Today was my last early (6a-2p) shift in the ER...thank God. I'm sure there will be periods of time when I'll need to be awake that early for residency, but I guess I'll have to cross that bridge when I get to it. A friend of mine is doing a surgery rotation in California and he has to get up every day at 4:30. Excuse me?? Je ne comprends pas! That hour does not compute. And you want to go into this field why?? But I'm getting off track. Today was an interesting day.
For starters, I had a new attending today. Always awkward. He spent twenty-five minutes lecturing my fellow students about brevity...
I walked into a room to find that both people in the room were expecting to be treated. This isn't exactly typical, so I just hopped back to the desk to make sure that both patients indeed were registered before I went through the rigamarole of examining both of them. I don't typically read too much about a patient before I see them because I want to see them from scratch. Good thing I did that, too. Both patients, indeed, were registered. For genital discharge. Oh goody. I must've made some sort of face, or audible expression because half the staff at the desk and the attending started to laugh. It became clear at that point that the attending was purposefully not seeing that patient before whichever schmuck of a student got lucky and took that patient. Thankfully a thorough examination was not necessary. What I did observe however, was that the female (aged 21) had this ever so sexy habit of sucking on her thumb while she was talking. Yes ma'am. Nothin' says sexy more than a 21 year-old who can't speak English properly AND sucks her thumb. Mmmmm baby. Oh, and by the way, soap is cheap. Please use it more than twice a month. You reek. The 20 year-old guy in the pair was clueless. Or stone. Or perhaps both. I don't know. He just kept walking around like he didn't realize he was in a room...with walls. I kept waiting for him to hit a wall and then bounce off of it in a daze. Really, a real pair these two were. What a special time I'm sure this was in their relationship. Getting treated...together...for the clap. They got sent home with a shot of ceftriaxone, and scrips for azithromycin and doxycycline. Please don't ever come to the ER for STIs again. I will hurt you. And I have the right to do so, since I'm paying for your ER visit. Also, wear a damn condom because I really don't want to have to pay for the baby you two chuckleheads will invariably make...and not know how.
I also correctly diagnosed a migraine from presentation! Thank you neurology and awesome neurology attending. I'm not sure I would have recognized it as a migraine off the bat without that experience. Go me?
I diagnosed several URIs in kids under two. It's that time of year folks. I understand love for one's children, but I also think that when 16 year-olds start bringing their 19 month-old children into the ER because they are PANICKED because they have been coughing for six hours...that it's time to stop letting uneducated 16 year-olds have children. This brilliant girl didn't grasp, despite several declarations, that a bottle, is indeed feeding a child. Oy, some people.
I had more than one patient whose parents didn't speak English. And I found myself rattling off Spanish like I actually knew what I was saying. Weird. I have days like that every once in a while, but few and far between.