Monday, June 28, 2010
acid base irregularities and anion gaps
It's seems no matter how often I go over the acid-base rules, it seems like it's new every time. There are so many times that I think I need to understand these things so I can care for my patients but seem to just go back to basics to make sure that my gut response is correct. It's amazing to me that we are able to learn so much about our patients' health and metabolism based on anions and cations.
Medicine is so cool.
Saturday, June 26, 2010
mmmmm, tastes like summer
after 4 weeks of paediatrics I'm ecstatic to have the weekend off. Not just off, but spending it outside listening to live music and enjoying the weather. And becoming mildly intoxicated.
In the paeds ED, in no paticular order I:
sutured 3 fingers, a lip, a head
saw kid vs. lawnmower
saw what emotional shock can do to the parent of kid vs. lawnmower
fish hook in finger
first presentation of brain cancer
set 2 feet and 2 arms
way too many kids with constipation, gastritis or a cold
one over worked mom who just needed a bit of quiet time and reassurance
several cases of cocksackie
possible child abuse vs. anorexia ?vs. crohn's (that's something for inpatient to sort out)
a kid with a cold whose dad was worried the dying mother might get sick if they visited and wanted permission to go see Mom (heart breaking, especially when they were triaged as not important)
well,sick, happy and sad kids
it's been a good two weeks
Thursday, June 24, 2010
drives me crazy
so many people come outside emerg and smoke
it's disgusting and makes me literally sick at the end of my shift
Saturday, June 19, 2010
peds emerg has a predictable pattern
In the morning, it's the kids with colds so bad they couldn't sleep
the night before.
Right after school are some sick kids: those who are puking or overall
just look terrible.
Around 6 or 7 are the kids who have hurt themselves playing sports,
falling off the jungle gym or bike.
At 9 are the kids with wacky genital stuff that their parents saw
while giving the evening bath.
Friday, June 18, 2010
the best part of working in the ED is days off
This morning I'm sitting on my patio with my cats, drinking Starbucks, eating a scone, loving my garden, enjoying the weather and Reading a book for fun.
FOR FUN!!!
I'm reading Complications, A Surgeon's Notes on an Imperfect Science by Atul Gawande. He's a general surgeon out of Boston and unlike the general surgeons I've recently experienced is very thoughtful.
The chapter I'm currently reading is about the need for learners to practice and the ethical implications that what we need to practice on are people. Given the choice between a fellow and a consultant caring for his son, even though Gawande himself was a resident at the time, he chose the consultant.
I know I keep coming back to this problem in medicine, but I really think it's an important one. Learners learn through practice but who wants someone to practice on the one they love?
How will we get to do enough procedures master them and allow the generation before us to retire?
Thursday, June 17, 2010
cancer sucks
Tuesday, June 15, 2010
miscommunication sucks
To keep him comfy I offered him my phone to listen to a Dr. Seuss story that is read outloud. I offered him The Lorax, he asked if I had Cat in the Hat. Which, being the iPhone app junky I am, I had.
Saturday, June 12, 2010
there's no jobs in medicine (sic)
I don't want to say idiot but you know, they're idiots.
Tuesday, June 8, 2010
Sunday, June 6, 2010
apropos of nothing
It was my best friend's 13 birthday, the summer before we went to high school. We were in her dank unfinished basement in the dark with music playing and pop and chips. There was apparently a chair shortage since many of the girls needed to sit on boys' laps. Music was blasting (likely AC/DC or Bon Jovi) and I felt completely out of place. I don't think I've ever known how to behave at parties, let alone ones like this. These weren't really even our friends. If there was a movie theatre in town, I'm sure they would have rather been there, but with the slim pickings they found it worthwhile to be in the dark basement.
It's difficult to decide when it's time to go. Do I feign a curfew? A headache? Do I tell her I'm bored out of my skull because I don't have a lap to sit in?
These are the things I wish they'd taught us in health class instead of how our ovaries worked.
Saturday, June 5, 2010
more apps I'm using in clerkship
Friday, June 4, 2010
call night is usually spent in the ED
There are mostly snot nosed kids down in emerg. Also teens who are thinking about killing themselves, teens who drank too much and become beligerent, and young teens who may be pregnant.
It's incredibly odd to see the groups of cherubs next to these kooky teens.
Tuesday, June 1, 2010
Volunteering isn't always what you sign up for
One of my babies on the floor today was crying quite a bit. A
ridiculous amount. There was a little granny volunteer rocking baby,
snuggling her and trying to get her to calm down.
When baby finally settled, granny put her back into the crib with a
pacifier, rubbing her back keeping the pacifier in while baby fussed.
Then granny left.
When granny was half way down the hall, baby started crying again.
Granny almost ran down the hall. I'm sure she was thinking that this
wasn't what she'd signed up to do.