Life at Med School

Friday, January 23, 2004

My throat is sore. I bought a bunch of Oregon Chai tea today (yummy) and a bag of my favorite chips (salt and pepper kettle chips - a product of oregon). Oh and I discovered that I really like Cat Stevens' music.
Oh and next wednesday I'll actually have to start working hard again when I start Neurology - blah.
~me~ at 5:53 PM

Wednesday, January 21, 2004

Yea! The crazy guy Sam was fired on The Apprentice tonight! That guy irritated me and reminded me of the manic patients I have. But he apparently has been successful in life thus far so more power to the crazies I guess
Speaking of the crazies...today's crazy clinic was, well, crazy. My patient came back and at first things seemed fairly straight forward. He really didn't change which is understandable since he wasn't on meds yet and his labs were all normal and since we couldn't see if he had gotten the EKG, we were ready to give him lithium and then I asked him about the EKG and he did get it done and they gave him the copy. Um...how this man was allowed to leave the VA yesterday is beyond me because right at the top of the page, starred multiple times by the computer that interprets the EKG (not always right by the way) is:
*******ACUTE MI********
In addition to that, the EKG was classic MI ST changes with reciprocal change in other leads! SO obvious even I was able to see it. Well, I did get 100% on the EKG test so perhaps I'm underestimating my ekg reading abilities. Anyway, the tech who did the ekg gave my patient his ekg and then let him leave! How lucky is this person that my patient didn't drop dead over night. Well, we then escorted him to the ER to get this further evaluated and I went on to write my note. He then appears at my office door and says "they want to draw more blood and I just want to leave." In short, he feels that he doesn't have time to be admitted to the hospital but did let the docs draw 1 set of cardiac enzymes, do a new ekg , and take a chest xray but then he signed out AMA to come back monday for cardiac stress testing. If it were my choice, I would have done an emergency commitment because I don't think he had good judgment to say that he didn't need to be there but then again, I'm new at this whole game of determining competence and Dr. R explained that since he is able to understand a lot of different things, he is competent to make this choice. Oddly enough, for someone who doesn't want his heart to be taken care of emergently, he did return again after the labs and studies were done to ask if he should pick up his antipsychotic today and start taking it tonight and to tell us that he will be in monday to do the heart studies and then on wednesday for his next mental health clinic appointment. Well, I am good at that establishing rapport thing...I just hope it's not a pathological relationship he has in his head. Dr. R. laughed and said it's looking like the movie "What About Bob" where bill murray's character follows the shrink on vacation. Great. Well, today was the last clinic day for me so hopefully he'll continue to be compliant with a new med student.

I love the crazies and the crazies love me
God bless the crazies and God save me
~me~ at 8:27 PM

Monday, January 19, 2004

Can I just say I have the crappiest luck. The first night I was on call there was a Hornets basketball game and traffic sucked especially since I had to reroute my way to the parking garage and then the second time I was on call there was another damn game. I hate traffic.
And then we had a deans hour that officially began the ulcer formation that is the residency application process. I have no freaking clue where my interview outfit I used for med school interviews is and unlike the med school application process, I have a very limited choice in where I get to go. I'm jealous of the military kids. They find out in december if they were picked and where they will be spending the next few years while we find out in march. Just thinking about it makes my stomach churn...or wait, is that just my tummy telling me I need a snack? Being an adult sucks. And I bet being a real adult with a real job sucks even more. And having a mental meltdown is out of the question since the last place I want to be spending my mental collapse is on a locked unit in this city.
~me~ at 2:22 PM

Life at Med School
the life of a torn bubble trying to stay afloat
Friday, January 23, 2004 My throat is sore. I bought a bunch of Oregon Chai tea today (yummy) and a bag of my favorite chips (salt and pepper kettle chips - a product of oregon). Oh and I discovered that I really like Cat Stevens' music. Oh and next wednesday I'll actually have to start working hard again when I start Neurology - blah. ~me~ at 5:53 PM Wednesday, January 21, 2004 Yea! The crazy guy Sam was fired on The Apprentice tonight! That guy irritated me and reminded me of the manic patients I have. But he apparently has been successful in life thus far so more power to the crazies I guess Speaking of the crazies...today's crazy clinic was, well, crazy. My patient came back and at first things seemed fairly straight forward. He really didn't change which is understandable since he wasn't on meds yet and his labs were all normal and since we couldn't see if he had gotten the EKG, we were ready to give him lithium and then I asked him about the EKG and he did get it done and they gave him the copy. Um...how this man was allowed to leave the VA yesterday is beyond me because right at the top of the page, starred multiple times by the computer that interprets the EKG (not always right by the way) is: *****ACUTE MI**** In addition to that, the EKG was classic MI ST changes with reciprocal change in other leads! SO obvious even I was able to see it. Well, I did get 100% on the EKG test so perhaps I'm underestimating my ekg reading abilities. Anyway, the tech who did the ekg gave my patient his ekg and then let him leave! How lucky is this person that my patient didn't drop dead over night. Well, we then escorted him to the ER to get this further evaluated and I went on to write my note. He then appears at my office door and says "they want to draw more blood and I just want to leave." In short, he feels that he doesn't have time to be admitted to the hospital but did let the docs draw 1 set of cardiac enzymes, do a new ekg , and take a chest xray but then he signed out AMA to come back monday for cardiac stress testing. If it were my choice, I would have done an emergency commitment because I don't think he had good judgment to say that he didn't need to be there but then again, I'm new at this whole game of determining competence and Dr. R explained that since he is able to understand a lot of different things, he is competent to make this choice. Oddly enough, for someone who doesn't want his heart to be taken care of emergently, he did return again after the labs and studies were done to ask if he should pick up his antipsychotic today and start taking it tonight and to tell us that he will be in monday to do the heart studies and then on wednesday for his next mental health clinic appointment. Well, I am good at that establishing rapport thing...I just hope it's not a pathological relationship he has in his head. Dr. R. laughed and said it's looking like the movie "What About Bob" where bill murray's character follows the shrink on vacation. Great. Well, today was the last clinic day for me so hopefully he'll continue to be compliant with a new med student. I love the crazies and the crazies love me God bless the crazies and God save me ~me~ at 8:27 PM Monday, January 19, 2004** Can I just say I have the crappiest luck. The first night I was on call there was a Hornets basketball game and traffic sucked especially since I had to reroute my way to the parking garage and then the second time I was on call there was another damn game. I hate traffic. And then we had a deans hour that officially began the ulcer formation that is the residency application process. I have no freaking clue where my interview outfit I used for med school interviews is and unlike the med school application process, I have a very limited choice in where I get to go. I'm jealous of the military kids. They find out in december if they were picked and where they will be spending the next few years while we find out in march. Just thinking about it makes my stomach churn...or wait, is that just my tummy telling me I need a snack? Being an adult sucks. And I bet being a real adult with a real job sucks even more. And having a mental meltdown is out of the question since the last place I want to be spending my mental collapse is on a locked unit in this city. ~me~ at 2:22 PM
where have all the monkeys gone?