Thursday, May 27, 2004

Argh! I'm so frustrated and annoyed! First annoyance is this. My preceptor, for the past 4 weeks has said at each session (twice a week) "I really need to hear more presentations from you" when looking at the 4 of us who were, at that time, in the NICU or in clinics. And every f-ing time (sorry dad, had to use the bad word to show how annoyed I am) one of us would tell him that there have been no opportunities to do an H&P because there were no new patients or if in clinics, there's really no opportunity to do a full H&P and besides, all the kids were healthy and in clinics for regular checkups or for random rashes that were all from allergies. And in addition to that, we also told him that once we switched over to wards, we would have patient H&Ps to present. Yet every f-ing time, he'd end our sessions with "I really need to hear from you..." somehow forgetting what we had told him 4 days prior week after week. So today I got to look at my evals (mid-block review) and what does he write? "I would like to hear more presentations from cara." What the F!?! Clearly he's hearing the words but is having comprehension problems! And here's the funny part, when we now have patients to present (I can present 3 at the next session and this is just my first week on wards!), he cancelled our session tomorrow and monday is a school holiday! So I've realized now more than ever, that it pisses me off to be nagged time and again about something I really had no control over until now. It would be an entirely different story if I wasn't presenting because I didn't want to. I wanted to present I just had no interesting cases to present. Not that these are interesting but then again, very few of the cases presented thus far have held my attention...perhaps I show my disinterest a little too much at the end of the year. Which is more evident by having a team mate who is way more interested than me in some of the things these patients have.

Second annoyance happened not too long ago in the ER. I had to do an H&P on a sickle cell patient and was getting pimped on the way down to the ER...at 5 pm, I just don't give a rats ass about q&A sessions so I just said I didn't know to the questions being tossed at me cause I wasn't interested in this stupid game. Anyway, the resident and intern both decided to sit in to take notes while I did my thing but I also wanted to jot notes down. I probably didn't have to do this in retrospect but anyway, so i'm asking questions and doing the typical HPI questions. And the other 2 randomly are asking questions that were in my routine questioning. I guess I get into a certain mode to make sure I ask certain questions all the time and so these extra people kind of throw me off. What makes it worse is that this patient isn't there so we're asking her mom all these questions and her mom doesn't seem to comprehend some questions so I rephrase. or if it was one of the other 2, they had to rephrase a few questions. For example, I was told by the mom that her daugther had iron deficiency anemia as well as sickle cell anemia and so we (now it's just the intern and I) are just finding out if she's been symptomatic from that (so we can treat that and her pain crisis) and so I ask if she has been tired recently and the mom said "yes, whenever she has bone pain she just lies around on the couch." SO I ask, "in between her pain crises, is she tired? or does she have more energy like playing outside?" And she replies "yes, whenever she has bone pain she just lies around on the couch." Is there something wrong with the way I asked the question? I suppose I could have asked "when she doesn't have a bone crisis is she tired?" Oh wait, I did that too and got the same damn response. Then the intern asks, "has she been tired over the past 3 months and she says no. Was I being too specific? Used too many words perhaps and she got lost? Then the intern asked if her daughter ate meat. And she says "no" so I follow up with "does she eat chicken or is she a vegetarian?" She says her daughter doesn't eat chicken so I ask, "so what does she eat?" And the mom says "well, she'll eat a few pieces of a piece of chicken, but she won't eat the whole piece." Um, am I missing something here? Do I have a Broca's aphasia and can't produce comprehensible speech? I probably sound snotty but it was getting annoying having to put ask questions in the form a child would understand to get answers from an adult but I think it was only because I was annoyed at the residents at that point and this annoyance was exacerbated by this mother. Her daughter was better at answering my questions.
~me~ at 7:03 PM

Sunday, May 23, 2004

I'm right eye dominant. It actually hurts my face to try and use only my left eye when using the ophthalmoscope. It takes at least twice the effort for me to keep only my left eye open and this of course makes actually seeing anything with my left eye hopeless...odd considering that my left eye is actually better than my right eye according to the special machines at the eye doctor...not much stronger but stronger none the less. My face doesn't get as contorted and tired if I use my right eye with the ophthalmoscope. I've been told that I just need to train my left eye to be just as useful as my right eye but I just can't do that. I also have a harder time using microscopes and the ophthalmoscope if I have my glasses on. I'm a freak of nature but oh well...not that you didn't know that already!
~me~ at 3:42 PM