Day 0: Rounds
A series of essays from Round and Round We Go, an anthology of thoughts and reflections during patient rounds.
Rounds is an interesting word. It connotes something circular, or at least curved around the ages. It could mean something that starts, finishes, then starts all over again. Or up, down, then back up again, as Sisyphus did as he pushed his rock for eternity.
To doctors, rounds is a noun. the term we use when we visit patients. During rounds, we say hi, do a physical exam, and then write notes on what we did. “Will do rounds today,” a doctor might say. “Done with rounds?” says a colleague. Its origin comes from long ago when hospital wards were shaped in a circle, and thus going on rounds truly meant going around in circles.
Round is not how I would describe hospital wards these days. The way hospital wards are designed nowadays, we don’t actually walk in circles—it’s more like a zigzag or a maze than it is a circle. Yet the name persists, we still call it rounds, and somehow everyone knows what they mean.
Rounds is also a good way to describe the iterative process we go through daily. It’s more or less the same pattern of saying hi, asking for symptoms, doing a physical exam, and finally writing all of these in the patient’s record. We’re told that documentation is everything. Whatever’s not written never happened. The process repeats itself for every patient, then repeats for every day, over and over. And with each patient that leaves - whether dead or discharged - another is bound to be admitted, and the process repeats.
That’s what I’d like to capture here: the iterative, Sisyphus-like process doctors do daily and the stories that come with each round. I became a doctor because I like talking to people. I enjoy listening to stories and learning from other people’s lives. As you see more and more patients, you find that the most compelling stories have nothing to do with how interesting, how rare or complex the disease is. Ironically, sometimes the disease becomes the least intriguing part. As with most things in life, what’s captivating are the little things - the TV shows they watch, the house they grew up in, the meals they love, the people they choose to be with them when they’re sick, and the things they wish they had done on the brink of death. Health is our armor, allowing us the privilege to hide our scars, while disease strips off our layers one at a time.
The bedside is a humbling and invigorating place to be. But the exhaustion and repetition can kill the wonder and curiosity, and it takes extraordinary effort to keep it alive. This, this is my extraordinary effort to do that, to find stories and moments that inspire and interrogate; to actively seek the magic that led me to the bedside in the first place. Doctors are in an extraordinary front-row seat to life, disease, and death, and I remind myself to never lose sight of what a blessing that is.
