Intense Night

My clock says 1715. I just woke up (from a fuzzy dream) about twenty-five minutes ago after about six hours of MUCH-needed sleep. I had an intense night at the hospital whereby we were on constant call until about 5am. We saw, among others:
A patient with DKA, diabetic foot ulcer, HTN, and an above-the-knee amputation
A patient with radiating chest pain an nausea with a history of three MIs
A patient with vomiting x 3 days, history of pyelonephritis and chronic kidney injury with a BUN of 51 and a creatinine of 3.44. No wonder she was loopy. Nephrology was consulted...
A patient with : SOB, chest pain, back pain a history of (take a deep breath) CHF, COPD, CAD, cardiomyopathy, chronic pain, HTN, depression, and the poor guy couldn't pee. When the patient was catheterized, 1600mL of urine came out of the bladder in about two minutes. Two minutes later there was almost 2000mL (that's a two liter bottle of coke folks!) in the bag. OUCH!!

Night float Update...with some kvetching

Yeah...even I'm annoyed that I keep writing about night float. I'm trying really hard not to be grumpy about it but it's consuming everything. I go in on Monday and Friday nights at 7. And leave the next day. I then have Tuesday and Thursday off. Why the kvetching so you say? Welllll, I also have to be at the hospital on Tuesday morning at 8am, Wednesday at 730am, and Friday at 8am. So, my sleep schedule is all farkakte. I get grumpy. I get disoriented. Days run together. I'm not a night owl. I do not like staying up late. I never have. So two more weeks of this unpleasantness. I am perfectly fine with being at the hospital from 7am to 7 or 8 at night. Not a big deal. Those hours between midnight and six...yeah, we've never been been properly introduced. I don't think we'll ever get along.

Moment of the Day:

I was doing some shopping on State Street, and stood agape as I watched a guy start screaming (literally screaming) "WHAT DO YOU GET WHEN YOU GUZZLE DOWN SWEETS?? EATING AS MUCH AS AN ELEPHANT EATS!!! OOMPA LOOMPA DOOPITY DOO..." as he eats a chocolate bar...
I very slowly broke off in the other direction. And felt the need to call a psych consult because he was not joking.
And that's a true story folks.

Night rounds

First patient of the night: Doesn't speak English (nothing unusual). Doesn't speak Spanish, only speaks Polish (unusual in my hospital). Oh good.
What to do?
I speak maybe two words of Polish, neither of which is helpful in the hospital. Luckily, there is a telephone translator service. It was cumbersome, a bit slow, but we got it done. Now, some part of me wants to rotate through a hospital in a Polish neighborhood so I can learn Polish. That definitely appeals to my vanity. :p

Correction

I have decided NOT to change the address of this blog. Fouled up too many things!! Sorry guys!

Night Call

So I'm sure anyone who actually reads this is dying to know how my first week on overnight call has gone. Truthfully? Exhausting.

My shift with Awesome Partner began at 7pm, and there were nonstop admissions until 4am. It was intense, but in a good way. We saw:

A patient who coded four times, going out on his fourth code. I got to practice my compressions on this way. It was a bit surreal. I had never done it before, and a real body has a lot more give to it than those plastic dummies they teach you on.

A patient who had asymmetric facial features due to half her face being smashed in an MVA. In addition, there were possible absence seizures (she went into one in the middle of my exam, which was bizarre), and a suspected TIA. Just a really interesting case.

Yet another pancreatitis case, which must've been about the fifth in a week.

The rest of the cases weren't remarkable enough for me to actually remember them, unfortunately. But I feel like I did learn a fair bit!!

The next two days however...I literally had to try to think. After a Tuesday morning lecture, we had the rest of the day off, during which I hoped to get some sleep. Alas, no. I got about two hours of sleep the entire day, and thankfully went to bed very early because I had to be back at the hospital at 7am on Wednesday for a day shift. Hence the inability-to-think part.

Let the night shift begin!!!

Overnight call has begun...and I have a pounding headache. Oh goody.

Disgusting.

May the powers at be at Penn State rot. It's disgusting, absolutely disgusting to let all that happen for a game. A GAME!!

Le sigh...maybe there's a lesson here.

After my royal hissy fit the other day about an absolutely BAD day I've had a chance to do a bit of reflecting. (This means I have thought about it constantly due to the fact that I wanted to be violently ill that entire night. Awesome Partner has said that she couldn't stop thinking about it either.)

So...with that in mind. I don't know why that day was just destined to be bad, but it was. Whoever coordinates the sh**list at Chicago Hope Hospital drew our names out of a hat on Monday and spread the word. You win!!!!!

I always try to say hello and be polite to nurses. I learned a long time ago, and have said so in numerous interviews and discussions about the practice of medicine, that nurses are a doctor's best friend on the floor. But I guess sometimes I slip, or people don't hear me, or I'm in hurry and I don't really care if I'm actually being polite because I feel like my bum is on the line. Not the best way to be, I know, but if I'm going to rant and rave about somebody else's shortcomings shouldn't I be at least marginally honest about my own? Something to work on...

The following day we indeed were working with Psycho Nurse Lady again. The next day was perfectly fine. I still don't understand WHY this nurse went off on us, because Awesome Partner said hello...and I hadn't even had the chance. I told my attending that, indeed, we were not given a chance to be polite. But it doesn't really matter does it? Perception is what is remembered--such as my perception of how I felt I was treated by the nurse and the doctor. Everyone is going to have bad days. I certainly do. But I think it's nasty how we take our bad days out on other people.

Why Did I Get Up This Morning??

10:15 this morning: My attending tries to call my partner...the call is dropped due to spotty reception on some floors at Chicago Hope Hospital. I was already going to move to a different floor, so I call her...then I lose signal. I call her back...this is what I get: "Luckyone, I'm really busy right now what do you need?"

...excuse me all to hell lady. 

Me: "Oh Hi Dr. Busy. Awesome Partner dropped the call so I was seeing what was up."

Dr. Busy: "Oh yeah...I haven't seen either of you this morning...I was waiting for you."

Me: "We had lecture at nine this morning. I wrote two of my notes before then, I didn't see you on the floor. I'm now on One Floor, Awesome Partner is on Another Floor.

 ....dead silence...doctor speaks to peeps in the back ground...blah blah blah blah CLICK!!

 Grand.

A fellow student informs me that just before I made this phone call, Dr. Busy (who is pregnant) drops her brand new iPhone (that apparently had its own drama) in between the elevator and the door...from a floor we do not round on with her. Naturally this must be my fault. It turns out she spends an hour trying to get her phone out of the bottom of the elevator shaft while I was seeing my patients.

An hour or so later (still no clue where this woman's been because both of us have been on the respective floors she rounds on) we're going to lunch and she sees us...on a floor that has nothing to do with patient care

Dr. Busy: I WAS WAITING FOR YOU IN THE ICU AT 7 AM FOR AN HOUR (PS We never round before 8, and are always called to round and FYI,  Luckyone was in the ICU at 745...no doctor)

This isn't how this rotation goes, you can't just write your note...you have to round with me." (which we do, DAILY). At this point I want to say: um, but we were ON THE effing FLOOR WAITING FOR YOU WHILE WE SAW OUR PATIENTS and this is what we've been doing for three weeks while you run off god knows where while we see our patients, and at some random, magical time throughout the day we discuss the patients with you. But you can't say that...as much as you'd love to...So you just smile and nod and feel your dignity shrink with the Greek economy...

So...that drama over with: 1pm, we get called (as usual) to the ER by the doctor to see two new patients. I go to one end, and come to find the necessary chart is at the other ER desk, where my partner has gone for her patient. I walk up to the desk, am there for about two seconds....we get accosted by one of the nurses at the desk: 

Nurse Psycho: "This just really bothers me about medical students. They just walk in and start going through things and never say hello and think they own the place..."

Awesome Partner: "Um, I'm sorry you didn't hear me say hello, I said it but you were talking and I thought you were ignoring me." 

We go see our patients and get out of the ER to get away from Psycho Nurse Lady, informing Dr. Busy that we've seen the patients, they're being admitted, and we're writing our H&Ps. She says she's coming to the floor. Half an hour later she shows up: 

"Why didn't you wait for me in the ER? Were you too afraid after being reprimanded??"

GAHHHHHHH GET BENT YOU BITCH NURSE AND BLAST ALL THE REST OF YOU NURSES WHO GO OUT OF YOUR WAY TO BE RUDE. If I say hello you act like I'm BOTHERING YOU...WHAT THE HELL DO YOU PEOPLE WANT.

I'm so sorry, Dr. Busy. Yes I INDEED made your phone fall four floors down the elevator. I indeed prevented you from getting a protective case. I HAVE THAT POWER and I can SO read your mind when you do not inform us that you want us on the floor an hour earlier than you've ever told us to be there....I'M THAT GOOD. It, assuredly, is my fault that while we were doing what we were INSTRUCTED to do...by YOU, you were worrying about your phone--a privilege I most assuredly would not be afforded--and thus I should wait to be reprimanded for not rounding and seeing the patients. I am SO sorry that I couldn't track you down by my powers of telepathy...so I had to call you to find you so we could round....and I'm on the RIGHT BLOODY FLOOR...while you are NOT

 while you drop your phone...which again is my fualt...because I HAVE THAT POWER. So sorry to interupt your day...that you then blamed me for not doing...CURSES AND ROT!!!!!! I'm so sorry that you're pregnant and ill. Even though said baby is clearly not mine...

At the end of the day, Awesome Partner and I just sat there looking at each other going...Fuck.me

I should've gone back to bed when I  rounded the corner this morning to find I would need to run to catch my bus...

Wimbledon 2012

Dear Serena Williams...please stop thanking Jehovah...I didn't see any evidence of him when you were threatening to shove a ball down a line judge's throat...or calling an umpire unattractive...or muttering expletives in your sister's direction and calling her a "bitch" while you played each other. I'm not buying it.

Well hello there...

As I was walking to a nearby friend's apartment, I walked past Mr. HAIR. That's three times now...

Did I miss a memo???

Freak thunderstorm of doom...
Obnoxious heat index (106 to be precise)...
Trains stopping in the middle of the tracks between stops...
Multiple buses not showing up...at all (three to be precise, one this morning and two this afternoon)...
Why did I get up today!!! 


I think the whole city of Chicago is hung over from yesterday's festivities...


In other news, today's Patient of the Day was came in after 15 minutes of non-responsiveness following a suspected MI...Patient is still non-responsive and exhibiting decerebrate posturing. Not looking good. The neurologist suspects severe intracranial edema due to anoxia.

Interesting cases

Complicated diverticulitis with abscess
Several appendicitis
AMS due to alcohol intoxication -- hepatic encephalopathy with serum acetone very elevated -- Pablo Personality, too

Acute pancreatitis with possible cholelithiasis

Thyroid storm

Just got back from a weekend trip to St. Louis with mom and the bro. I enjoyed it! I will hopefully have a chance in the coming days to detail it. At the moment the most prominent thing on my mind is the measly little thunderstorm that rolled through Chicago, closing O'Hare and resulting in me spending about two extra hours at Lambert International Airport. Which, if truth be told, is about three more hours than necessary...