Sunday, July 29, 2007

Despite the fact that I myself have worn scrubs day in and day out basically since I started residency, I still notice other people's clothes. There are certain accessories that make or break people's outfits at the hospital. On women, it's shoes. On men, it's ties. Seriously, a stupid tie can take a nicely dressed man from zero to idiot in 3 seconds flat.

A really attractive male medical student just rotated through our service, and EVERYONE noticed him. When he finally came through ob while I was on I finally had a chance to meet this guy who had all the residents talking. (Yes, yes, we value people's MINDS, we do not objectify people, blah blah professionalism-cakes.) Unfortunately, I couldn't take him seriously after seeing his tie:


The answer is: NO. A Mickey Mouse tie is NEVER appropriate.

Sunday, July 22, 2007

I think it's funny that anytime I ask a medical student a question they assume I'm pimping them, when, in fact, I'm asking them because I myself don't have a damn clue.

Case in point: today was my first day of my Labor & Delivery rotation. I haven't done obstetrics since I was a third year medical student, which was three years ago. Today I was all like, "Uh...the baby comes out of the where now?"

I went to do a History and Physical on a patient about to be induced for labor, and I asked about bleeding, gushes of fluid, contractions, fetal movement, and then I ran out of questions. The patient and I stared at each other for a while until I turned to the medical student, "Uh...James, what else do we want to ask the patient?" And he was all, "Well, we must ask about right upper quadrant pain, visual changes, BLAH BLAH pre-eclampsia-cakes." Whilst I nodded my head sagely at all the Socratic teaching I was bestowing upon my pupil. Then I left the room and quickly made a note to ask all patients about pre-e symptoms during their H&P.

First days of rotations, especially as an intern, are just painful. You don't know where anything is, you don't know the nurses, you don't know how any of the paperwork is done, and you basically just get in the way and hinder actual work getting done. Also, I have a hard time getting used to the fact that I'm the one people are calling for when they say RESIDENT TO ROOM 65 STAT. So I'll run to room 65 and when I get there I wonder what exactly I'm supposed to do.

Also, when they say RESIDENT FOR DELIVERY they are also referring to me apparently, so I run into the room as the nurses are preparing the light, pushing the sterile table to the field and breaking the bed. The attending was already there getting gowned and gloved and she told me to go ahead and put on some booties, a surgical bouffant, a mask and goggles before getting gowned and gloved. Everyone was too busy running around in preparation for the baby about to fall out of the mom's vagina so I couldn't ask anyone where exactly all those things were kept, so I randomly started opening cabinets and drawers looking for the protective gear. I stuck a cap on my head and found the booties and had jammed my leg into one of them, and was hopping around trying to get my other leg into one when the baby delivered. Seriously, I felt like the world's biggest idiot. I bet the attending is still laughing at me.

In other news, I got to deliver babies! I like the adrenaline on labor and delivery and I like my teammates so I don't mind the long hours. Anyway, I'm on overnight call tomorrow night. I'm not sure how this is going to pan out. I'm tired after 3 hours on L&D.

Tuesday, July 17, 2007

Hi everybody! Sorry about the delay here!! I'm still getting accustomed to, uh, having a steady job and whatnot, thus explaining the tumbleweed around these parts.

Next week I switch over to obstetrics which should be fun (Yay!! Babies!!) but also terrifying (OMIGODBABIES). So far work has been exactly my speed but I have a feeling I'm about to be bowled over. I have resolved to make a more concerted effort at posting, though. You're welcome.

So, hmm, yes, hot-button medical issues and social commentary. But first: embarassing stories about my lovelife!

I had vacation 2 weeks ago, and it was all very nice, all laundry-home-sleeping 14 hours a day-watching TV-couch-pajamas-not-showering and then during the latter half of the week I went to California to see VCAE. I was pretty nervous about the trip, given the disasters that have recently comprised my lovelife, but I'm happy to report that it was officially: not terrible! There was wine-tasting, and hiking, and double dates with his friends, then with my friends, and shopping (where OMIGOD he bought things on my recommendation) and most of all, Planet Earth on DVD and quality time on the couch, which cemented the bond of nerdliness we share.

Thus leading up to the embarassing story: on Saturday after having dinner out with some of my friends we returned to his apartment to get ready to go out that night. I was flipping through a magazine on the couch and he was in the kitchen doing the dishes when I realized my right eye felt a little itchy. I kept scratching it then finally asked him if my eye looked okay because it felt a little weird.

VCAE walked over and his face was completely expressionless. "Uh...it's ..just a little bit swollen."

"Swollen? Wait, let me go look at it in the bathroom mirror."

"Hold on, hold on. I think you need to sit for a minute. It's really not that bad, but it might be a little...surprising. Seriously, sit down. I'll bring you a compact so you can look at it."

VCAE brings over one of my compacts and gingerly hands it over. My right eyelid is swollen to the size of a golf ball and occluding 80% of my right eye. Yes, I'm sure it was all very sexy.

"OMIGOD. HOW DID THIS HAPPEN?!?!"

"It's ok, you're ok. I really think it'll be ok."

"ITISNOTOKIAMQUASIMODO."

This very lovely story ends with VCAE making me hold an ice pack to my eye for an hour and a half while he called his dad, an ER attending, who diagnosed me with "bug bite" and told me to use Benadryl when I was ready to go to bed. It was really a fun way for me to meet his dad.

The swelling returned to normal overnight but the sweetest part of the story was when he confessed that he cleaned his apartment from floor to ceiling in preparation for my arrival and felt so terrible when I got bitten by something there that he put bug spray on all the plants on his patio to make sure no bugs could find their way into his apartment to attack me again.

Wednesday, July 04, 2007

Oh. There you are.

Hello everybody! Sorry about the, uh, total lack of communication on my part here. I can't even claim that residency has sucked away all my free time..I mean, it's sucked away the vast majority of my free time, but I've just been a smidge lazy lately on my down time.

So...where were we? Ah yes! I had moved to STL for residency, my computer croaked, and I was in the midst of a minor myocardial infarction myself. An incredible person saved my computer for $80, and I lost all my iTunes but that was a totally acceptable alternative to losing EVERYTHING, because then someone might have had to die.

I started residency, and am currently on benign surgery. I get in around 5:30 and usually leave around 6:30. It's really not bad right now, with the exception of weekend call which I basically have every weekend this block - either 24 hours on Saturday or Friday night/Sunday day. Currently, though, I'm on vacation. Yes. That's correct. I worked for 3 weeks and then I was awarded one of the precious THREE vacation weeks I get all year. It's ok though, to be honest I could use a breather right now, and I'm happy that it's warm enough that I can actually do enjoyable things with my time off...like visit a certain very charming aerospace engineer (VCAE) I met at a wedding a few weeks ago. (Ok...if you really want all the painful details I met him when I interviewed at a program in California back in November, and we just happened to see each other again at this wedding.)

I like surgery. I like this rotation. I get to operate all day and then just come home. Our patients are rarely seriously ill and have few post-operative complications. The only bad part about being the benign intern is that we have to do circumcisions. Which I hate hate HATE doing. I'm not passing opinion on the circs themselves, but I think it's dumb that ob/gyns got stuck doing them. We practice medicine and operate on the reproductive tracts of adult women. How the hell did I get stuck slicing the foreskin of newborn baby boy penii?

First, I have to go consent the mother. I always take great pains to explain that this is an ELECTIVE procedure, meaning NOT MEDICALLY NECESSARY, and we are only doing it ELECTIVELY. I also explain the usual risks of infection, bleeding, blah blah complication-cakes, but the most important risk is the risk that what looks like a good circumcision to me may not look like a good circumcision to them. Though, for most of the circs I've done, I think we can all agree that I haven't produced some good-looking penii. NOTE: This is a cosmetic issue only. I know what I'm doing enough to take the foreskin off in a clean and safe manner with no harm to the head of the penis. These babies will urinate and have babies of their own in the future, but they won't have the most attractive penis in the world. Sometimes I'm just a little uneven in the actual amount of foreskin I remove from the front and back. There's a lot of that stuff to go around, and it's awfully wrinkly and bunchy.

The best part about consenting patients (or in this case their moms) is that occasionally one will say no and just flat-out refuse the procedure. In this case, where it's an elective procedure that I hate doing, I am completely okay with this. In fact, I've considered carrying around the actual restraint gear we STRAP the baby to.
I think being strapped down is the most upsetting part for the babies.

As far as actual procedural devices, I'm a Gomco girl myself.


It takes a little longer and requires some more coordination than the Mogen, but I like that the little bell protectively sits over the head of the penis, thus ensuring that no goofage and injury to the penis head will occur. I offered to bring both devices to VCAE and give him a demonstration but he politely demurred.