I speak in love

You must understand that I was one of the most nervous third year medical students of all time. It's terrifying when you're suddenly thrust out of the warm, comfortable womb of classroom case studies into the harsh glaring lights of an actual hospital with actual real live patients who they are actually going to let you touch and possibly break.

But the boy student sets all new standards for not quite ready to cut the cord.

It turns out that his first day choice to awkwardly orbit within five feet of me at all times was actually the best case scenario as I was paged by not one, but three, charge nurses in the afternoon after I sent the boy one across the hall to get a chart(literally open the door, turn right, chart rack).

"Hi, I'm calling from PICU south/infant unit 3/2b (which are literally on completely different floors on opposite sides of the hospital), I have your medical student here, he's lost and he's not sure how to find you."

For some reason, once lost, he decided the best way to proceed would be to leave the unit and ascend stairs.

Poor lost duckie.

And I've arrived

So the day has come!

I showed up yesterday morning for more baby plumping fun and got the following 911 page:

"Scopes, go pick up your medical students from the lounge, they don't know where to go."

Yes, loves, I have my very own bright eyed nervous-as-all-get-out third year of medical school ducklings to do whatever I please with for the next three weeks.

No matter what project I assign them, they manage to do it while nervously fluttering around exactly three feet behind me and two feet to either side. Everywhere I go they're there, looking at me expectantly. "Teach me," plead their eyes, "And please please please assign me a project I can successfully accomplish without injuring anyone or passing out."

The girl one (I-have-a-phd-I'm-a-doctor-and-a-half!) is picking things up relatively well, and spends her down time at least pretending to research stuff or work on her notes. The boy one (it's-wildly-unclear-how-I-got-into-medical-school-to-start-with-and-please-don't-count-on-me-to-help-you-with-any-phone-calls-because-I-will-forget-my-name-panic-and-hand-the-phone-to-you) is having a tough time.

The following breathless page is not atypical (approximately 35 minutes after I sent him to another ward to check if a patient's surgical scar is healing well).

"Hi, Dr. S. I got to the patient's room. What should I do now?"

Well, try looking in the room and seeing if the patient is there or not.

"Um. ::agonizing 27 second pause:: The curtain is closed. I can't tell."

Love, you are now a student doctor. You may enter the room and look inside the curtain, then check the scar site for redness, tenderness, pus, and make sure it's well-aligned.

::50 minutes later, back at the work room.::

"Okay, she's there, I looked at her and she looks fine. Her pupils are equal and reactive to light, she has reflexes present in both kness, I can't tell if she has a murmur or not. . ."

::I interrupt:: Butterfly, sweetheart, what did the incision site look like?

"Oh. The incision?? The incision. Oh yeah! The incision. I didn't check."

Repeat times 80 times a day.

Feed the babies

I'm currently working on one of the developmental pediatrics wards. Most of our patients are teeny little "failure to thrive" babies (below 3rd percentile for weight). I spent most of the first week frantically ordering genetic testing, swallow studies, abdominal x-rays, examining poops (how much of my day is spent talking about poops? Oh, about 97.3% of it.) . Basically looking for any reason these little button bbs are remaining little tiny button bbs.

(Is there anything sadder than a skinny baby?).

So my staff put up with all my nonsense for about three days and then, in the middle of yet another description of various surgery consults I want to order to evaluate ye randome rare GI condition by biopsy, she stops me.

"Scopes."

I look up.

"If you feed them, they will grow."

Important

Presenter at morning conference: "I couldn't find a good visual representing appropriate post-drowning CPR, but I thought this was actually pretty close."

True EMS presentation

Winter.

"Two sisters, 13 and 15, were drinking in the backyard when one fell into their swimming pool. The other jumped in to rescue her sister, but was unable to get her out of the pool.

Their mother, also drunk, came outside to look for the girls and fell into the pool. EMS was involved when a neighbor called police to file a noise complaint against the family.

The good news is that the alcohol-induced vasodilation allowed them to cool so quickly, they were all able to be resuscitated when rewarmed."

Yay!

AwwS

A somewhat depressing sentence from my cardiology review book:

No waiting is necessary to have sex after [a heart attack]. Sex does not significantly increase the risk of [another heart attack], because neither the duration nor the intensity of exertion is sufficient to provoke ischemia in most cases.

Good news! But sad at the same time.

I know . . .

. . . this is supposed to be funny.

But my, how much trouble it would save us:




And we need all our energy to panic about swine flu.

In swine-flu-related news

At pediatrics clinic, we've come up with a cute little nickname for the H1N1 virus that's a little easier to say and less likely to panic people.

I think it's adorable.

But we've been causing a bit of concern with the patients when they hear us asking the nurse for a
"hiney" exam.









Heehee, hiney.

It's here!

I've spent the past six months with my head buried firmly in the sand, insisting that all this swine flu silliness was just going to blow over, that it's exactly like any flu, really not a big deal. Totally shrugged off any discussion of it. I figured it was going to be a total nothing. If we had to deal with anything at the hospital, I imagined it would just be a steady stream of worried well trying to stockpile antivirals.

But over the past week or so our hospital has been pretty firmly whomped with a steady trickle of very early and very severe flu cases, and a fair number of them are H1N1.

Now I do have an inexplicable passionate love affair with horror movies, and most especially those of the viral apocalypse variety. Nonetheless, I am not at all excited about the prospect of my first ever year as a doctor being the year we all die of the flu.

(Mostly because I'm just not sure my uterus is up to the task of repopulating the world).

I may have felt a tiny tingle of excitement as I snapped the elastic of my respirator behind my ears and headed down the hallway to see my first verified H1N1 patient. But as we tried to tease out who might have been exposed and how many high risk contacts he had and whether he needed to be admitted and whether he met the criteria for antiviral treatment and whether his one month old baby with a fever and runny nose needed treatment, I just thought oh no.

I may not be getting very much sleep on call this winter.

brand new pet peeve #1

Doctors (and it's always doctors) who push the blue handicapped wall button to open every single door in the hospital. Every single time.