The Not So Easy Firsts in Medicine

There are a lot of “firsts” in medical training. Some are really positive things that we love to talk about

like your first real patient encounter, your first delivery during obstetrics, or your first time diagnosing

something right. But less physicians talk about the difficult “firsts” like failing your first test, losing your

first patient, or being involved in your first code. These can be really difficult and can make you feel

isolated and alone. Training sometimes does not prepare you for these scenarios, which is why we must

talk about them so we can gain better insight and realize we all go through the same emotions.



Code Blue. These two words bring fear into every physician’s heart no matter how seasoned or what

they may tell you. It gets announced over the PA system in the hospital and can cause a tad bit of chaos

with people from multiple specialties running to the room called. It means a patient is dying and

requires immediate resuscitation.


I remember my first code blue like it was yesterday. He was only a teenager. He was an athlete with a potential sports career ahead of him. He was healthy with no underlying illnesses. He had such a bright future…until he rolled into our pediatric ICU.


I was on my first PICU rotation in residency. We got a call for a transfer from a nearby emergency

department. “We have a teenager in respiratory failure with pulmonary hemorrhage. We have

intubated him and are requesting a transfer.” He had been diagnosed with the flu just a few days prior.