Well it's official, I'm 1/3 of a doctor.
That is, if you measure it by the licensing exams.
I've passed the first step of the boards - which means I'm allowed to keep being a fake doctor. And it also means that I will be able to continue bringing you more stories from those adventures.
Saturday, July 23, 2011
Wednesday, July 20, 2011
Code Assist!
Some more amusing stories from recent encounters:
~~~~~
Our attending referring to an elderly Italian patient: "Be nice to him, he might be in the mafia!"
~~~~~
On an intern's progress note: "Discharge to sniff." I'm not sure if that means to smell the patient before discharge, but I'm pretty sure they meant to write "Discharge to SNF" which stands for Skilled Nursing Facility.
~~~~~
Me to a patient: Is your COPD worse than your baseline?
Pt: Oh yes, much worse!
Me: What makes you say it's worse?
Pt: Well, I know it's really bad when I can't hit a cig. I mean...when I can't take a deep enough breath to even finish a cigarette - I know that my lungs aren't good.
Me (only slightly sarcastic): That sounds...terrible.
Note: The patient refused smoking cessation help and asked if she could take her oxygen tank outside to smoke.
No...no, you cannot.
~~~~~
A common occurrence in the hospital: The attending spoke very loudly and slowly to a Spanish-speaking patient who had an interpreter with them. The patient isn't hard of hearing, or slow to comprehend...they just don't speak English. Speaking slower or louder doesn't suddenly give them understanding.
~~~~~
An elderly patient was told that he may need to have back surgery and replied "I would rather die right now than have to go through that!" Later on, when he realized that surgery was his only option for being able to walk again he said:
Pt: I have a really tough decision to make!
Me: What are you deciding between?
Pt: Well, I'm not sure what to do! I either need to have the surgery so I can live in my home again, or I'm going to have to live with my daughter because I won't be able to live alone.
Me: What are your thoughts on that?
Pt: I'm honestly not sure if surgery or my daughter would be worse.
~~~~~
Occasionally over the hospital-wide speaker system, we hear a "Code Assist" called. Those codes are called when someone who isn't a patient needs help. Often, it means a patient's visitor or family member has fainted or fallen and needs assistance to be sure they aren't seriously hurt - but there were some amusing codes called recently. When a code assist is called, several high level physicians have to respond and rush to the area...just imagine high ranking physicians rushing to these codes:
One Code Assist was called recently because someone walked in the main entrance doors and kindly asked the information desk where the ED was. Taking that as a sign that the person must need serious help, the volunteer decided to push the code assist alert button rather that just direct them to the correct doors. A team of 10 doctors came running, just to point someone in the right direction...
My favorite code assist call happened in the bathroom. A woman, I'll call her Jane, was using the restroom when she realized that there wasn't any toilet paper in her stall. Jane asked a woman in the next stall, Renee, if she could help get her some toilet paper. Instead of simply handing the woman some toilet paper, Renee decides to walk out to the nearest information desk and say "There is a woman in the bathroom who needs help" and then walk away without further explanation. Next time you ask for toilet paper, consider if you would like it delivered by 10 doctors.
~~~~~
~~~~~
Our attending referring to an elderly Italian patient: "Be nice to him, he might be in the mafia!"
~~~~~
On an intern's progress note: "Discharge to sniff." I'm not sure if that means to smell the patient before discharge, but I'm pretty sure they meant to write "Discharge to SNF" which stands for Skilled Nursing Facility.
~~~~~
Me to a patient: Is your COPD worse than your baseline?
Pt: Oh yes, much worse!
Me: What makes you say it's worse?
Pt: Well, I know it's really bad when I can't hit a cig. I mean...when I can't take a deep enough breath to even finish a cigarette - I know that my lungs aren't good.
Me (only slightly sarcastic): That sounds...terrible.
Note: The patient refused smoking cessation help and asked if she could take her oxygen tank outside to smoke.
No...no, you cannot.
~~~~~
A common occurrence in the hospital: The attending spoke very loudly and slowly to a Spanish-speaking patient who had an interpreter with them. The patient isn't hard of hearing, or slow to comprehend...they just don't speak English. Speaking slower or louder doesn't suddenly give them understanding.
~~~~~
An elderly patient was told that he may need to have back surgery and replied "I would rather die right now than have to go through that!" Later on, when he realized that surgery was his only option for being able to walk again he said:
Pt: I have a really tough decision to make!
Me: What are you deciding between?
Pt: Well, I'm not sure what to do! I either need to have the surgery so I can live in my home again, or I'm going to have to live with my daughter because I won't be able to live alone.
Me: What are your thoughts on that?
Pt: I'm honestly not sure if surgery or my daughter would be worse.
~~~~~
Occasionally over the hospital-wide speaker system, we hear a "Code Assist" called. Those codes are called when someone who isn't a patient needs help. Often, it means a patient's visitor or family member has fainted or fallen and needs assistance to be sure they aren't seriously hurt - but there were some amusing codes called recently. When a code assist is called, several high level physicians have to respond and rush to the area...just imagine high ranking physicians rushing to these codes:
One Code Assist was called recently because someone walked in the main entrance doors and kindly asked the information desk where the ED was. Taking that as a sign that the person must need serious help, the volunteer decided to push the code assist alert button rather that just direct them to the correct doors. A team of 10 doctors came running, just to point someone in the right direction...
My favorite code assist call happened in the bathroom. A woman, I'll call her Jane, was using the restroom when she realized that there wasn't any toilet paper in her stall. Jane asked a woman in the next stall, Renee, if she could help get her some toilet paper. Instead of simply handing the woman some toilet paper, Renee decides to walk out to the nearest information desk and say "There is a woman in the bathroom who needs help" and then walk away without further explanation. Next time you ask for toilet paper, consider if you would like it delivered by 10 doctors.
~~~~~
We don't count.
Resident 1: Why do they have the med students work so much?
Resident 2: It's not as bad as residency.
Resident 1: Sometimes it's worse! We get more days off! Don't they have work hour restrictions?
Resident 2: I don't think so. They don't need them.
Me: Why not?
Resident 2: Because your decisions don't count, so we don't care if you're tired.
Well...I'm glad we got that straightened out!
Resident 2: It's not as bad as residency.
Resident 1: Sometimes it's worse! We get more days off! Don't they have work hour restrictions?
Resident 2: I don't think so. They don't need them.
Me: Why not?
Resident 2: Because your decisions don't count, so we don't care if you're tired.
Well...I'm glad we got that straightened out!
Friday, July 15, 2011
I don't like adults.
My night week ended up being slightly different than expected. I was told to not go to lecture so I could have more time off, then also told to not go into work Thursday night because I had already worked enough nights in a row. So the week wasn't quite as bad as it could have been, but I still worked 56 hours in 4 days.
My week also wasn't quite as amusing as my first week and thus I don't really have any stories that can rival last week's blog. Although I do have some observations:
~~~~~
I don't like adults. I really don't like adults - at least in the healthcare setting. Chances are, if you're reading this - I like you and you're the exception to the rule - but I found adults very frustrating this week. 90% of the adults I admitted from the ED (Emergency Dept) had their health issues because they had done something to get themselves in that position. Not only that, but they won't own up to the decisions they've made. I'm not perfect - I've made unhealthy decisions (such as the massive quantity of chips I ate yesterday) and I've been non-compliant with medications...but I would not be shocked, or blame other people, if something happened as a consequence of those decisions. A 70 something year old man who had smoked for 50 years asked me why I thought he had COPD. A woman who refused to take her prescribed medications was shocked that her blood sugar was over 500 (normal is <100). A woman came in with "excruciating pain" but refused to take the recommended meds in the ED because she knew better than the doctors what would be the right meds for her.
All of that to say - I know it's only been two weeks, but I'm leaning even more towards pediatrics. It really hit me when a woman came in to the ED and I was supposed to examine her and get her story but all I wanted to do was check out her 4 day old baby.
~~~~~
I also witnessed my first code blue this week, which is basically when someone's heart stops working. The patient was brought back to life after a few shocks, but it's most likely only a matter of time until he wont be able to be revived. It was a strange realization during the code knowing that I could be a few feet away from a patient that may die any second. It was an interesting reminder that at any point I could be seeing someone die right in front of me - which isn't a side of medicine you can really prepare for.
~~~~~
My week also wasn't quite as amusing as my first week and thus I don't really have any stories that can rival last week's blog. Although I do have some observations:
~~~~~
I don't like adults. I really don't like adults - at least in the healthcare setting. Chances are, if you're reading this - I like you and you're the exception to the rule - but I found adults very frustrating this week. 90% of the adults I admitted from the ED (Emergency Dept) had their health issues because they had done something to get themselves in that position. Not only that, but they won't own up to the decisions they've made. I'm not perfect - I've made unhealthy decisions (such as the massive quantity of chips I ate yesterday) and I've been non-compliant with medications...but I would not be shocked, or blame other people, if something happened as a consequence of those decisions. A 70 something year old man who had smoked for 50 years asked me why I thought he had COPD. A woman who refused to take her prescribed medications was shocked that her blood sugar was over 500 (normal is <100). A woman came in with "excruciating pain" but refused to take the recommended meds in the ED because she knew better than the doctors what would be the right meds for her.
All of that to say - I know it's only been two weeks, but I'm leaning even more towards pediatrics. It really hit me when a woman came in to the ED and I was supposed to examine her and get her story but all I wanted to do was check out her 4 day old baby.
~~~~~
I also witnessed my first code blue this week, which is basically when someone's heart stops working. The patient was brought back to life after a few shocks, but it's most likely only a matter of time until he wont be able to be revived. It was a strange realization during the code knowing that I could be a few feet away from a patient that may die any second. It was an interesting reminder that at any point I could be seeing someone die right in front of me - which isn't a side of medicine you can really prepare for.
~~~~~
Friday, July 8, 2011
I "have an intense face"
Next week I'm on night shift - which will be quite the adjustment! I work Sunday night through Thursday night from 5pm-7am. Five days in a row of 14 hour shifts will be tough, especially with trying to adjust my sleep schedule at the same time. The worst will be Monday/Tuesday. I have to work 5pm Monday night - 7am Tuesday morning. Then I have just 5 hours off to drive home, eat, sleep, shower, and drive back. Then I have a 5 hour lecture followed by another 14 hour shift. So I basically work 14 hours, have 5 hours off, then work another 19 hours. I'm not sure how I'm going to survive that one!
~~~~~
Here are some of my favorite quotes/stories from my first week:
~~~~~
On a radiology report I was reading: "Patient was short of breast and therefore laying flat was difficult for her." It's tough for me to lie flat as well.
~~~~~
A transgender (M2F) and likely high patient gave me an interesting interview (as a note, I have no disrespect for the transgender population, this particular patient was just quite the character) :
Me: Do you identify as transgender?
He/She (imagine in the most stereotypical flamboyant male voice possible): Yes.
Me: Would you prefer to be referred to as "he" or "she"?
He/She: You know girl, I just don't even know!
Me: What do you identify as your sexual orientation?
(Still) He/She: You know girl, I guess homosexual. But I love girls too. I got a sister, and she's one of the coolest people I know. I just love hanging out with girls too. But I guess I'm gay.
Me: (Silence...trying to figure out what the answer was to my last question...)
He/She: (Patient hits the button that turns off the lights to the room) DID THE SUN JUST GO DOWN?!
Me: Um...Maybe! (It's 8am...)
This patient's tox screen on admission was positive for cocaine, opiates and alcohol. Also, the patient was dozing off in the middle of the conversation, sometimes mid-sentence...until the sun went down - then it was party time!
~~~~~
One of my colleagues had to deliver the news to a patient that her lab results came back positive for gonorrhea and chlamydia. Before the doctor was even out of the room the patient was quickly calling her fling: "*#&% you! You gave me chlamydia!"
I was down the hall and could hear the screaming as the doctor politely dismissed himself from the room.
~~~~~
Resident: Do you med students (we aren't important enough for names yet) know what field you want to go into?
MS 1: Maybe OB/Gyn.
Resident: I could see that. What about you?
MS 2: Family Medicine!
Resident: I totally would have guessed that, it really suits you. (Turns to me) What about you?
Me: You seem good at guessing - what do you think?
Resident: Something intense. Maybe surgery.
Me: Seriously? Why?
Resident: You have an intense face. You should do something intense.
Me: What does that even mean?!
Resident: I don't know...but you should do something intense.
Me: I was thinking Peds actually.
Resident: No way - that doesn't suit you at all! (She's spent about two days with me). You should do Med-Peds if you insist on Peds!
Me: We'll see. But I'm still thinking Peds...even if it isn't intense.
~~~~~
~~~~~
Here are some of my favorite quotes/stories from my first week:
~~~~~
On a radiology report I was reading: "Patient was short of breast and therefore laying flat was difficult for her." It's tough for me to lie flat as well.
~~~~~
A transgender (M2F) and likely high patient gave me an interesting interview (as a note, I have no disrespect for the transgender population, this particular patient was just quite the character) :
Me: Do you identify as transgender?
He/She (imagine in the most stereotypical flamboyant male voice possible): Yes.
Me: Would you prefer to be referred to as "he" or "she"?
He/She: You know girl, I just don't even know!
Me: What do you identify as your sexual orientation?
(Still) He/She: You know girl, I guess homosexual. But I love girls too. I got a sister, and she's one of the coolest people I know. I just love hanging out with girls too. But I guess I'm gay.
Me: (Silence...trying to figure out what the answer was to my last question...)
He/She: (Patient hits the button that turns off the lights to the room) DID THE SUN JUST GO DOWN?!
Me: Um...Maybe! (It's 8am...)
This patient's tox screen on admission was positive for cocaine, opiates and alcohol. Also, the patient was dozing off in the middle of the conversation, sometimes mid-sentence...until the sun went down - then it was party time!
~~~~~
One of my colleagues had to deliver the news to a patient that her lab results came back positive for gonorrhea and chlamydia. Before the doctor was even out of the room the patient was quickly calling her fling: "*#&% you! You gave me chlamydia!"
I was down the hall and could hear the screaming as the doctor politely dismissed himself from the room.
~~~~~
Resident: Do you med students (we aren't important enough for names yet) know what field you want to go into?
MS 1: Maybe OB/Gyn.
Resident: I could see that. What about you?
MS 2: Family Medicine!
Resident: I totally would have guessed that, it really suits you. (Turns to me) What about you?
Me: You seem good at guessing - what do you think?
Resident: Something intense. Maybe surgery.
Me: Seriously? Why?
Resident: You have an intense face. You should do something intense.
Me: What does that even mean?!
Resident: I don't know...but you should do something intense.
Me: I was thinking Peds actually.
Resident: No way - that doesn't suit you at all! (She's spent about two days with me). You should do Med-Peds if you insist on Peds!
Me: We'll see. But I'm still thinking Peds...even if it isn't intense.
~~~~~
Tuesday, July 5, 2011
Officially a Med 3!
My first day as a clinician started today with getting up at 6am (after only a few hours of sleep), spilling coffee on my white coat, being given the wrong directions to the room to which I was supposed to report, and thus showing up a few minutes late to the correct room. Later in the day I was given 20 minutes to eat lunch, drive to another hospital, and find the next place to which I needed to report. The day ended with attempting to take a history from a patient who wanted nothing to do with me unless I could find her some tomato soup.
It's going to be a fantastic year.
No really, it's going to be a fantastic year.
As much as all of these little bumps today could have thrown me off, I can honestly say I enjoyed today. Despite little sleep and feeling entirely incompetent the entire day (I don't even know how to turn my pager on - seriously, who still uses a pager?!), it marks the beginning of an incredible journey that I am eager to begin (and eager to finish).
My patient today, despite mainly being concerned with tomato soup, was my first real patient in the hospital. And despite the patient's intense depression and lack of desire to do anything but lie in bed, I was able to get her to smile. As cheesy and cliche as it sounds, that was enough for me. A few weeks or months into this year, I may not be so easily encouraged - but I'm going to enjoy it while it lasts. I need patients like her to remind me why I'm investing so much in this education.
I'm actually looking forward to seeing her tomorrow and trying to get another smile out of her. I'll be doing well if all it takes is tomato soup to make my patients' days.
A side note on my rotations: As part of privacy laws, I have to be extremely careful in talking about any patients and their health issues. Because of this, I'm not going to specify which of the many hospitals in the Columbus area I will be assigned to each month. I also will often change certain details (dates, age, gender, etc) to make it impossible to identify the actual patient to which I am referring. If I ever refer to a patient by name, it will never be their real name. I may make up a name to help with story telling without revealing the patient's identity. I also, to protect myself, will change the names of any staff/other medical personnel I talk about. Not because it's illegal to mention them by name, but because it's stupid.
I hope to use this blog to tell some interesting and entertaining stories about some of the situations into which I will be thrown this year. If I'm going to be stressed or humiliated, I figure you might as well be entertained.
It's going to be a fantastic year.
No really, it's going to be a fantastic year.
As much as all of these little bumps today could have thrown me off, I can honestly say I enjoyed today. Despite little sleep and feeling entirely incompetent the entire day (I don't even know how to turn my pager on - seriously, who still uses a pager?!), it marks the beginning of an incredible journey that I am eager to begin (and eager to finish).
My patient today, despite mainly being concerned with tomato soup, was my first real patient in the hospital. And despite the patient's intense depression and lack of desire to do anything but lie in bed, I was able to get her to smile. As cheesy and cliche as it sounds, that was enough for me. A few weeks or months into this year, I may not be so easily encouraged - but I'm going to enjoy it while it lasts. I need patients like her to remind me why I'm investing so much in this education.
I'm actually looking forward to seeing her tomorrow and trying to get another smile out of her. I'll be doing well if all it takes is tomato soup to make my patients' days.
A side note on my rotations: As part of privacy laws, I have to be extremely careful in talking about any patients and their health issues. Because of this, I'm not going to specify which of the many hospitals in the Columbus area I will be assigned to each month. I also will often change certain details (dates, age, gender, etc) to make it impossible to identify the actual patient to which I am referring. If I ever refer to a patient by name, it will never be their real name. I may make up a name to help with story telling without revealing the patient's identity. I also, to protect myself, will change the names of any staff/other medical personnel I talk about. Not because it's illegal to mention them by name, but because it's stupid.
I hope to use this blog to tell some interesting and entertaining stories about some of the situations into which I will be thrown this year. If I'm going to be stressed or humiliated, I figure you might as well be entertained.
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