bitch

grocery store check-out clerk: "paper or plastic? or do you just wanna use those bags under your eyes?"

Watch out, world.

I found the secret to success.

PEP talk

I went to work at a hospital in Africa last year, and as a precaution (since I would be in the OR, and HIV prevalence there is about 25%, and needlesticks do happen), I brought along anti-retroviral medication for post-exposure prophylaxis. It's kind of expensive, so I didn't throw it away after I got home.

I just know that, some day, someone will snoop through my medicine cabinet, find my bottle of Truvada, and conclude that I have AIDS.

Understatement of the Year

Surgery Exit Eval:
"Dr. Psychobitch PGY-3 was difficult to work with as her mood can be unpredictable".

I'm no Superman

I (appropriately, considering the circumstances) rewatched the first episode of Scrubs. The one where JD starts his internship and realizes that after 4 years of med school, he still doesn't know crap. I laughed then at the absurdity. I laugh now at the irony. And the scary thing is, there are thousands of us interns.

The triage nurse understands this (this being my incompetence, and near misses with incontinence), and so she distributes patients accordingly. First patient I saw today: deaf. Earwax was clogging his ears. On the up side, I figured this out even before looking in his ears (he told me he could hear himself talk just fine, but couldn't hear others at all. Saved me the trouble of doing a Rinne test myself). Kobe! On the down side, it took me almost 45 minutes to figure out all the charting that had to be done. Also, I don't actually know how to remove earwax, so I referred him to ENT. I think they use miniature shovels. I wonder if they also have small rakes, and hoes, and flower beds. They probably keep ear gardens.

Thanks for your referral, we only treat healthy patients

Today we tried to arrange for some Occupational Therapy for a lady with weakness in the median nerve distribution.

OT said they wouldn't take her until she had regained full nerve function.

"Wouldn't she benefit from fine motor exercises to help her regain that function?"

"No, it's like turning up the volume on a radio that's not even plugged in. She needs to have regained FULL FUNCTION with 5/5 strength before we can start working with her."

They must see a lot of patients referred for a chief complaint of "full strength and function".

Today I paid for Step 2 CS.

I am MD.

Dr. M, vascular surgeon: (pointing): Ming, do you see the artery pulsating?

Ming: ...............no.

Dr. M: what?? it's right HERE!

Ming: ...............sorry.

Dr. M: well at least we've learned 2 things today - a) you're honest, and b) you're blind.

psych attending quote:
"that kid's acne is so bad it hurts me. I mean I can only stand there so long looking at him..."

2 minutes later in the middle of discussing another patient he silently gets up and leaves...that's how our rounds ended for the day.

Doctor T: so you have an ulcer in your stomach, have you had it for a while?

Patient: oh I know when I got it - when I got married.

Where was the Scrub Nurse??

As I was on my anesthesia rotation, I was watching a 3rd year Anesthesia Resident extubate a young patient after surgery. The patient was successfully extubated and as the resident was deep suctioning the patient, he dropped the suction on the ground... right next to his shoe (that did not have a shoe cover!).... He then proceeded to pick up the suction and went right back to deep suctioning.
ewwwww

Shhhh.....

Patient: pointing to stethoscope: hey do you ever use that thing to listen to stuff that...well...stuff you aren't normally supposed to listen to?

Me: ....like what?

Patient: you know, like to listen to people...through walls and stuff.

Me: no, sir, I have not.

Patient: how much does one of them cost?

Why wasn't this in our orientation?

Surgery attending: so what year are you?

New student: (enthusiastically) first year!

Surgery attending: it doesn't get any better

APD

Resident: "Did you see if the patient had an APD?"

Me: "No...?"

Resident: "Do you know what an APD is?"

Me: "No"

And that's all that was said. I still don't know what an APD is.

attending: take this coker and pull up on it while applying a downward pressure.

I See You

After a week and a half of scrubbing into surgeries lasting for less time than it takes to scrub in AND providing as much entertainment and education as an old bandage, I finally get to witness a big case: a total colectomy with ileoanal pullthrough.

After scrubbing in for a total of 5 minutes, Senior Resident Spidermonkey tells me to scrub out and help Intern Teddybear.

WTF?

Intern Teddybear sends me off to do a consult because he "needs to leave and doesn't want to be stuck here all day".

Up in the ICU, I find a chart 6 inches thick. After an hour of wading through indecipherable handwriting, I reach the tentative conclusion that Patient has PNA, got a chest tube, but nothing's coming out. IR had written, "start tPA if not draining after 1-2 days". It's been 3 days.

A resident wanders by. She happens to be part of the primary team. However, she has no idea what's going on. "We didn't consult you, why are you here?" she asks.

Eh?

After much confusion and frantic pages to Intern TB, she finds the order in the chart. "Oh," she says.

She doesn't know anything about the tPA. "Can I assume you're not giving it?" I ask.

"Yeah."

The rest of her team wanders up. "What's going on with the tPA?" I ask, "Maybe we can try that before we proceed with something surgical?"

"It's not going to work, we're not going to give it."

Intern TB's long gone by now, so I chief to Resident Buschka and Dr. Flowerchild.

Resident Buschka, "The ICU team here is useless."

Dr. Flowerchild, "We're gonna start tPA."

Medical Student Syndrome: A common disease found among those studying the science of medicine, especially pronounced during the 3rd year. The Syndrome includes pathognomonic sleep deprivation, as well as the inability to answer questions from Attending Physicians on rounds. Dietary deficits may also be seen due to chronic cafeteria food ingestion. Complications include morbid depression refractory to treatment. Overall, prognosis is poor.