Saturday, July 23, 2011

I'm gonna, gonna lose my baby / so I always keep a bottle near

Amy Winehouse died today, aged 27.  I think it's pretty obvious that it was from her completely unchecked alcohol and drug addictions, but I'm sad nonetheless.  Music got me through a lot of the very low points of medical school, and Amy Winehouse's music really expressed much of how I felt.  I know that she was often falling down drunk at live performances, so I'm including a clip here to show that she really and truly was a talented girl who just couldn't get it together in the end.

Amy, sorry it didn't work out for you.  We'll miss your voice and your soul.

Thursday, July 21, 2011

Today's "Oh, crap!" moment of the day is brought to you by

Monday night, 10 pm, on call.  While rounding in another part of the ICU, my intern gets a page that one of our post-op patients is desatting.  She desatted earlier in the day, but we got her back with aggressive suctioning, so my intern leaves to try this out.  2 minutes later, I walk in.

Me: Whoa, she's down to 78%?  That's worse than before... and her pressure's dropped!
Intern: Oh, yeah.
*my friend E, the medical resident on that evening, walks in with his intern*
Me: E!  Oh, thank god.  Listen, she desatted earlier but we got her back with suctioning.  I'm going to bump up her O2 and attach this ventimask while I suction her.  Wait, that's not a ventimask... do we have anything else?
Nurse: Can't you see that I'm BUSY?!  (Gets back on phone)
E: Ok, let's get a second O2 sat monitor, this thing is jumping around and I'm not sure if it's working.
Me: Great idea.  Hmm, this really isn't getting better.  I'm going to sit her up.
Intern: She's only satting 60% now, on this new machine.  And her pulse just dropped to 50.
E: *listening to chest* Nurse, page respiratory - we need a proper mask.  She's not getting adequate ventilation here.
Me: *nearly hysterical* Holy shit, her sat's now 50%.
E: *silent*
Me: *silent*
Us: *simultaneous realization that two 2nd year residents are in charge and nobody more senior is coming to help us*  Uhhhhhhh.....
*300 years pass*
Respiratory: Did someone page respiratory?
Respiratory: Ok.  Move.  *Intubates*
Me: Mrs. Jones?  Can you hear me?
Mrs. Jones: *big smile*
Sarada's Ass: Wow, I don't think I'm going to be able to pass stool for days now.

Sunday, July 10, 2011

Samaritan Woes

I think it's pretty reasonable that, after awhile of training in medicine, a person starts to imagine scenarios where they get called in to serve.  Usually it's the airplane scene, where someone starts to have chest pain at 30,000 feet and the airline hostess gets on the intercom and says something like "Is there a doctor aboard?" or similar nonsense.  Most practicing physicians say they really dread these kinds of situations, because of the lack of equipment needed and lack of control over the situation.  (Not to mention, the extreme obligation it places on the physician who is escaping an insanely busy practice to get just a few days away with the family.)

It never occurred to me that there would also be an extreme sensation of terror upon getting involved with this type of scenario.

Last night, after lazily laying about all day and watching Hindi movies on Hulu, I got dolled up to meet a girlfriend for dinner and drinks.  I was already running late when I got out of the subway in the West Village and was walking briskly along when I saw a crowd of twenty people surrounding a body lying on the sidewalk outside a shop.  Getting nervous, I asked one of the women standing there what happened, and she said that they just saw this guy lying there and someone had called EMS.  I asked if anyone had checked him to make sure he had a pulse and was breathing, and she said no.

My heart dropped out of my chest.

"Are you kidding me?" was really all I could say.  I crouched down next to the guy, put my purse down next to me, and started getting my hands all over him to look for a pulse, breath sounds, responsiveness, anything.  Another woman asked me if I was a doctor.  "Oh shit," I thought to myself with increasing horror, "I am.  Oh, god."  I realized in a moment of further panic that I didn't even have a stethoscope, and just put my ear to his chest to see if his breathing was appropriate or junky.  I got lucky - he wasn't tachypneic or tachycardic, and sounded pretty clear - he seemed to really have just passed out.

He suddenly got up, and it became apparent that this guy was chronically intoxicated.  We sat him in a chair and I pulled off his hat to check for signs of head trauma, as he reached into his pocket to roll a cigarette (or "cigarette").  He was oriented but clearly confused, as he told me that he had simply tripped going down a few steps into the shop (but somehow fell on his back, above the staircase).  EMS showed up and pulled on some gloves before touching him, and a creeping grossness overcame me as I ran to the bathroom to wash my hands and arms, and soak a paper towel in rubbing alcohol to clean off my left ear as I tried hard not to think about scabies.

My friend showed up on the sidewalk, in the meantime, with a shocked look on her face as I came out of the store looking as though the world had just ended.  We walked away, while EMS tried to coax the guy into their truck so they could take his vitals, and went about our dinner plans.

On the way out of the last bar of the night, we passed an EMS team evaluating a young man completely passed out in front of a garden apartment.  I kept walking.

Wednesday, July 6, 2011


Things I have learned during my first week of being a 2nd year surgical resident:

1) Having an intern is like having a kid.  I'm just so anxious for how well they're doing.  I stay awake just thinking about it.

2) My residents were actually snooping behind my back when I was an intern and checking charts and stuff!!  No wonder they could always tell when I was lying.

3) Being a resident makes you feel POWERFUL.  Until someone asks you to do something and you remember that you don't know squat.

4) ...but the title sure does count for a lot, as snoop dogg intern points out (from 1:05)