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!

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!!!

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!

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!

Very Special Blog

Please check out the very special post I wrote on my NEW very special blog =)

Trust Me...I'm (Halfway) A Doctor

I got to thinking today while I was in the ER seeing patients. ("Thinking"....what a concept!) A nurse had just asked me what drugs and labs I was planning to order for a patient I had just seen. To which I responded with perfect practice, "I'm just the medical student...I can't make that decision. Let me talk to the doctor and I'll let you know."

I might have been able to make a few good guesses about what the doctor would order....but chances are, something would have been wrong.

It is sort of nice not having any responsibility for the patient. I can't mess up. Well, I can.....but there is someone to catch my mistake. Plus, unless I knowingly do something harmful to the patient (like punching him in the face), I can't be held responsible.

What a scary thought to think that in a little over one year I will be the responsible one. The nurses will ask me that question and I'll have to respond with an appropriate drug and lab. I won't have the luxury and safety of saying, "I'm just the medical student..." By then I will be a doctor. Gosh....scary!

ER Patient of the Day - Part 2

ME: What brings you in here today, sir?

IDIOT PATIENT: I have weakness all over.

ME: When did this start?

IDIOT PATIENT: Oh, I've had this about 2 years.

ME: Did something happen? Why did you choose today to come in for this problem?

IDIOT PATIENT: No reason. Just thought it was time to get it checked out.




Give me a break Mr. Idiot Patient....what the heck are we going to do in the ER for you to treat this generalized weakness that has been present for 2 years? You dummy!

ER Patient of the Day

***100+ white female in the ER for confusion***

PATIENT: Get in here!

ME: Hi, ma'am. Do you need help?

PATIENT: No. What do you want?

ME: Well, I heard you call for someone...so I came to see if you needed help.

PATIENT: No one helps me. You all have broken my cookies. MY COOKIES ARE BROKEN!

ME: Your cookies are broken?

PATIENT: I am over 5 years old. You all want me to die!

ME: We don't want that. We are here to help you.

PATIENT: Get out of here!

***I start leaving the room***

PATIENT: Get back in here, sir!

***Please note: I am NOT a sir......last time I checked in the mirror, I was female.......***

ME: Yes, ma'am?

PATIENT: Get someone here to help me.

***Here is when I call for a nurse...not knowing what to do with my 3rd year medical student experience***

NURSE: Can we help you, ma'am?

PATIENT: Get this off of me!!!

***Patient rips out IV. As the nurse goes to grab it from her, she starts whipping the nurse with the tubing***

PATIENT: That's mine!

NURSE: You have pulled your IV out. Stop hitting! We need to reattach this.

PATIENT: You aren't helping me. Someone has to help me all the time.

NURSE: We ARE helping you.

PATIENT: ***Looking to me*** Who are you?

ME: I'm the medical student.

PATIENT: Well, you're NOT doing a very good job at it!

ME: ***Already starting to laugh at the situation*** Oh man! You're the first patient that has EVER told me that! I'm sorry to hear you say that.

PATIENT: I'm going to tell your folks and they are NOT going to be happy about it!



Hahahaha!!! I have been laughing at this situation the rest of the day. First she whipped the nurse with her pulled-out IV tube, then told me I was not doing a good job. It was so humorous! Better than that, when I passed her room about 5 minutes later, she had no idea who I was! Hahaha....I will remember her for a LONG time!

Check it out!

I meant to write a blog about my sister's recent engagement....but I guess I forgot!

Lucky for you, you can check out their new website dedicated to the planning of "The Big Day".

It is a really fun site to look at...and I'm sure will be updated by my sister, Kasey, quite frequently! I'll look forward to creating one whenever it's time for ME to get married!

Great Perspective

I've posted quite a few things that have been forwarded on to me from my Aunt Bobbie. Here is another great one.....apparently written by Jay Leno....although this cannot be confirmed. Either way, whoever wrote it.....it's a great perspective!

"The other day I was reading Newsweek magazine and came across some poll data I found rather hard to believe. It must be true, given the source, right? The Newsweek poll alleges that 67% of Americans are unhappy with the direction the country is headed, and 69% of the country is unhappy with the performance of the President. In essence, 2/3's of the citizenry just ain't happy and want a change.

So being the "knuckle dragger" I am, I started thinking. 'What are we so unhappy about?' Is it that we have electricity and running water 24 hours a day, 7 days a week? Is our unhappiness the result of having air conditioning in the summer and heating in the winter? Could it be that 95.4% of these unhappy folks have a job? Maybe it is the ability to walk into a grocery store at any time, and see more food in moments than Darfur has seen in the last year? Maybe it is the ability to drive from the Pacific Ocean to the Atlantic Ocean without having to present identification papers as we move through each state? Or possibly the hundreds of clean and safe motels we would find along the way that can provide temporary shelter? I guess having thousands of restaurants with varying cuisine from around the world is just not good enough.

Or could it be that when we wreck our car, emergency workers show up and provide services to help all, and even send a helicopter to take you to the hospital? Perhaps you are one of the 70% of Americans who own a home. You may be upset with knowing that in the unfortunate case of a fire, a group of trained firefighters will appear in moments and use top notch equipment to extinguish the flames thus saving you, your family and your belongings. Or if, while at home watching one of your many flat screen TVs, a burglar or prowler intrudes, an officer equipped with a gun and a bullet-proof vest will come to defend you and your family against attack or loss. This all in the backdrop of a neighborhood free of bombs or militias raping and pillaging the residents. Neighborhoods where 90% of teenagers own cell phones and computers.

How about the complete religious, social and political freedoms we enjoy that are the envy of everyone in the world? Maybe that is what has 67% of you folks unhappy.

Fact is we are the largest group of ungrateful, spoiled brats the world has ever seen. No wonder the world loves the U.S., yet has a great disdain for its citizens. They see us for what we are. The most blessed people in the world who do nothing but complain about what we don't have, and what we hate about the country instead of thanking the good Lord we live here.

I know, I know. What about the President who took us into war and has no plan to get us out? The President who has a measly 31% approval rating? Is this the same President who guided the nation in the dark days after 9/11? The President that cut taxes to bring an economy out of recession? Could this be the same guy who has been called every name in the book for succeeding in keeping all the spoiled ungrateful brats safe from terrorist attacks? The Commander-In Chief of an all-volunteer army that is out there defending you and me?

Did you hear how bad the President is on the news or talk show? Did this news affect you so much, make you so unhappy you couldn't take a look around for yourself and see all the good things and be glad? Think about it...are you upset at the President because he actually caused you personal pain OR is it because the 'Media' told you he was failing to kiss your sorry ungrateful behind every day?

Make no mistake about it. The troops in Iraq and Afghanistan have volunteered to serve, and in many cases may have died for your freedom. There is currently no draft in this country. They didn't have to go. They are able to refuse to go and end up with either a "general" discharge, an "other than honorable" discharge or, worst case scenario, a "dishonorable" discharge after a few days in the brig.

So why then the flat-out discontentment in the minds of 69% of Americans?

Say what you want, but I blame it on the media. If it bleeds, it leads; and they specialize in bad news. Everybody will watch a car crash with blood and guts. How many will watch kids selling lemonade at the corner?

The media knows this and media outlets are for-profit corporations. They offer what sells, and when criticized, try to defend their actions by "justifying" them in one way or another. Just ask why they tried to allow a murderer like O.J. Simpson to write a book about 'how he didn't kill his wife, but if he did he would have done it this way'...Insane!

Stop buying the negativism you are fed everyday by the media. Shut off the TV, burn Newsweek, and use the New York Times for the bottom of your bird cage. Then start being grateful for all we have as a country.

There is exponentially more good than bad. We are among the most blessed people on Earth, and should thank God several times a day...or at least be thankful and appreciative."

Grand Cayman, Here We Come!

My brain is fried.

I just realized that I haven't really had a break since I started my clinical rotations on August 6, 2007. That is 7 months without a break! Well, okay....I had a week off at Christmas...but that holiday is just so dang busy that I can't really count it as a break!

I usually get home from the clinic or hospital and am so tired that I'm hitting the sack by 9pm! Then I wake up at 5:30 or 6am to start it all over again. Is it bad to just want some time AWAY from the patients, lab values, X-rays, physicians, and studying?

My family - including my sister's fiance, my boyfriend, and other sister's friend - are leaving for a week and a half trip to Grand Cayman in one week. I can't wait!!!

Here is a brief list of what I am excited about:

1. Stepping off the plane to the smell of salt water in the air

2. Stingray City

3. Scuba diving

4. Snorkeling with my boyfriend

5. Cliff diving at Pedro's Castle

6. "Beaching it"

7. Getting tan

8. Playing tennis in the evening

9. Walking along Seven Mile Beach

10. Eating a meat-pie after diving

11. Messing around with my sister's underwater camera

I'd like to say that I won't study at all while I'm there. But in all honesty, I'll probably have some board review books to look through while I'm soaking up the rays. Even though I should take advantage of the sun, I also know that I've only got 6 months before my next medical board exam. YUCK!!!

Anyways, my boyfriend and I will be leaving Tennessee on Monday to drive back home. Then we'll be leaving late Wednesday night to head to Cayman. I'll keep a "vacation diary" while we are gone!!! We'll miss you all!!!