By Eugene Y. Chan, MD
Somewhere around 3 AM in the morning at the Massachusetts General Hospital one day, I remember a particular instance of having to draw blood from a very ill patient. By that time, I had already worked for 20 hours straight, with my beeper ringing every few minutes. What is so urgent that requires a blood draw at this hour? I looked at the patient’s medical record and saw a history of HIV and HCV. This patient was in renal and liver failure. I looked for a suitable vein in the antecubital fossa but could not find any. I look elsewhere on the arm, but still no. My eyes were feeling heavy from my day and also staring closely in the dark to look for a thin blue vein that I could target. Finally, I found a potential vein, on the dorsal surface of the foot. It was so thin and collapsed, but it was my only hope. I knew that if I were not careful, I could indeed inadvertently stick myself, which could put me at risk for both HIV and HCV. I also knew that I did not draw the patient’s blood, she would have a high likelihood of not making it through the night. It is in times like this, where if your mind wanders, even for a brief moment, the outcome would be highly undesirable. This is when you need mental clarity, this is when you need that moment of unwavering focus. Have you been in a circumstance like this? Maybe not treating a patient, but interviewing for a most coveted job, giving the most important sales presentation, or pushing yourself to win that race? Fortunately, the outcome that morning was positive, the important medical tests were highly informative for the course of her care and the patient made it through the night. There are situations like that that arise often, and often unexpected, and you have to be prepared to make those yours. Stay focused and be at your best, always.