NEW YORK, NY – Internal medicine attending Lauren Stevens was really impressed with her third-year medical student Steven Donnelly, in particular the energy and enthusiasm he brought to work each and every morning. When she asked him during end-of-month feedback today what was his secret, his answer came in two simple words: cocaine use.
“It all made sense!” Stevens told Gomerblog. She was finally putting the pieces together. “He would give these excellent presentations, but would always have to pause himself to slow his speech and catch his breath. I thought it was all anxiety, with how much he was sweating and occasionally clutching his chest. No wonder why he was popping aspirin each day.”
Stevens thought about it more.
“He also took really in-depth social histories, now that I think about it, like scary in depth. He would talk about drugs, some of which I didn’t know existed, or he’d use their street names like it was second nature,” Stevens added, saying that the social history was always the longest part of his presentation on any patient. She sank back in her chair, hit with an epiphany. “That also explains his frequent nosebleeds on rounds and all the bloodstains on his white coat.”
Thankfully Donnelly has been receptive to both feedback and counseling, and will plan to kick the habit.
“I started to realize,” Donnelly said, “that the main reason my presentations fell apart at the assessment and plan is because the withdrawal would kick in and I’d just collapse into the fetal position. The cocaine blues is real, you know? What? You don’t know? Oh… gotcha. Maybe I should stick with coffee.”
Stevens has some advice for health care professionals. “Next time you have a wide-eyed student who is a little too enthusiastic about something like the Krebs cycle, check for dilated pupils and ask for a urine sample.”