Sunday, January 27, 2013

Courtesy Redundacy

As I have ranted about before, I dislike writing thank you notes. In some circles they are perfunctory, and a necessary evil. If I had a dime for every time I heard "if you don't want to write the note then just give the present back," I would be living in a fantastically expensive address in the Gold Coast and driving a Jaguar. I was a bit late writing my Thank-Yous this year (an obnoxiously dense schedule of overnights in the delivery room can do that to a body). I heard from my mother today, telling me that a relative had received my note, and said thank you.

The relative said THANK YOU for the THANK YOU note. Now, should I say thank you for the thank for the thank you??? Where does the gentility end!!??!

Wednesday, January 23, 2013

Psychiatry PEARLS

So far I am really enjoying psychiatry. The psychiatrist I'm working with is the head psychiatrist at Chicago Hope Hospital, and is frankly a much better teacher than the other doctor we had the option of working with. Word-of-mouth led me and my partners to choose accordingly.

While in between patients yesterday, he went over a few "basics."

1. If a patient who is acting crazy says otherwise, care should be taken.
2. A person claiming they feel crazy is most likely extremely anxious.
3. A person whose associates say they're crazy or psychotic is most likely actually psychotic. The patient will usually be unaware of their psychosis.

Tuesday, January 15, 2013

Yeah I'm on psych...but...

While pre-rounding this morning, my partner and I stumbled across the fact that one of our patients has dextrocardia. For the non Doctorese speakers, this means the heart is reversed, and found in the right side of the chest as opposed to the left. Totally unrelated to psych, but cool nonetheless.

Sunday, January 13, 2013

Last Day of OB

On my last day of OB/GYN, because nothing is easy, it was meant to make sure this day will be long.

I walked into the unit at 630 (always a thrill) to be met with one patient, who had just been admitted. Said patient is nowhere near delivering and will probably not deliver before I leave. Grand. I figured I would attempt to document some of the things that I have seen and/or done lately.

C-section due to breach presentation. The baby came out looking very funny, with a flat head and his feet up by his ears (from the breach).

A resident who took five minutes to even get sterile gloves on his hands. All medical students wrestle with the sterile gloves at least once, but this dude is a resident, and the scrub tech was putting his on for him--and he still had issues.

Ambiguous genilatlia. In what turned out to be a baby girl with 21-alpha-hydroxylase deficiency. The neonatologist would not assign a sex to the baby due the ambiguity.

A whole host of normal deliveries. Why is that just when you think you're getting the hang of things it's time to go. I am just starting to get the hang of being in the Delivery Room and what to expect.

I enjoyed OB, more than I thought I would. Having said that I still don't think I want to do OB. I thought the rotation was very well-organized, so it went by quickly. I feel like I learned a lot, and, barring any serious complications, I could deliver a baby on a plane.

Bring on the crazy people in psych next week!!!!

Tuesday, January 8, 2013

There's no business like show business

One of the attendings on the OB floor at Chicago Hope Hospital enjoys singing...endlessly. Oh, he whistles, too. If I'm tired, cranky, annoyed, cantankerous, or just plain grumpy, it can get on my nerves. More than one of my fellow students shares my sentiment. More than once we have been sitting around the corner from the desk, and the Human Karaoke Machine starts whistling and/or singing (a particular favorite of his during the holiday season was "The Prayer"). After HOURS of this we are grinding our teeth, wishing death, pain, blunt force injury, or just simple layngitis. We have sat there grinding our teeth to a fine powder Shut up! Please shut up! Just willing him to button it for an hour of peace and quiet.

Today reached new lows. Beginning the morning with a selection of his favorites from Phantom of the Opera, Les Miserables, and what I think was supposed to be "Send in the Clowns." I wondered how much worse things could become when I was answered. The Human Karaoke Machine started singing "There's No Business Like Show Business." Then, because we just weren't suffering enough, one of the nurses joined it. And then, just to throw some salt in the wound, he starts singing "Besame mucho," and be damned if another doctor doesn't start singing too.

Thursday, January 3, 2013

Night Call

Last night I had another night shift. Frequently on night shift it is quite quiet and I am able to abscond to the call room and get at least two or three hours of what is amusingly called "sleep." Not last night. Last night, I walked onto the floor, and saw a full board. Half of whom were likely to deliver. Here we go! I settle in and prep myself for a busy night. Sure enough, it was busy. I had at least four admissions, and four deliveries. 

The first delivery was going something like this: Normal delivery...normal delivery...normal....HOLY CRAP BABY PROJECTILE BABY!!! The mother had elected not to receive an epidural, and seemed bound and determined to get the kid out. Out it a cannonball. I definitely was not ready for that. 

Later, there was another delivery, relatively straightforward, with no notable complications. Afterward I was starving so I went to grab some food, and I come back to find a baby being pushed out. Curses
The funniest part was this exchange, with a Spanish-speaking patient.

Midwife: That's probably the hymenal ring tearing and bleeding here.
Me: Isn't it a bit late for that??
Nurses die laughing. I'm not sure had it not been three in the morning I would've made that joke right then and there.

After more admissions, and perhaps another delivery?? It was about 515 in the morning, and I was starting to wonder how I was going to be able to last another hour and fifteen minutes. Right about that time We ehard somebody yell NURSE!...Just when you're wondering how to stay awake one more hour...a father come storming out of the room yelling HEY, THE BABY CAME OUT...And just like that I'm wide awake...This mother had elected to receive an epidural, and apparently it was so effective and she dilated so quickly she did not feel herself contracting the baby right out of her uterus. We all jumped up and sure enough, there was the baby just sitting there on the bed, crying. I quickly grabbed some gloves and took care of the cord and cord blood (seemingly my role). After that it was about thirty minutes until my reliever was due, and I read and chatted. I had started to get rather annoyed with one of the nurses in particular who would not stop talking, and loudly at that. But I kept my mouth shut and stayed in the corner, wanting to smack her and ask her to please shut her trap. I mean c'mon...people are sleeping and more importantly, sleep-deprived medical students are annoyed. 

I went home and hopped in the shower (it's absolutely necessary to rinse off the hospital grime and shtook) and promptly went to sleep. I slept far later than I intended, past two o'clock. Now I'm hoping that I don't have difficulties getting to sleep tonight. In the hopes that it helps, I plan on going for a run for about thirty minutes.