Monday, November 27. 2006
Yes, still alive... it has been nearly 6 weeks since I've posted in earnest, eh? It's not so much that I'm busy as much as things have stabilized. My residency-hating has mostly abated, seeing as now I'm in the middle of my vacation. It's amazing how much perspective you can get when you get enough sleep. It's nice to feel happy in my residency choice, something that's taken less time than I really expected. I remember college didn't truly feel comfortable until 3rd year, and med school until 2nd year. Maybe I'm adapting faster.
Anyways, the photo above is from about a month ago, I think. Kiran had vacation, so he and Sandeep flew out from the east coast to Vegas, and Eric and I met up with them there. Leaving Friday after work, we didn't really get there until almost midnight... We found them in the Venetian rather drunk, and I'm not ashamed to say we might have joined them in the festivities. I managed to break the glass on my first drink, a testament to Kiran's drinking prowess (he chose the drink, after all). We wandered around the casino, and I watched Eric and Kiran play War. Yes, that stupid card game we all used to play when we were young and bored. Despite my mockery, they managed to win some money. 'deep didn't fare so well at roulette.
So anyways, we ended up in a cheesecake factory inside the casino, and we ordered beer. The remainder of the night was a bit of a blur. Suffice to say, we got kicked out and apparently we're no longer welcome at the Venetian... Next thing you know we're walking along the interstate-15 at 4 am trying to figure out a way to cross back to the side where we were staying. We did eventually find the hotel, and crashed, and hence Kiran above.
Sadly, we had to drive back after sampling the lunch buffet. I don't think we were even in Vegas 12 hours, but I was on-call the next day, after all. Medicine wards no less...
Anyways, seeing as I'm on vacation, I should take some new pictures! Particularly since my camera broke, and I got a shiny new one. Gotta love extended warrantees...
Friday, October 13. 2006
Wednesday, October 11. 2006
I'm on the top of the world... looking down on creation...
Wow, done with my first medicine ward month! To say it was brutal would be kind. At times it felt like I was starting internship over, and well, yeah, I felt like an idiot every day. There's no doubt in my mind that some people hurt more because of me, and some folks suffered unnecessary injuries. I've never needed a good night's sleep more in my life.
Anyways, one of the few things that got me through were actually my call buddies - two of my fellow interns (whom I consider good friends now ^_^) were on call with me, and we always got into some sort of mischief. From the campfire (see two posts down) to breaking into the doctor's cafeteria at 2 am to get raisin bran to whatever else have you, the few minutes of play in the hours of work made for a much better experience. I'm gonna miss our little group.
The last night on call, we decided we wanted to see the city. Previously we had gotten on the roof (19th floor) but the walls were high and the stairwell to the 20th floor landing was locked behind a big door with a high voltage symbol. I had seen a landing on the 12th floor, so we tried to get there, but no luck, the walls were high around that terrace as well. On the other side of the hospital, we saw an open door to the 13th floor terrace, and although it was surrounded by high walls too, it was kind of cool just by it's odd design, and you could kind of see the city from the stairwell... not good enough.
Finally, we went back to the high voltage signed door on the 19th floor. I noticed the lock was the auto-locking kind, not an actual deadbolt... 15 seconds and 2 credit cards later, I had the lock open. (Hopefully no one from my residency office is reading this...) The promised land! Thus, the photo above, from a dizzying 20 stories up, with naught but a flimsy railing. At 2am, I just had to snap some more photos. And so, a photo of my partner in crime:
I had wanted to get a photo of all three of us, but someone didn't want to wake up to go exploring... Finally, the view I had lusted after:
A little hazy, but then again, LA always seems to be covered in that smog.
Tuesday, September 19. 2006
Let's face it, Q4 sucks. There are few experiences as grueling as staying up for 30 straight hours, seeing patients through the night as your pager drags you from one hospital floor to the next; and at the end of it all, you get it do it again after 2 days.
I lucked out this month, though; two of my new friends (and fellow medpeds interns) happen to be on call with me! We're not on the same team and we otherwise wouldn't see each other at all, but we make it a point to page each other before dinner and before the midnight meal. The midnight meal in particular is a perfect time to find a little solace from the insanity of the hospital, a time when most patients are sleeping and we're each somewhere between admissions 3 and 4. So that's how, last night, we found ourselves on the roof of our hospital eating cereal and cheezit's.
It felt like an imaginary campfire of sorts, a small corridor surrounded by high walls and barbed wire and the open sky above. Luckily no one actually paged us while we were up there, although we didn't get to stay too long. The creaking and the groaning of a 75-year-old building can get to you, and that thump-thump-thump-buzz did sound like a zombie dragging a chainsaw across the ground, just about to turn the corner... Thus the photo above of my compatriots turning to see what just made that crashing sound.
Also, I've now definitively decided that, while the razr is a very nice phone, its camera sucks something terrible.
Sunday, August 20. 2006
Sorry no posts in a while, I haven't really touched my camera since residency started... but here's photo of my medpeds intern class of 2010. They're awesome, I love them to death. Anyways, my post is totally unrelated to this picture. ^_^
10 yo HM. Nephrotic syndrome. They say you never forget your first patient. Yet I can’t remember his name for the life of me. I do remember Dr. Opas telling me that 1. He never forgot his first patient and 2. That my job as a doctor was to turn down the air conditioning when the room got cold. I remember the kid was cute, and that he had all the side-effects of cyclosporine like gingival hyperplasia and hirsutism, as Dr. Opas pointed out to me after I matter-of-factly told him that my patient had a normal physical exam. Oops. Screw-up number one…
So I’ve managed to survive my first two months of internship. The first month was pretty easy; after all, there’s really nothing like a nice month of outpatient pediatrics to ease my way into residency. The second month wasn’t nearly as easy. I got to experience my first night on call admitting 5 patients (which is not nearly the crazy censuses of some teaching hospitals, btw) and things frankly started to get confusing. Falling asleep over my paperwork, my pen would continue to move as I would nod off, and first my carefully constructed sentence would start to go to nonsensical words, and finally just pen strokes as my pen would fall out of my hand.
More mistakes happened than I really thought would, as well. Some were minor, such as when a friend of mine sent a patient off to the CT scanner on the wrong date – a big affair only because, well, we don’t have a CT scanner in the women and children’s hospital, and getting a CT involves a quick ambulance ride to the general hospital. Oops. The annoyed look on the faces of the paramedics, patient and her mom were priceless as they came back to the floor from CT, where they were undoubtedly told in a very kind manner that they had arrived on the wrong day.
As for myself, well, I’ve made plenty of mistakes too. Judgment really clouds up under stress. Most involve things like the wrong dosing on a medication (which luckily are checked both by nursing and by the pharmacy prior to administration) or the wrong test (I ordered an xray+contrast study instead of a nuclear medicine study). Just the other day, I confused two patients who had the exact same name and described the wrong patient entirely to our endocrinologist. I ended up having to page him five minutes later and explain how I just told him everything I knew about the wrong patient.
One patient in particular was a much closer call, however. I ordered a load of dilantin on this child, after having reviewed his order log to make sure that he had not already received one. Medication loads are high doses that we use to bring rapidly someone’s blood levels of a medication to therapeutic levels. They really should only be done once. My mistake was that I had forgotten that the patient had already been loaded in the ER, which uses a different order sheet.
So there I was, sitting at this desk and falling asleep when I remembered that this patient had indeed received a load. I debated whether or not it mattered, prudence got the better of me and I told my senior. “I think he already got a dilantin load in the ER…” She snapped out of her half-asleep state and after verifying it on the ER ordering sheet, ran out of the room to see if she could cancel the order. Thankfully the patient had not yet received his medication, and she was able to cancel the order in time, and I did not poison my patient. It’s truly amazing the dumb things I can do.