For my mid-rotation evaluation I presented an H&P on a 31 year old male presenting with abdominal pain and inability to tolerate PO x 4 days. The patient had significant past medical history of ulcerative colitis, had a proctocolectomy with diverting ileostomy done in November 2019, and was now POD 13 ileostomy reversal. The pain was sharp, surrounded his prior ileostomy site, and was relieved only by refraining from eating. Professor Herel provided informative critique with emphasis on organizing the chronological order of events. It was essential that my H&P properly sequenced information to make the story as understandable as possible to the reader. It should be clear what exactly happened on initial admission to the emergency room vs. what was going on post-operatively in the step down unit.

For my final evaluation I presented another H&P, this time featuring a 52 year old man with significant PMH of a pituitary adenoma s/p transnasal transphenoidal resection of a pituitary tumor. It was brought to my attention that it would have been a more exciting writeup had I written it from the point of view of the patient’s initial admission to the emergency room and not their recovery in PACU as I had written. For future rotations I should continue to work on exploring the bigger picture to ensure that I also focus on the initial complaints of the patient’s admission, since that is what brought them to the hospital in the first place.