January 2012
8 posts
December 2011
16 posts
Facing Fears
My mother likes to compare me to my brother by saying that when we were kids, he was the uber cautious one afraid to try new things and I’d been the one with the dumb fearlessness. Guess that says something about my brother, because I’d say that I still play it pretty safe. It really is something, though, to face your fears head on, and realize that things change, sometimes for better,...
Lisa's Five Non-negotiables
drive/ambition
similar values
compatibly quirky sense of humor
challenges me
*can dance
*I’d probably trade in #5 for any sort of artsy fartsy/creative leanings. (Dancing is a major plus though.)
Last day of Neuro
Halfway through third year and I don’t feel like I know all that much more now than I did before I started this rotation. But I like to think that I absorbed more than I think.
Dr. R at Einstein was impressed by us. Unfortunately, we only worked with him for one day. Dr. D thought we were idiots and looked at us with a condescending flutter of her eyelashes, though she was oddly perky...
Getting played
Got played by another pt for the umpteenth time. My attending got really upset by him and wrote out a prescription for neurontin begrudgingly.
I can’t see through patients the way other doctors can. I have some sort of super naive defective personality where I believe the good in everyone. I’m far too forgiving and write off potentially serious flaws as personality...
Sometimes I have dreams that feel so real I become upset with people and have to remind myself that none of it ever happened after waking up.
New Directions
I was pretty set on doing the minimal number of years for residency training (3-4), but now with ideas of pediatric emergency medicine percolating through my head, maybe I’m willing to put in a few more years for a happier patient population? Those family med people and their quality of life studies. Sheesh.
TGIF
“Mom, listen, I haven’t been together with Topanga for 22 years, but we have been together for 16. That’s a lot longer than most couples have been together. I mean, when we were born, you told me that we used to take walks in our strollers together around the block. When we were two, we were best friends. I mean, I knew everything about this girl. I knew her favorite color, her favorite food. Then...
Neurology - Week 2
I’m back at Einstein and I’ll admit that I’m enjoying neurology more than expected. Maybe it’s because somehow I care even less than before, that I have less responsibilities, that Dr. N is a great teacher, or that I think Dr. S is such a cutie (in that adorable grandfatherly sort of way). Or maybe that I’m finally able to focus, but I actually kind of like learning...
November 2011
17 posts
Life, Death, and when to let go
Last week we had a pt who showed up as a transfer from another hospital. Long story short, he was essentially brain-dead/comatose, incredibly uremic, sacral decubs, everything pointing to a vegetable slowly wasting away. He had been that way for a long time, but his wife refused to let him go. Not interested in hospice or palliative measures, she demanded that he be dialyzed, but refused to have...
Medicine vs. Surgery
Q: How do you hide something from an internist?
A: Cover it with a dressing.
Q: How do you hide something from a surgeon?
A: Publish it.
One of us
33 yo F h/o stroke and L hemiparesis s/p postpartum vasoconstrictive syndrome p/w SVT converted with adenosine in the ambulance. Due to the ICH, she’s now missing part of her skull and R brain, so there’s a marked concavity in her R skull. She lost all sensation and power on her L side, though she’s regained some strength in the R side with the addition of tremors. She has a PEG...
All Over Again
Scores. Grades. Extracurriculars. Research. Leadership. CV. Letters of Rec. All determine 4th year and residency, but more importantly, future geography. It never seems to end.
Hospital. Mortality. Family.
60 yo M, PMH includes prior ETOH abuse, p/w acute/subacute stroke, ketoacidosis from malnourishment, and decubitus ulcer/osteomyelitis.
And yet, this 60yo guy still lives with his mother. He is a social recluse, and is so stubborn, belligerent, and miserly, refusing to eat or leave his room/bed, that he has to fall out of bed from a stroke before his mother dares to call 911 and have him taken...
Quotables from Dr. W
About an 88yo pt with a previously decreased level of consciousness: “wow, Ms ___ is RAUNCHY today! Let’s get her out of here!” — I think he meant feisty? She’d been nearly comatose for days.. it was good to see her perky again. She went home the next day, and after telling her she was heading home, she grinned and let out a soft “Whoopie!”
About a...
October 2011
22 posts
Growing Old and my Golden weekend
88yo F, COPD, CHF, SSS s/p PPM, CAD s/p MI, Htn, HL, GERD, glaucoma, p/w parotitis, MRSA bacteremia, SOB, pleural effusions, and now AKI. Likely due to contrast from a PICC placed for the MRSA bacteremia. And the vancomycin. And the lisinopril we started her on. Very much decreased UOP lately, cloudy urine with sedimentation. Also, very hard of hearing, so I’m constantly yelling at her. Yet,...
Green Medicine at TJUH Day 1
I established some pretty awesome “rapport” with my patient. She enjoyed that a “shit” slipped (I was establishing when exactly that the “shit hit the fan”). Hung out and listened to her and her housemate tell stories for a while. Normocytic pernicious anemia with pantyhose distribution of neuropathy and pancytopenia (Hb 2.4, plts 13, WBC 2). Interesting.
But,...