A Love Letter to PM Rounds

By Aparna Ragupathi

*All names have been changed for patient and staff privacy

It’s 4:12 PM when I leave the PACU. One of the chaplains in the hallway smiles at me, and I realize I’m still wearing my OR bonnet. I take it off and toss it in the trash can by the security desk. On my phone, I scroll past the class group chat notifications and Uber Eats deals to find what I’m looking for.

A text message. “PM rounding on 5T,” one of the surgical floors at our hospital.

I trade my phone for the folded patient list in my back pocket. The elevator beams me up to 5 Tower and I find my residents in front of room 6. The fishbones on Jamie’s list have numbers now, which feels like a full tank of gas. We meet Carter in room 6, Jeannine’s brother. He brightens up when we tell him that, because his sister’s LFTs are down, we can add Tylenol to help with pain. It’s a familiar name, a medicine they have in their cabinet at home. To Carter, this is a sign that things are going back to normal. He squeezes Jeannine’s hand.

Ms. Thompson isn’t in room 9 when we stop by, but we see her on the way to room 13. She’s walking with her daughter, who has her eyes and talks just like her. She’s a physical therapist, and she’s very good at taking her mother on walks. Ms. Thompson laughs and pats her daughter’s arm. I like seeing Ms. Thompson like this.

In James Pearson’s room, the four of us collectively describe the hospital cafeteria so that his father can get him some solid food. You can tell that I like the protein shakes from the way I recite the flavors, that Jamie frequents the salad bar, and that John has tried every pudding concoction in the dessert fridge. James Pearson now wants to try a bit of everything. He gives his father a respectable shopping list. Yesterday, he decided he liked the chicken broth more than the vegetable broth and told us that he will give us a full review of the solid food when we see him tomorrow. With a sigh and an eye roll, he agrees to our chief resident’s request for him to eat more peanut butter and cottage cheese. Thanks to PM rounds, we’ve learned that James Pearson loves to cook and knows more about food than we do.

Ms. Baker is watching National Geographic in room 14. She turns the volume down so we can see her drains better. She tells us she loves animals. At home, she has a dog and two cats. Her sister takes good care of them while she’s here.

I follow the team through the stairwell shortcuts as we go down and up, and then back down through our patient list. We finish back on 5 Tower, and as they sit down to do their notes, I see a tail from behind the nurse’s station. A nurse practitioner gasps and squats down to greet Jack the therapy dog. I go up to his owner and ask if he’s still seeing patients. I pull my list back out and ask if he can stop by Ms. Baker’s room. And maybe James Pearson’s.

I tag along with Jack to visit Ms. Baker, who is overjoyed. Jack licks her hand, and she can’t stop smiling. A blessing, she calls him.

***

When I first told people I wanted to go into surgery, I was often met with surprise.

“Aren’t you a people person?”

“I thought you’d do well in primary care.”

For some, the thought of operating on patients under anesthesia or having limited follow-up periods meant that meaningful connections were few and far between in surgery. And in the darkness of morning rounds, it could be easy to let patients become their abdominal exams and NG tube outputs.

In the daylight, during visiting hours, I get to catch a trademark James Pearson eyeroll, be proud of Ms. Thompson’s daughter, and cheer Ms. Baker up with a therapy dog. In clinic, my mentors draw diagrams on the exam table paper to explain procedures. Residents take a knee to be eye-level with family members in the ED. Patients hug attendings during their two-week post-op visits, and some send their friends and family to the same surgeon who operated on them. Sometimes, as a medical student on surgery, I get to hold a patient’s hand when they go under general anesthesia.

Thanks to PM rounds, I know that surgery isn’t just about what happens in the OR. Through quiet moments and conversations, surgeons build trust and incredibly meaningful relationships with their patients. They treat people, not just problems. So, as a people person, I can’t wait to become a surgeon.

Aparna Ragupathi is a 4th year medical student at Robert Wood Johnson Medical School who is applying for general surgery residency in the upcoming match cycle. She is a writer and a Spanish-English medical interpreter that is passionate about patient-surgeon communication and understanding the effects of social determinants on surgical outcomes. She is also a proud member of the blog and podcast committees at AWS.