1) I am tired! I've been on Internal Medicine Service for the past few weeks...and getting to the hospital every single morning at 6 is wearing me out! And I'm afraid I've got a few more months of getting up this early too - next is pediatrics and then surgery!
2) I am hopeful that I will get some Family Practice rotations set up in the next few days. I've been in touch with a doctor I worked with - who put me in touch with another doctor - who might be willing to take a student for 1-2 months next school year. Plus, the rotation would be close to town! I should be hearing in the next day or so - and that will make it so much easier to schedule everything else!
Tuesday, May 27, 2008
Sunday, May 25, 2008
Suicidal Patients
I've been at the county hospital for a month and a half now. And even though I've seen patients come in who have attempted suicide, I've seen way more in the past month and half than I have my entire third year of medical school. I don't know if this is a direct result of being in the county hospital or not - I just know the numbers I have seen.
I had a patient this past week who ingested, intentionally, way too much Tylenol. Acetaminophen (Tylenol) is toxic to the liver when you get over 7,000mg. This patient presented to the hospital after ingesting - drum roll please - 25,000mg! Unbelievable! Can you imagine how bad life must have been in order to do this? Oh, and if that wasn't enough, throw in quite a bit of EtOH (that's how doctors write alcohol....we're so smart!) - which is another toxic agent to the liver.
We saved the patient's life - and, subsequently, transferred the patient to the psych ward. My guess is that I will see this patient again before my time is done at the county hospital.
I had another patient this week who presented with acute pancreatitis. Apparently the patient had been drinking about a gallon of vodka the few days leading up to the current attack. Of special note - the patient was also a chronic drug seeker. My favorite. And wouldn't you know...pain control is one of the top managements of pancreatitis? Yep.
The patient was also newly homeless.
While most patients only need a few days in the hospital to get the pancreas back to "normal", this patient seemed to like the hospital and stayed about 6 days. No surprise to me...or the resident...or the attending....when we learned that the patient was taking smoke breaks during the day and bringing back dirty laundry that needed to be washed. And when we told the patient that we were planning to discharge, the patient actually said, "Well, I have some phone calls I need to make. Maybe tomorrow would be better."
I saw the patient a few days after discharge, sleeping in a car in the hospital parking lot. Looked like there was freshly cleaned laundry in there too.
I'm guessing there might be another "pancreatic attack" before I'm through.
On another note, please take a look at "Ah Yes, Residency". This post is awesome - and please note "The Shadow" which sums up my medical student experience!
I had a patient this past week who ingested, intentionally, way too much Tylenol. Acetaminophen (Tylenol) is toxic to the liver when you get over 7,000mg. This patient presented to the hospital after ingesting - drum roll please - 25,000mg! Unbelievable! Can you imagine how bad life must have been in order to do this? Oh, and if that wasn't enough, throw in quite a bit of EtOH (that's how doctors write alcohol....we're so smart!) - which is another toxic agent to the liver.
We saved the patient's life - and, subsequently, transferred the patient to the psych ward. My guess is that I will see this patient again before my time is done at the county hospital.
I had another patient this week who presented with acute pancreatitis. Apparently the patient had been drinking about a gallon of vodka the few days leading up to the current attack. Of special note - the patient was also a chronic drug seeker. My favorite. And wouldn't you know...pain control is one of the top managements of pancreatitis? Yep.
The patient was also newly homeless.
While most patients only need a few days in the hospital to get the pancreas back to "normal", this patient seemed to like the hospital and stayed about 6 days. No surprise to me...or the resident...or the attending....when we learned that the patient was taking smoke breaks during the day and bringing back dirty laundry that needed to be washed. And when we told the patient that we were planning to discharge, the patient actually said, "Well, I have some phone calls I need to make. Maybe tomorrow would be better."
I saw the patient a few days after discharge, sleeping in a car in the hospital parking lot. Looked like there was freshly cleaned laundry in there too.
I'm guessing there might be another "pancreatic attack" before I'm through.
On another note, please take a look at "Ah Yes, Residency". This post is awesome - and please note "The Shadow" which sums up my medical student experience!
Thursday, May 15, 2008
Scheduling Rotations BAD: Family Achievements GOOD
I struck out again today - twice - trying to schedule family practice rotations. What the heck!?!?!? I put in another couple of requests, but at this rate, I'll be lucky to stay in the Midwest for these 2 months, let alone in Iowa. Cross your fingers!!!
2.) Okay, so this example did include a little bit of luck - okay, a lot of luck! The same sister AKA "Prom Queen" won a dang bike at After Prom. Anyone need a bike?
3.) Same sister - different example. While playing in the Regional Tennis Finals today at Indianola, "Prom Queen" and her doubles partner WON!!! That's right - District and Regional doubles champions!!! That earned them a bid at the State Tournament in two weeks! They played great today and won 3 straight matches to work their way through the bracket.
Despite the bad luck with school rotations, my family has had excellent luck this past week. Well, not so much "luck"....more like bad-a$$ skill! (Sorry Mom! - I'll wash my mouth out with soap right now!) I could preface the following by saying, "I'm not bragging," but, darn it, I'm just so dang proud of everyone right now that I am pleased to be able to brag about my family.
1) My youngest sister was named "Prom Queen" of her high school last weekend. In a class of 700+, it really was an honor just for her to be nominated! (I sound SO CHEESY!!!) I don't think her Senior class could have chosen anyone better!
2.) Okay, so this example did include a little bit of luck - okay, a lot of luck! The same sister AKA "Prom Queen" won a dang bike at After Prom. Anyone need a bike?
3.) Same sister - different example. While playing in the Regional Tennis Finals today at Indianola, "Prom Queen" and her doubles partner WON!!! That's right - District and Regional doubles champions!!! That earned them a bid at the State Tournament in two weeks! They played great today and won 3 straight matches to work their way through the bracket.4.) My other sister - we'll call her "Hollywood" - is a presenter for the Graceland SIFE team who was competing at Nationals the past couple of days in Chicago. After an impressive opening round, they moved on in the competition - competing again this morning and making the final four. After their afternoon presentation, they were named "2nd Runner Up" in the entire nation! My parents were able to be in Chicago and they said it was another excellent showing by the GU SIFE team. I know the SIFE team is bummed that "Hollywood" - their top presenter - is graduating next week!!!
5.) Finally, I need to brag a little bit about the Graceland Men's Tennis team - and not just because my grandfather is the coach or my cousin is the #2 player on the team. The GU tennis team was also competing in their National tournament this week in Mobile, Alabama. Never before has GU made it through 2 rounds of the tournament - and this year, they did!!! Top 8 in the Nation, baby!!! They knocked out the 6th seed in their 2nd round - becoming instant celebrities among the schools - before being beaten by the 3rd seed yesterday. It was the best finish a Graceland team has ever had...and I'm so proud of my grandfather, cousin, and the rest of the team!
So there you have it. I'm glad you've allowed me to brag a little bit - it's always nice to be so proud of your family!
Wednesday, May 14, 2008
Dang Rotations!
Well, I have unsuccessfully been trying to submit 4th year rotation sites for the past 2 hours. At my school, because we don't have an affiliate hospital, we are left to find rotations on our own. So even though I don't have any desire to do Family Practice, I still have to schedule 2 months worth during my 4th year.
I understand the importance of Family Practice and I'm not knocking this as a career. It's just not in my cards. I'm planning to do ER - which you could argue functions somewhat as family practice anyway - because it is more exciting to me. I like to "think on my toes" and be a "jack of all trades".
Here is where my problem lies:
The class below mine is now required to stay in-state for 3rd year. While I understand my school's purpose for doing this - keeping students closer and having more control over education - it poses quite the dilemma for my class. In the past, 4th year students had precedence over 3rd year students. That makes sense. Well, now that they have to stay in-state, the 3rd years get precedence over 4th years. Hmmm... That means 4th year students either 1) have to travel out of state for required rotations or 2) get stuck with left-over spots which could be anywhere in the state. This is a bummer - especially when you don't want to do Family Practice.
So, back to my unsuccessful attempts - I've already struck out 3 times for rotations near Des Moines. I've resubmitted a few of them with different dates, but I'm not too hopeful. Thankfully, everything has worked out well for me in the past - and I'm hoping this will be no different. But, still....it's very frustrating!
On a good note, I did get a Pediatric ICU/Peds ER rotation scheduled. Despite the fact that I will be dealing with really sick kids (which is just plain sad!) I think this will be a good addition to my schedule heading into an ER residency!
I understand the importance of Family Practice and I'm not knocking this as a career. It's just not in my cards. I'm planning to do ER - which you could argue functions somewhat as family practice anyway - because it is more exciting to me. I like to "think on my toes" and be a "jack of all trades".
Here is where my problem lies:
The class below mine is now required to stay in-state for 3rd year. While I understand my school's purpose for doing this - keeping students closer and having more control over education - it poses quite the dilemma for my class. In the past, 4th year students had precedence over 3rd year students. That makes sense. Well, now that they have to stay in-state, the 3rd years get precedence over 4th years. Hmmm... That means 4th year students either 1) have to travel out of state for required rotations or 2) get stuck with left-over spots which could be anywhere in the state. This is a bummer - especially when you don't want to do Family Practice.
So, back to my unsuccessful attempts - I've already struck out 3 times for rotations near Des Moines. I've resubmitted a few of them with different dates, but I'm not too hopeful. Thankfully, everything has worked out well for me in the past - and I'm hoping this will be no different. But, still....it's very frustrating!
On a good note, I did get a Pediatric ICU/Peds ER rotation scheduled. Despite the fact that I will be dealing with really sick kids (which is just plain sad!) I think this will be a good addition to my schedule heading into an ER residency!
Wednesday, May 07, 2008
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