Thursday, February 19, 2009

My Proposed Plan

We had a patient come in today for a check up. She was a nice lady, but a smoker with a lot of health problems. She needed all her medications filled - and, oh by the way - "I don't have insurance. I can't pay for my visit today. Do you have samples of these medications? I can't pay for them."

The doctor was very nice with the patient and gave her a big sack full of medicines to take home. Other than the fact that she was a smoker, I felt bad for the patient that she couldn't afford the medicines she needed.

The patient left and the doctor pulled me into her office.

"A few weeks ago, my friend and I went to the casino. Guess who was there? HER! She was at the slot machines playing....smoking her life away."


It made me really mad that this patient had portrayed herself as being someone who couldn't afford these meds she needed....but had enough disposable money to be playing the slot machines. And cigarettes are $4-5 a pack!

My proposed plan (although it would never fly with the casinos): In order to get into a casino, one must show I.D. which is hooked to a computer system. If that person "can't afford" insurance or a $15 copay, or is living on government assistance like welfare, they can't get in to the casino. Is that harsh? Yes, probably. But good grief...

Monday, February 09, 2009

Match Results

I am OFFICIALLY going to be an Emergency Medicine resident.....................
in Columbus, Ohio!!!!
Thank you all for your thoughts and prayers!!! This was my 1st choice program...and I couldn't be happier!

Sunday, February 08, 2009

Match Day

Hello Faithful Readers (or those who have just stumbled upon this blog....)-

Tomorrow is Match Day. Tomorrow I find out where I am going to be practicing Emergency Medicine for the next 4 years!

I didn't think I would be THIS nervous....but my stomach is already feeling the butterflies!

Please keep your fingers crossed!!!

Results will be posted for me at 11:00am!

Monday, February 02, 2009

I Can't Remember What I Forgot!

I got slammed by the anesthesiologist today.

Not in a bad way - but in a wow-I-know-I-learned-this-at-some-point-but-I-can't-for-the-life-of-me-remember-the-answer sort of way. It made me realize that I need to go back and review basic physiology.

When on medical rotations, you sort of get into a groove. Everyone gives (well, most of the time) Versed, Fentanyl, and Propofol to put people to sleep. Then we use Sux before we intubate. I can pretty much guess the exact drug the doc is going to pick.....but today he asked me "why?". Darn.....he had to ask that question. So there I go, searching for the answer in the only book I carry these Emergency Medicine Manual. Guess what? An appropriate answer can't be found there.

Needless to say, I have done a lot of reading up on my anesthesia drugs tonight. Hopefully I'll have the correct answer in the morning!

Sunday, February 01, 2009

Life is Short

It's not too often that you speak to someone at 7am and pronounce them dead at 4:31pm. I am currently on an anesthesia rotation...and that is just what happened to me last Thursday.

Long story short, this patient was having a CABG/MVR (coronary artery bypass graft/mitral valve replacement). The patient was already in bad health....and had been on long term steroids, making the tissues harder to work with. We came off bypass (the first time) just fine...but when the surgeon spotted an area that needed more work, we had to put the patient back on bypass. Unfortunately, the patient didn't come off the second time as well. The grafts that the surgeon had just placed starting breaking apart. No matter how much blood we gave and how quickly the surgeon tried to fix things, the tissues couldn't take it - the patient died on the table.

This is the first time this has happened to me during medical school. I performed CPR once before...and the patient left the ER alive, only to die 12 hours later....but this happened right before my eyes.

Surprisingly, it didn't hit me as hard as I thought an experience like that might. I think I've had so much experience doing autopsies that death seems a huge part of LIFE to me. Actually, when I first met the patient at 6:50am that morning, I already had a bad feeling for the day....I think I had already prepared myself that the outcome may not be very good. Unfortunately, my prediction was correct.