So a patient we saw a couple weeks ago died. He wasn't my patient or anything, but I did manage to botch his blood draw twice even though he had really awesome veins, and instead of being a whiny jerk about it like some people are on even the first stick when they're in the hospital primarily because they like dilaudid and would like more of it, instead he said it was no problem and asked if I wanted him to kick his family out if they were making me nervous.
Basically, the thing with him is he didn't seem very sick, and he was a nice guy. I mean, he had a lot of troubling symptoms, but he was a healthy guy, not a particularly old guy, and didn't have any risk factors. He didn't smoke, drink heavily, or have unprotected sex with IV drug abusing unimmunized bestiality-specializing prostitutes. He stayed in shape. He just got sick, got short of breath, and died extremely rapidly without much of anything medicine could do for him short of botch his blood draws while he was insisting he didn't have AIDS (he didn't). Weirdly, AIDS would have been a far better diagnosis. Weirdly as well, it was the one all the students were hoping he wouldn't have just before they discovered how much deadlier "idiopathic" is. If this were an episode of House, there'd just be some banter about how "idiopathic" means "f- if we know" and there'd be some miracle diagnosis at the 49 minute mark and this guy would go home to his wife. But, as mentioned, medicine is way more like Scrubs, so everything just carries along normally, and everyone's making jokes, and then they just cap someone in the last five minutes because it's sweeps week.
Weirdly, in this sort of thing, it's just a sort of depressing blip in your day before you go back to being told how unmotivated and incompetent you are before proving your maturity by framing one of your colleague's for stealing the other's reflex hammer. It's the way it goes. But it sucks sometimes.
Sep 17, 2009
Sep 15, 2009
So I did the whole 5K thing...
And woohoo, definitely a fan. Hooray for breast cancer research and running in Central Park. In celebration, our Heme/Onc lecture today was on breast cancer. I figured running in the 5K should make me exempt, but life isn't fair.
Speaking of life not being fair, this whole sickle cell/HIV combo everyone seems to have is a bitch. I feel genuinely bad for most of my patients, which should inspire me towards going into IM and helping them more, but more, it kind of inspires me to lean toward surgery since IM seems like a lot of playing with medications while watching people die. Not all of them, obviously. Oh, and lectures. Tons and tons and tons of lectures. I'm not knocking lectures, and more of them are clinically relevant than say, memorizing the essential amino acids, but it's SO much lecture. I attend way more lecture in clinicals than I ever did in basic sciences, not that that's saying much. I'm also doing more reading. I've already read enough of Blueprints that I'm searching for other books to buy because I need a more comprehensive coverage.
Oh yeah, the 5K (like I'm going to cover things in order?), over 25,000 people in Central Park. Very difficult to jog through unless you want to risk invoking the karma of pushing down breast cancer survivors, but still awesome, and still snagged a better time than usual for my 5K, helped by the fact that Central Park doesn't have the terminal hill of death that Prospect Park does.
My mom's moved to the city (upper east though; no Brooklyn for her!) so she came out to cheer, and I spent a good portion of the last weekend playing New York to New Jersey and back again Pong. Strangely, the forces of a GPS navigation system seemed hellbent on dumping me in Times Square as many times as possible, in one instance getting me there just in time to be caught in an angry 9/11 conspiracy theory mob. Oh joy. The other time, I just got the unprecedented joy of driving through it on a Friday night, which is surprisingly easier than walking through it.
Uhhh... this weekend, headed for the Jersey Shore with a bunch of H&Ps (History and Physicals) to write and relevant articles to read in the interim. IM is destroying a bit of my weekday hedonistic drives, but it shall not break the weekend!
Speaking of life not being fair, this whole sickle cell/HIV combo everyone seems to have is a bitch. I feel genuinely bad for most of my patients, which should inspire me towards going into IM and helping them more, but more, it kind of inspires me to lean toward surgery since IM seems like a lot of playing with medications while watching people die. Not all of them, obviously. Oh, and lectures. Tons and tons and tons of lectures. I'm not knocking lectures, and more of them are clinically relevant than say, memorizing the essential amino acids, but it's SO much lecture. I attend way more lecture in clinicals than I ever did in basic sciences, not that that's saying much. I'm also doing more reading. I've already read enough of Blueprints that I'm searching for other books to buy because I need a more comprehensive coverage.
Oh yeah, the 5K (like I'm going to cover things in order?), over 25,000 people in Central Park. Very difficult to jog through unless you want to risk invoking the karma of pushing down breast cancer survivors, but still awesome, and still snagged a better time than usual for my 5K, helped by the fact that Central Park doesn't have the terminal hill of death that Prospect Park does.
My mom's moved to the city (upper east though; no Brooklyn for her!) so she came out to cheer, and I spent a good portion of the last weekend playing New York to New Jersey and back again Pong. Strangely, the forces of a GPS navigation system seemed hellbent on dumping me in Times Square as many times as possible, in one instance getting me there just in time to be caught in an angry 9/11 conspiracy theory mob. Oh joy. The other time, I just got the unprecedented joy of driving through it on a Friday night, which is surprisingly easier than walking through it.
Uhhh... this weekend, headed for the Jersey Shore with a bunch of H&Ps (History and Physicals) to write and relevant articles to read in the interim. IM is destroying a bit of my weekday hedonistic drives, but it shall not break the weekend!
Sep 1, 2009
Sometimes a favor isn't a favor...
Hi again... still here trying not to violate HIPAA or torch my evals.
There's a couple other third year students from another school rotating with us. We had the last two just rotate off and now we just got two more yesterday. I had two patients and didn't really get a chance to get much of a history/physical on one yesterday because rounds started early, so today, since one of the students had no patients and wanted to do something, I asked if she wanted the one I hadn't done much on, since the patient had been really nice yesterday.
The other student enthusiastically agreed, so I talked to my remaining patient, checked the new labs and vitals and got ready to write up my progress note. I wandered by the other patient's room only to hear LOUD profanity carrying from the room as the student tried to get a history from a woman that was cussing the hospital and everything in it up and down.
Whoopsie. It's a testament to other student that she doesn't hate me now. I swear I didn't know!
In related news, I'm still not great at dealing with hostile patients when I actually have to talk to them. In the ED it's easy because you just walk by hastily while looking at a chart because you aren't charged with getting a 40 minute history and several follow ups while the patient screams at you.
On an unrelated note, I've discovered that it's only taken a few short months for me to be completely desensitized to genitals in all forms. I was pretty blasé about them before, but now it's just ridiculous. Fortunately this has taken place at the hospital and not in the subway. As I saw a man wandering naked through the halls dragging his bedclothes, my first thought was "Oh crap; I hope he doesn't trip over his blanket" the second "Oh crap; that means a decline in his mental status" and third "Oh crap; I hope Dr. X doesn't make us list all the differentials for mental status change. Where the frig is my textbook? Rounds start in 15 minutes."
Other things I'm learning as a medical student:
-With a few exceptions, you are In The Way. You will be reminded of this frequently.
-The thrill of the white coat wears off really really fast. At first it's a "I'm gonna be a real doctor!" The next day it's "Oh god, people are calling me doc and expect me to do something". The day after it's, "Hey, I can store all my crap in these pockets!" After about a week, it's "My shoulders are killing me! Why do I have all this crap in my pockets?" Yes, that's right... you can actually shove enough seemingly necessary stuff into your coat to cause permanent orthopedic damage. And Batman does it all with a belt. Git.
-The stethoscope does not grant status. What grants status is being so high on the totem pole that you just miscellaneously grab other people's stethoscopes and use them.
-No matter how much you read, any answer you give is going to be met with rolled eyes and "Oh my god". Lest you think that means not reading, think again.
-During conference room lectures on any floor, there are two temperatures: Balls-Hot and Tomb-Cold. Dress in layers and don't be too proud to grab a blanket out of the storeroom.
-Ramadan affords the opportunity to score free lunch tickets from fellow students; however, caution should be taken when teasing these individuals. Fasting + Getting Pimped = Cranky. Love ya, J ;)
-Noon conference = Resident/student naptime. Do not disturb. Those unable to sleep during noon conference due to a Mountain Dew bolus during lunch can entertain yourselves by taking pictures of your sleeping colleagues and superiors. Just remember to turn the flash off.
-If you forget to bring a 4X4 gauze pad into a patient's room when you do a blood draw or give a shot, the patient WILL bleed from the site of a tiny little needle hole as if you've opened up their aorta with a chainsaw. Sleeves, the bedsheets, or the packaging to the needle are considered poor substitutions for gauze. Crying, praying, swearing, and fleeing the room are also considered unacceptable.
-Protonix, Lactulose, Motrin, and Heparin.
-Kerley B lines are a myth perpetuated by radiologists to see how many medical professionals they can get to claim they see them.
-No, no one actually believes you're allergic to tylenol, toradol, motrin, aspirin, and codeine.
-Know all the system passwords. Know them early.
-Yes, it's exactly like Scrubs. No, it's nothing like House.
There's a couple other third year students from another school rotating with us. We had the last two just rotate off and now we just got two more yesterday. I had two patients and didn't really get a chance to get much of a history/physical on one yesterday because rounds started early, so today, since one of the students had no patients and wanted to do something, I asked if she wanted the one I hadn't done much on, since the patient had been really nice yesterday.
The other student enthusiastically agreed, so I talked to my remaining patient, checked the new labs and vitals and got ready to write up my progress note. I wandered by the other patient's room only to hear LOUD profanity carrying from the room as the student tried to get a history from a woman that was cussing the hospital and everything in it up and down.
Whoopsie. It's a testament to other student that she doesn't hate me now. I swear I didn't know!
In related news, I'm still not great at dealing with hostile patients when I actually have to talk to them. In the ED it's easy because you just walk by hastily while looking at a chart because you aren't charged with getting a 40 minute history and several follow ups while the patient screams at you.
On an unrelated note, I've discovered that it's only taken a few short months for me to be completely desensitized to genitals in all forms. I was pretty blasé about them before, but now it's just ridiculous. Fortunately this has taken place at the hospital and not in the subway. As I saw a man wandering naked through the halls dragging his bedclothes, my first thought was "Oh crap; I hope he doesn't trip over his blanket" the second "Oh crap; that means a decline in his mental status" and third "Oh crap; I hope Dr. X doesn't make us list all the differentials for mental status change. Where the frig is my textbook? Rounds start in 15 minutes."
Other things I'm learning as a medical student:
-With a few exceptions, you are In The Way. You will be reminded of this frequently.
-The thrill of the white coat wears off really really fast. At first it's a "I'm gonna be a real doctor!" The next day it's "Oh god, people are calling me doc and expect me to do something". The day after it's, "Hey, I can store all my crap in these pockets!" After about a week, it's "My shoulders are killing me! Why do I have all this crap in my pockets?" Yes, that's right... you can actually shove enough seemingly necessary stuff into your coat to cause permanent orthopedic damage. And Batman does it all with a belt. Git.
-The stethoscope does not grant status. What grants status is being so high on the totem pole that you just miscellaneously grab other people's stethoscopes and use them.
-No matter how much you read, any answer you give is going to be met with rolled eyes and "Oh my god". Lest you think that means not reading, think again.
-During conference room lectures on any floor, there are two temperatures: Balls-Hot and Tomb-Cold. Dress in layers and don't be too proud to grab a blanket out of the storeroom.
-Ramadan affords the opportunity to score free lunch tickets from fellow students; however, caution should be taken when teasing these individuals. Fasting + Getting Pimped = Cranky. Love ya, J ;)
-Noon conference = Resident/student naptime. Do not disturb. Those unable to sleep during noon conference due to a Mountain Dew bolus during lunch can entertain yourselves by taking pictures of your sleeping colleagues and superiors. Just remember to turn the flash off.
-If you forget to bring a 4X4 gauze pad into a patient's room when you do a blood draw or give a shot, the patient WILL bleed from the site of a tiny little needle hole as if you've opened up their aorta with a chainsaw. Sleeves, the bedsheets, or the packaging to the needle are considered poor substitutions for gauze. Crying, praying, swearing, and fleeing the room are also considered unacceptable.
-Protonix, Lactulose, Motrin, and Heparin.
-Kerley B lines are a myth perpetuated by radiologists to see how many medical professionals they can get to claim they see them.
-No, no one actually believes you're allergic to tylenol, toradol, motrin, aspirin, and codeine.
-Know all the system passwords. Know them early.
-Yes, it's exactly like Scrubs. No, it's nothing like House.
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