves in it and a resident stole my penlight.
4:00 a.m. – Espresso + step up to medicine book + empty room + black eyed peas = strange fun
4:15 a.m. – “Is this real life?”
4:32 a.m. – I think I have liver spots.
4:44 a.m. – Ativan is your friend. Never turn your back on your friends.
4:58 a.m. – The title of the section of the book I’m reading: diarrhea pearls
5:14 a.m. – Dead Kendra walking…
5:21 a.m. – Sitting in the hospital lobby with homeless people. All my patients are sleeping.
5:37 a.m. – Drunk guy in ER pukes on me and says “I want my free phone call.” I said, “this is not jail!”
5:44 a.m. – Bored again and decompensating.
5:57 a.m. – I think I just pulled up the anchor on the reality boat.
6:00 a.m. – If no more admissions, I can leave in an hour. For goodness sake do NOT come to my hospital!
6:05 a.m. – Walking laps around deserted floor of hospital. Kinda creepy, but keeping me awake.
6:15 a.m. – Walking through ED always gives me a lot to be thankful for!
6:17 a.m. – I would be much happier right now if I were in scrubs.
6:21 a.m. – I wonder if you can OD on twittering.
6:30 a.m. – 30 minutes and I can go home if no new admits. Thinking about blocking ED entrance.
6:50 a.m. – 10 minutes to go. I just had a flat out hallucination.
7:05 a.m. – FREEDOM! The sun also rises….

Congrats if you made it to the end of my tweets! It’s kind of interesting for me to go back and read this in my now fully rested state. It gives me a fun perspective on what was not entirely a fun night.

My tweets are obviously not in the faintest bit as exciting as real-time surgeries. But hey, I made no promises! Anyway, what do you all think? Is twittering in medicine a good thing or bad?

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