life

they posted the pictures of the incoming interns on our family practice office door. The pictures are really really bad. I hate to say that, but one girl looked like she just woke up with bed head. Anyway, the group is diverse ethnically and is composed of 6 guys and 6 girls. We needed guys to offset the fact that many females, including myself, plan to get pregnant during residency.

I'm still trying to comfortably catch babies in my maternity rotation. The numbers are always low when I'm on, but my co-intern is always busy when he's on-call. In clinic, on the other hand, I'm trying to see patients at lightning speeds. We are told that we need to see at least 11 patients in a half day by 3rd year and will probably see 15-20 in our practice. Eeekk. I don't know how to shut my patients up . . .and sometimes I don't think I should.

Yes, I'm starting to feel the stress of becoming a 2nd year. I just don't feel like I'm ready. I'm going to have to teach these interns about medicine and some of them have had experience being doctors already.

beer 101

A friend of mine taught a beer 101 class today at the flying saucer. i have never liked the taste of beer, but since this friend did me a favor, i was kind of obligated to go. He's a phd in biochemistry and an MD in my program and has even written a book on brewing. Anyway, I learned more than I ever thought I would about beer. I tasted about 17 types and by the end, I finally tried one that I liked, a belgium raspberry framboise. $5 a glass.

anyhow, I did learn that all american beers are subpar. Budweiser actually has added acetyaldehyde to purposefully make one drunk. Budweiser was given as the first taste test to show us what bad beer is. We talked about the color, the smell, clarity and carbonation of each beer. We swirled the glass, tilted it against the light, smelled its aroma, and finally swished it around our mouths so as it expose the salty, bitter and sweet parts of our tongues. I feel so cultured . . .ha

Maternity
My maternity experience so far has been ok. I still feel like the cervical exams are subjective and "mushy" but I'm getting to be a little more comfortable. I don't really enjoy maternity though. I like the joy of delivering a baby, but that's it. I don't like checking these women every two hours to see how dilated their cervix is. It's a very invasive, uncomfortable, smelly, nasty, wet, experience.

four more days, one more call to go!

The ccu has been busy and even more since we have a new team. My last team left last Friday and instead of bringing two interns to fill the ones that left, only one intern came to fill both their places. Because of that, I am now on every 4th day call and carrying 14 patients plus. Luckily for me, I only have till Sunday left and start delivering babies on Monday. I sympathize with my replacement b/c she'll have three weeks of torture, until a new team comes along for her last week.

I have learned a lot about heart attacks though. One of my patients is a 24 year old male. YES, you can have a heart attack at 24. How????? Well, I'm sure untreated diabetes and cocaine use had a lot to do with it . . .

Another patient hadn't been to the doctor in 20 years. He didn't know he had diabetes or high blood pressure and woke up chest pain.

Another <20 year old female got a scare after binging on cocaine--no heart attack, but really bad chest pain caused by the spasm of her coronary (heart) arteries. We gave her a good scare . . .hopefully she makes a change for the better.

please, don't ask me questions at 11 pm

On my last call, when I was trying my best to get work done so I could get to sleep, a nurse came up to me saying that a patient wanted to ask me a question. I rolled my eyes (it's 11 pm woman!). At 11 pm, my patience gets tried big time.

Anyway, this was a patient I wasn't following, but on call, you basically "cross-cover" or take care of your colleagues patients for the night. I knew her last name and somewhere heard she was the one with breast implants that went bad. She was 61 with make-up on and a hospital gown. That's what you call HISTRIONIC.

She sat down next to me oh so gingerly. In her squeaky voice she asked me why she had high cholesterol and had to take a pill for it when all this time, she just knew her cholesterol panel was superb. This is a question i don't mind answering in my clinic or during the day, when I'm not on call and pressed for time, and when I'm not sleepy. I had to put my sarcasm aside.

So I asked her "Well, what do you consider "good" cholesterol?" She didn't answer my question and just started yapping away about how her doctor always told her her "good" cholesterol was ok and her "bad" cholesterol was great. yap yap yap yap. But I was nice. I looked up her cholesterol panel and explained to her what her goals were and how they compared to hers. She didn't understand after I explained twice. So I then wrote down her cholesterol numbers and beside them, wrote down what they should be.

"So what is my bad and good cholesterol?" (in my mind, i said, "I JUST TOLD YOU, YOU IDIOT!!!!).

I showed her again about 5 more times and she went on her merry way. I think I did change my tone with her by the 4th time. but oh well, i didn't have to deal with her in the morning.

cat fight in the ccu

During rounds, one of the other interns told me that on her call night, two female patients "had it out" and shouted racial slurrs and all kinds of other derogatory statements to eachother. Finally, one patient was moved to another room and the other had a room to herself. The woman who got to stay by herself and who also ended up being the instigator of the entire situation turned out to also be a patient of mine I had in the ccu in september. I remember her as being really nice, but very "needy." Since that time, while I had been on other rotations, I had seen her in the ER once and on the wards another time. She had become a "frequent flyer."

I purposely didn't go to visit her in her room when I found out she had caused the brawl. I had too many other patients to deal with and really didn't want to get involved. But then, on my call night, her husband cornered me in the hall, just when I was heading towards the bathroom. He wanted to change his wife's primary doctor to me and started going on and on about how her current doctor was terrible.

I heard him out for about 30 minutes and told him that I understood his frustration, but that in this system (the university system), it takes a while for things to get done. Patients don't get their prescriptions when they want them, some medicines are not available, and appointments take 3 months to get set. I assured him that his current doctor was probably doing the best she could in terms of what she had to work with in the system, but that it would be best to stay with the doctor who "knows" the patient.

I guess I convinced him and had to hint to him that I was busy. I don't mind the actual patient too much, but her husband I thought was more annoying than she ever had been. To me, he enabled her neediness.

nightmare
I didn't sleep that night except from 6am to 6:30 am. All 5 patients showed up at the same time and 2 needed to be in the unit while the others either spoke SPANISH only or showed marked signs of dementia. I had a tough night and am not looking forward to call on Friday.