Monday, January 12, 2004
I'm moving... in case I have readers other than Mom and Sis...
DrEvil 15:45 - [Link]
1st day off since Surgery started. My chief is fantastic. She's funny and cool and doesn't insult people for sport like so many of her colleagues do. The hours aren't great, but they're better than ER.
Thursday, January 01, 2004
I woke up at about 10:30am. I have about 12 loads of laundry to do. I think I'll do 3 and go out for a lottery ticket.
I got to "drive" in a laparoscopic cholecystectomy while I was on call on Saturday. What stress. Too close, too far, too close. Geesh. It's a difference of moving my hand under an inch in each direction, and holding it there for hours. My back was crying for release at the end, but we had three consults in the ER to do before bed...
drained an abscess...
an IV drug user (most people say 'abuser'... but that's like saying I abuse chocolate) anyway - he had broken off a needle in his arm that showed up on xray. My intern 'probed' the abscess with his finger. I thought that was brave, considering the very sharp object he knew to be inside that arm was still there. He had even mentioned to me that the guy might have HIV since his white blood cell count was not high in the face of this big abscess. So I suggested that perhaps that wasn't a good idea and he poo-pooed me, saying it wasn't an issue.
The next morning, he reported to the chief about the patient, and the chief said,"I know you didn't probe it, right? Tell me you didn't probe it." A wicked smile fought with me, then won its place across my face.
I'm smarter. So there, nyah.
They wanted to know what to write on my long white coat to be worn at the event where we are to be 'cloaked' by attending docs in an ancient ceremony of the medical community's self congratulation. The first line is your name... Joe Bob Blow, MD, or Dr. Joebob Blow, or Dr. Blow.
The second line typically has your specialty.
Joe Bob Blow, MD
At first, I thought perhaps:
But then, since I chose pathology, I wanted:
Smarter Than You
looking for love in all the wrong places
I'll take suggestions at firstname.lastname@example.org, make the subject Blogstudio or I'll delete you without a second thought.
DrEvil 14:29 - [Link]
My hatred of the ER has catapulted forward my drive to complete my residency application. I even wrote a rough draft of my personal statement. I could not have done better for myself, no matter what my dean says. My classmates, eyes wide open saying while shaking their heads "You have to get it done!" What the hell do they know about my situation?
Wednesday, December 31, 2003
I saved myself a year of hell as far as I can tell... even if I work as a temp next year while re-applying.
I am content with myself for a few hours... I have to go to work in the ER tomorrow morning... and the night shift has control of my circadian cycle. I woke up today at 3:10pm, with a yell, "Help!" trying to escape a smelly man who had his arm around my neck in the shower... and I didn't even eat turkey last night. (Turkey usually gives me nightmares)
I've chosen a specialty.
I've written a rough draft of a personal statement.
I've completed most of my application.
There's no sign-in sheet for the ER, so if I miss a shift they won't really know.
I'm 1/2 done applying for Step 2. ($435 paid)
I signed up for the match. ($110 paid)
Oh shit - I need to pay for parking. ($120)
Thank the lord I'm applying to only area residencies so I don't have to fly all over the country to interview (not that I'd get interviews this late)
Happy New Year everyone. Stay out of the ER.
DrEvil 16:59 - [Link]
This morning I picked up a chart - my last patient before I was to go home after an overnight shift. My last patient the day before (as you may read below) was a nightmarish ghoul of a woman who just spewed evil with every look and breath... so this one couldn't be that bad - the chart said "wrist pain", a simple level 4 to write up quick - maybe get an xray - and go... of course that's not how it went:
So I went over to the patient and introduced myself.
"It says here that you have some wrist pain... What happened?"
"Oh I just said that so I could get in here."
For the next ten minutes, this woman described how she had been pushing her things in a wheelchair around my hospital (she never mentioned when) looking for social services, but was misdirected by the police, she got "agitated" and started "running" down the hall, when the wheelchair fell over and so did she and she bla blah blah because she was embarassed...
This is where I interrupted her to ask her to go back and describe the fall (the cause of her alleged pain as far as I could gather
"So you were running down the hall,"
At this point I was met with fire shooting out of her eyes as she yelled at me, hands on her hips, "Excuse me, I was talking... I was not running"
"I only said 'running' because you said 'running'"
So, unphased by my question (and in no way answering it), she continues with her completely illogical story, mentioning that she looked for the hospital police (knew them from her time in the psych ward) and had been assaulted by them...this is where she got various altercations with them confused, it seemed... She continued to describe an altercation and how she was carrying these two bags in her hands - this one under her chair - see? - and the other one outside in the waiting room - she left to go get it - and I took my leave, frustrated and dejected that after 20 minutes I hadn't gotten even a reasonable chief complaint figured out - much less a good history.
I went to ask the night shift attending for help - he said to take it to day shift. Punk. I asked the day shift attending - he told me to wait - as I waited I asked the night shift resident who had his coat on to leave and after giving some useful advice, told me if I couldn't handle it to put the chart back for someone else. I took that as a challenge he would never see the result of...
So I rounded with the day shift - who had been by then prepared by me to handle her - asking her matter of factly what her problem was - she told them that she had fallen at a different hospital (making me think she's trying to sue everyone) - then I went back with a take-charge attitude to test her strength. She pretended that she couldn't resist me (she had pain in one wrist but couldn't resist unexplicably in the other).
I could work with that.
"Patient uncooperative with physical exam" Hell, she was uncooperative with the history but I had already been unnecessarily wordy with my history. I wrote the results that I had observed - full range of motion, no obvious deformity... but hell - I didn't even know when this happened - or if she had pain how much it was and what produced it. I knew she woudn't give me answers - and so did the attending. He told me to write for some Motrin and send her on her way. I wrote the Motrin and left her to the med student coming on.
As I walked down the hall to my apartment my eyes started to well up with tears. I hated the ER.
I didn't want to hate it - I wanted to love it.
I wanted to hate pathology but I couldn't.
Goodbye drug company dinners, conferences in Hawaii, pens...
Hello basements, formaldehyde, stool samples, and stuck up surgeons.
There's a sense of calm, now... knowing (I think) what I want to be when I grow up.
I just hope I can keep this apartment.
Or get one in the neighborhood where I can have a dog - or timeshare a dog.
I have to buy a lottery ticket. I'm going to buy all La Perla underwear when I win.
DrEvil 04:38 - [Link]
My poor abandoned blog... a bit of a mirror of self, I'm afraid... He's 'disappeared' again. So I started the Emergency rotation without him. I came to med school hoping the whole time that I would one day become an ER doc. My hyperactive personality seemed to fit it. But after a week and a half, I hate it. I was waiting to put in my residency application which is months overdue until after I did the rotation. But I think I'm really moving towards pathology.
The ED is inner city, and serves "the underserved" (read as: the drunken rude SOBs who'll kill you just as soon as look at you). I read another blog by an ED doc with a list of patient no-nos. Among them was a few things about not insulting the nurses.
My patients spew forth bile at everyone and anyone. I actually wished that one woman would just die the other day. That was my clue that ER was not for me. She talked to me like I was her slave, insulting me, and telling me that I wasn't trying to help her. Up until that point, I HAD been trying to help her and I had been unusually professional with her. She hadn't received the meal she had requested over and over again in a span of 10 minutes - didn't need it because she was going to be discharged almost immediately after being registered (as she was in NO WAY ill.) After that, I wrote her discharge papers and wished to myself that she would starve to death or get pneumonia and die.
DrEvil 03:58 - [Link]