Seriously....

So the other day I had a patient who complained of headache. Here is how part of the conversation went (and might I mention that this is an adult patient):

Dr: Do you have any problems with your vision?

Pt: What's that?

Dr: When you see is it blurry or is it normal?

Pt: Oh, I don't know.

Dr: When you look at things, can you see them ok?

Pt: Yea, I can.

So either the education gap between me and this patient was large, or I really need to work on my communication skills...! I was having a hard time thinking of any other way to ask the question or be more clear. Really more a sad story than I funny one.

My first toenail removal

My first toenail removal was amazingly easy. The patient had an infection under the nail and it was almost falling off by itself. I didn't really know the steps of the procedure but my attending walked me throug it and before I knew it I was shoving a hemostat under the nail and prying it up. After that all I had to do was pull and there it was. Thank goodness for my masterfull anesthesia skills, a good digital block is key to a good nail removal.

Never a Dull Moment!

So one day I was working at a walk-in clinic on a Friday afternoon and I had the following patient encounter:

Nurse: What are you here for today?
Patient: My back hurts.
Nurse: Where does your back hurt?
Patient: I dunno, up here (touching upper back) and down here (touching lower back)
Patient: Do you think the doctor will give me some pain medicine? Because if I can't get any pain medicine I don't know what I'm doing here, I should just leave.
Nurse: I really don't know what kind of medicine the doctor might give you, how long has your pain been there?
Patient: Well about 2 weeks, but this pain in my low back has been there for like 2 years!
****
Nurse (to doctor): Just to let you know the patient in room 5 is asking for pain medicines.
Doctor: Well, I'm not going to give narcotics, but I'll talk to them and check it out.
****
Doctor: Nice to meet you, what brings you to the clinic today?
Patient: I need some more treatment for my herpes.

So Many Stories, so little....

There are so many random, interesting, funny, sad, whatever stories I've meant to archive in this space, but obviously it has not been happening. I could make a whole list of excuses... to little time, interest, energy, motivation, etc. But the stories are still there floating around in my memory, they won't be 'fresh' when I finally write them, but that is probably just as well. So coming someday... I will continue the "my first" series, like my first delivery, circumcision, suturing, death, chest tube, toenail removal ext. and also the "The other day I saw or did ____" series for other stories. So hopefully my memory will hold out until I can get whatever it is I need to write them down!

Paying back my sleep debt

during the month of june all of the hospital employees must complete our 'net learning'. On-line power point presentations about compliance, code pinks, & stroke team activation, each with a quiz at the end. the carrot they dangle in front of us is 'no christmas bonus if you don't complete all the modules!'

residents have a special module called SAFER which stands for something about sleep.... blah ..blah... residency.

in addition to recomending the impractical if not impossible (ie-you should never drive yourself home post call!) the SAFER module teaches that a person needs 8 hrs sleep per night, and when he does not get those 8 hours he incurs a 'sleep dept' that must be paid back!

well my debtor has come for payback for all of my intern year. My second year started on July first, and for my first month I work 8-5, M-F, no call. You'd think I'd be loving life and partying and using all that extra time for fun stuff. I feel just as, if not more exhausted now than I did all year! So apparently the time has come to begin paying back my sleep debt. I really have no idea how much I owe, but I've been getting about 9-10 hrs / night, so I've started to slowly may a dent in the surely massive sleep dept of internship.

off to bed with me!

baby overdose

recently I completed the required 6 weeks of pediatrics at my hospital's residency program. Our pediatrics rotation should really be call Newborn Nursery because all we see are newborns, even during our pediatric clinic hours we see the same babies we sent home just days before with a few 2 year old check ups sprinkled in and on a very rare occasion a sick visit from a 6 year old. But the morning rounds before clinic is the real exciting part: doing the exact same exam, writing the exact same note, and giving the exact same instructions to a dozen babies and moms every morning.

Even though I was blessed to have vacation during my time on pediatrics it was still too much, too many babies, too many bili's, too monotonous. That's how you learn, or so they say, by repetition. I do have my ER warnings speel down in Spanish and English!

During my rotation I told myself that I would take time out from the monotony of the paperwork and Ballard's exams and actually sit in a rocking chair and enjoy feeding one of the babies ... but it never happened, oh well. The take home lesson from the rotation is that I am so happy that I will not be a "Newborn Nursery" doctor full time, is anyone? if so how can they stand it?

an important deadline

so my economic hardship deferment paperwork on my medical school student loans is due soon. Because the sum of my student loans could feed a small country for a year, and my current salary can feed only a small household for a year, I get to put off paying back my loans for another year or 2 (and allow even more interest to accrue!) Good thing I love what I'm doing!