Him: Ella, what is the PMI?
Me: The point of maximum impulse?
Him: No
Me: Hmm. The beat of the heart at the apex?
Him: (sigh of frustration) No. Do you even know where it is?
Me: (worried and thinking I'm crazy) I believe that would be the left anterior mid-clavicular line at the fifth intercostal space.
Him: Absolutely not! Ella, you do realize that if you don't know something as elementary as the PMI, BASIC HUMAN ANATOMY (!), that I will have to fail you on this rotation. Its the FOURTH intercostal space!!!!
Me: (gulp holy shit what am I missing????)
Him: Go look it up.
Me: Yes sir.
Him: ( a few minutes later....) Well......? What does it say?
Me: Um, it says the point of maximum impulse is palpated at the left anterior mid-clavicular line at the fifth intercostal space
Him: LET ME SEE THAT!!!
Then, because he was pissed, he pimped me on a bunch of ridiculous shit that nobody in the group knew.
(now to be fair, though the literature does say the 5th intercostal space... I have also seen it as "between the 4th and the 5th")... but for Christ's sake he threatened to fail me over that! And mind you I have no bad history with the guy... it was only my 2nd day working. First day he said "good job"
Day 1 my attending was mystified how no one could hear a grade I/IV murmur while the patient was talking to us.
ReplyDeleteSometimes attendings are just unrealistic.
Whoa, that's crazy behavior. At least he can't fail you. Best of luck working with him for the rest of your rotation.
ReplyDeleteIn children it is palpated at the 4th intercostal space.
ReplyDeleteAnon~ I actually thought about it later and thought maybe that was the case. Thanks for the info.
ReplyDeleteHe probably has a small penis.
ReplyDeleteSo he WAS asking about the point of maximum impulse? I found that whole exchange confusing.
ReplyDeleteYou'll get through this rotation and then put it behind you. Sometimes people are just in a bad mood.
YOU found the whole exchange confusing, lol? Me too!!!
ReplyDelete