I'm on a child abuse elective and have been spending a few days a week observing trials in court.  I spend a majority of the time trying to contain my "squeeee!"s when they say "objection" or "order."  (That really happens!)

I also never realized how challenging it must be to be a state-appointed defense attorney when your client is clearly guilty.

And guilty of, like, sexually assaulting babies.  Oh yes, really. 

The DA yesterday looked visibly pained whenever the prosecutor didn't land a point or stumbled on her words and actually winked at her as she declined to cross-examine yet another prosecution witness. 

It's definitely better than an attorney being happy to defend a child molester, but a strange dynamic I hadn't thought about deeply before. 

I suppose it must feel a little bit like writing an order for morphine when you really don't think your patient is in pain.  

Almost there

I'm in the delivery suite getting ready for a premie who we're expecting to have some breathing difficulties.  The baby is crowning and the respiratory therapist still isn't in the room so I send her a page.

A few minutes later, she bursts into the room, out of breath, and. . . without any of the needed respiratory supplies.

Me:  Hi, respiratory therapist, I'm glad you're here.  You wouldn't, by chance, have any . . . respiratory equipment?

Respiratory therapist:  ::still panting::  You paged me STAT so I figured I shouldn't stop for the airway cart.


Oh boy.

Nonchalance of the year award

Note a 2 year old's mom received from daycare today:

Morning activity:  Today we learned proper handwashing.  Practiced using soap from a pump!
12:00 - 1:00: lunchtime, ate well.
1:00 - 2:10: naptime
2:10 - 2:40:  Shaking all over.  Seizure?
2:40 - 3:00:  Great participation in circle time!

Anyone looking for a new daycare?

Overheard in the ED

MD (to custodian carrying heavy-duty pliers): What do you think those are used for more often, cutting locks off lockers, or removing objects from genitalia?

Custodian: Eh, about 50/50

Ah, irrational hatred in the morning

Me (having a relatively skinny day, I think): Good morning!

Patient who instantly hates me for no clear reason: ::suspicious glare:: You pregnant?

Me: No, awkward ha ha, I just had a baby 7 weeks ago.

Full-of-hate: But you still got a bump like you pregnant.

Me: Okay. ::pointedly polite smile:: How can I help you today?

::Patient's friend enters the room:

FOH to friend: "This doctor isn't pregnant even though she got a tummy like she is."

Awesome.

It's all a matter of perspective

7:15am, first visit of the day at the peds urgent visit center. 17 year old male with no known medical problems.

Me: Hi! I'm Dr. Scopes. What brings you in today?

Him: So. . . ::dramatic sigh:: I'm trying to get it on with my lady last night and, I couldn't get it up for long enough.

Me: . . . . . Um. ::blink blink:: . . . . .

Him: Like she's hot and everything and it's all cool, but then when we go to do it, it just doesn't work any more.

Me: Well, we'll definitely try to help you out, but you know, this is the urgent visit center, it's really for people who are sick. You should probably talk to your regular doctor about this.

Him: Ma'am. It's an emergency to me.

Spelling 101

True baby name:

Lyllylla (I attempted to pronounce this as written and mom stared at me like I was a
block of cement. "It's Li-la." ::what's-wrong-with-you-glare::)

Bruklon (Mom: we just love New York.)

Teon and Tion (Twins! Pronunciation? Exactly the same.)

Sir Prince William (What do I even say when I enter the room? I said "William?" ::withering death stare from dad:: "It's Sir Prince. William's his middle name." My bad.)

Babyboy (A 32 year old. Legal name.)

Shocking

Scopes MD: So ma'am (stretching the term a bit), what makes your rectal pain worse?

Patient: When I wear a thong.

Neat-o

We are using maggot therapy on one of our patients with a terrible pressure ulcer.

It's endlessly delightful to pretend to be ultra-scientific about dumping a bunch of creepy-crawlies into sores. We use 4-5 maggots per square inch of wound. The dead tissue can usually be removed by 1-3 "applications."

The good news is it works, fantastically. Our patient loves it, says it's not uncomfortable at all.

It's working so well for him, in fact, that I got to spend a good part of my day was filling out forms to try to get Medicare to cover home maggot therapy.

We'll see if it goes through.

overseen in a chart

"Psychiatry was consulted, state that patient is not acutely suicidal or a threat to himself or others. Patient continues to state that he will jump off a bridge if discharged from the hospital."

Hmm