Say What??

This is an actual experience of mine from just a few days ago. We had a new consult in the ICU. The patient was brought in for acute respiratory failure and had been intubated. By the time I and Airhead Partner went in to see the patient he had woken up and was stable. We start to question the patient. The patient had a bilateral lower extremity amputation. We were trying to get to the bottom of why, but the patient couldn't talk very clearly because of the endotracheal tube, so here's how the conversation goes:

Me: "Sir, how did you lose your leg?"

I barely finish my sentence and Partner quips in: "Was it drugs?"

Patient: *shakes his finger no and draws his finger in a line along his arm* Ahh ok, something to do with circulation, as is usually the case. Now, was it an arterial thrombus, chronic infection due to his diabetes, injury, or poor circulation?

Before I can even finish my thoughts, as the patient is still pointing to his vessels...Partner: "Oh was it meth?! An explosion in a meth lab??!"

....Say what????

Me: After wiping what I'm sure was a befuddled look on my face and resisting the urge to tell my partner to S.T.F.U, I just took over and said "Sir, before we go any further do you think you could just write it down for me?" He wrote "Pore blood."

Me: "Thank you sir." And with that I walk out, wishing I was capable of conjuring up Petrificus totalus. If anyone could explain how Airhead went from the patient pointing to his wrist to the implication that his lost both of his legs in a meth lab explosion, never mind that most meth users are white and this guy was black...I'm all ears. 

An awesome quote

"Of religious people, there are some who feel that their religious beliefs make them better people. There are others who feel that their religious beliefs make them better than other people."

It brings to mind a passage in Romans 2:1-3

You, therefore, have no excuse, you who pass judgment on someone else, for at whatever point you judge another, you are condemning yourself, because you who pass judgment do the same things.  Now we know that God’s judgment against those who do such things is based on truth.  So when you, a mere human being, pass judgment on them and yet do the same things, do you think you will escape God’s judgment?

What a Day!!!

My day began with a patient that has been driving nurses crazy since she walked in. A 29 year old with End Stage Renal Disease, morbidly obese, enlarged heart (duh) and BAD attitude. Hardly ten minutes would go by when she doesn't need something completely unrelated to her health. I need a pillow. This is too many pillows. I'm hungry. (Family brings two slabs of ribs and a bucket of mac'n'cheese). My stomach hurts! Well no crap Jessica Fletcher, you just ate an entire cow. I wanna go home, let's get me home. I don't care if this medicine is supposed to get me better, let's fix the immediate problem. I don't want to take that medicine, I doesn't work. No I've never taken it before but I know it isn't gonna work. I don't mean to be overly cynical, but honestly half of this chick's problem is her attitude, and a likely diagnosis of Borderline Personality Disorder!!!

After THAT, my partners and I got stuck in an elevator for about ten minutes. And one had a panic attack. Oh, and did I mention the A/C wasn't working very well so the ICU got uncomfortably hot with two dozen people stuffed in there, computers running, and people running about. What.A.Day!!!

Paging Mother Nature

It's 56 degrees, like a November or December day in Georgia. I feel like there should be football on TV. It is literally 50 degrees cooler than this time last year. I vividly remember for about three weeks I would be getting on the bus about 6am and it would already be over 90 degrees. Some days there would even be a very hot wind blowing off the lake. Give me 50s and 60s in July any day of the week. Of course, this may mean that we are in for a very cold winter. Every month this year in Chicago has been colder month over month from the last two years. This past winter it didn't start snowing regularly until January, quite late from what I understand. I had OB/GYN in December with a Chicago native and he said he couldn't believe how warm it was for December (it was below freezing most every day). I found that I did not mind the cold one bit. So I say bring it on! This weather reminds of me of fall, my favorite time of year, and it's a nice-weird feeling to have in July. 

In other news, my ICU rotation has been going very well. I have to go in six days a week (we have arranged it so two of us get one of the weekend days off). Yesterday I was up at five and after taking a very long shower which mostly consisted of standing there and whining I don't wannnnnaaaaaa go in todayyyyyyy I was at the hospital by 645, seeing a few patients that were my parters'. I was done by 8, anticipating that's when the doctor would actually show up. Oh nay. Apparently there was a health fair at the hospital that Governor Quinn made an hour-long appearance at. My attending being the chief of staff naturally had to make an appearance. That would've been nice to know as we sat around for three hours until he showed up. On top of that, he is Muslim and it's Ramadan. Your breath starts to stink when you don't eat as your metabolism switches a bit. I spoke about this with another student who is Muslim, and apparently some people won't put anything but water in their mouths. As a result, a good four feet were needed between my sensitive nose and the attending.

What a Day!

Nurse: patient came back positive for TB. 

*everybody freaks*Nurse: Oh sorry I misspoke!! HepB. Positive for HepB!



Then later on...

Partner 1: Is he French or French Canadian?
Partner 2: I don't know. He has an accent he must be French. 
Me: Celine Dion has a French accent, though. 
Partner 2: Yeah but she's American. 
*Facepalm*

I'm trying really really hard not to be judgmental...

...but even I have my limit.

Loudspeaker: RAPID RESPONSE ROOM 123. RAPID RESPONSE ROOM 123! RAPID RESPONSE ROOM 123.

Me: "Oh, partner, that's your patient."

Partner: "What? Who? Where? What are you talking about?"

Me: "Never-mind." For the third time this week already I'll go take care of your patient because you were either an hour late getting here, and apparently don't listen when a code or rapid response is called. *Gets up and heads to telemetry.*

Said partner is actually a very nice person, but working with her is exasperating. She is an airhead and has yet to show up at the hospital before the doctor. Another partner has mentioned that she's losing patience with her as well. I have the best life, don't I??

Surprise!!!

The attending shows up an hour earlier. Only two of the four medical students are even here. Good job guys!!! I'll be happy to pick up your slack!!!

Blah Blah Blah...New Rotation

Started my new rotation yesterday: Pulmonary/Critical Care. It's going to be a lot more intense than ID was. Unlike ID, we actually have patients, sometimes over twenty. So we have stuff to do, every single day. And it's awesome. There are four of us to split up the patients, but it's still enough to keep me busy and thinking. Plus throughout the day there is at least one admission so it's definitely been cool to be able to integrate what I've (hopefully) learned over the past year or so.

Today was quite intense, and a bit frustrating. I've spent enough time at Chicago Memorial Hospital that I now have developed a rapport with some of the nurses, which is always a good thing. I've also had the chance to follow several patients over the course of several months, in several different disciplines. It's been fascinating. Today a patient came in that I had seen for several weeks during my Renal rotation. Patient has a history of bilateral breast cancer with mastectomy, urinary outflow obstruction causing chronic kidney disease and hydronephrosis, which lead to the placement of several stents, all of which became infected. All the while her kidney numbers are shooting up like crazy (of course, the woman can't pee!!!). At this point the nephrologist looks at me and says "Something else is going on here. I'm not sure what but this just isn't right. Something bigger is going on." Later, an ultrasound and a CT demonstrated metastases to the liver. Boom. Cause determined. Patient gets sent elsewhere to resume her cancer treatment, and I go about my business. Fast forward many weeks, and I see this patient's name on our consult list and I just know it cannot be good. As it is, I am not assigned to follow her, but there is probably some counter-transference going on here and I just can't help but feel sad. This is a sweet lady and all the cards are going against her all at once. Suffice it to say the cancer has spread and she's taken a turn for the worst.

Later in the day during clinic I encounter something that I'm not sure whether it should make me laugh or angry. An obese man who is so fat that he cannot breathe simply because he's too fat comes into the office. He's bound to a wheelchair. Who's pushing the wheelchair, ask ye? His wife. Who's fatter than he is, and carrying an oxygen tank around. You interpret that as you will. 

Over ID

It's been fun, but I'll be glad to move on to something else. My attending is just a smidge more scatterbrained than I'd care him to be, and he never, absolutely never runs out of things to say--useful or otherwise. As a result he's constantly late and rushing because he stops to talk to everybody, and then makes a running commentary about everybody. It can be exhausting just trying to listen for that long. It doesn't help that he's not the most organized person in the world, and as such we are running every which way trying to get things done. Ok, done kvetching.

On a better note, summer finally showed up in July. I've enjoyed being able to wear shorts, finally. I've also pulled my car out of the parking garage and park it on the street. It can be a bit hectic sometimes finding a spot, but I manage. With an awesome transportation system if I don't need the car, or know that I will be arriving home at the same time as everybody else in my neighborhood and will thus have to fight them for a spot, I plan better. It also encourages me to get back to using the bus and train. Odd as it may seem I had missed it. It's much less stressful and you get a little more exercise. It's incredible how something as simple as just driving to work encourages one to be more sedentary. 

Don't Know What to Do with Myself

It's been a little over two weeks since I took CK, and true to form I'm still unwinding from it. I'm only recently becoming aware of the levels of stress and pressure I experience and impose upon myself when I prepare for and take an exam like that. Well it turns out I'm still unwinding. I don't really know what to do with myself, and I'm still trying to piece my routine back together. It's weird. There is still a pile of laundry waiting to be folded because I got out of the habit of folding my laundry for about a month. My floors have been vacuumed and cleaned, but I still feel like what am I not doing??? It doesn't help that I have to be a bit stingy with my cash for the next few weeks. Blargh.

Infectious disease has been interesting and simultaneously boring. It's been more discussion than medicine, but at the same time that's important in this field. My attending must have been vaccinated with a phonograph needle because the man can talk. And talk and talk and talk and talk. He spent nearly half an hour talking today about seemingly everything and nothing. Topics seamlessly shifted and blended together. All the while I couldn't help but thinking that this is a man who mentions he doesn't get home until after 9 some nights...and in the four hours I spent with him today almost half were just mindless talking. He'd surely get home at a "normal" hour (should he want to) just by halving the chatter.