Monday, July 13, 2009

I had my first mom get mad at me today. Her 4 month kid was grossly overweight and over the 95th percentile for weight. He gained 6 pounds in the last 2 months. She told me that she puts cereal in the kid's formula and he eats an 8oz bottle every 2 hours. I told her not to put the cereal in the milk and she told me that her friends do it and she also did it for her other two kids. I then tried explaining to her that some people add a little bit of rice to the formula to thicken it up for kids who have reflux after feeding and maybe that's what she's confusing that with, but then she got mad at me.

Ok, fine, whatever. I showed you the growth chart, your kid is overweight already and the attending agreed with me. Your kid will probably be obese by the 6 month checkup.

Sunday, July 12, 2009

"The Residents"

The college of medicine has the rotating med students live in low-income housing. We have a lot of elderly and questionable people living with us. Last week I was really puzzled - I rode up the elevator with someone who was going to a floor above me. I went to my unit, grabbed some stuff, and then took the stairs down to the ground floor. When I was walking down the last steps down the stairwell to the ground floor, the SAME GUY from the elevator walked into the staircase from the ground floor outside. I have no idea how he got there. It was like a chase scene from Scooby Doo.

I also see an extremely short midget lady walking around all the time. I see her in the hospital too getting food. I think that's how she spends her day, walking around the building and eating at the hospital. I don't think she's living with anyone or has any family.

And then today, I was riding the elevator down to the basement to do laundry when this old lady with a walker got on. She was so slow that the elevator door closed on her but she didn't seem to care, she just kept on walking. It must happen to her a lot. We chatted for a little bit and when I got down to the ground floor, I wasn't sure if I was supposed to keep walking with her. Seriously, a snail's pace. I ended up going ahead of her to "look for an empty washer". I passed her again when I was on my way out to get groceries. She was just sitting there in the laundry room, waiting, not doing anything. I feel bad for her, it probably takes a lot of effort and time to do simple things, like laundry.

Basically, I think what I'm saying is that I'm scared of turning old. I am also tempted to talk to these people because I feel so badly for them...but then I imagine them coming and knocking on my door and bothering me when I need to study. We don't have a peep hole in our front door.

Wow, that makes me sound like an asshole.

Saturday, July 11, 2009

Good week

This week was a good week. I got to work with a lot of kids with Cystic Fibrosis (CF) and the attending I worked with was awesome. He was hilarious and non-intimidating and I felt comfortable enough to ask for feedback and practice my (very weak) presentation skills with him. This was one of the few clinics where we actually had a medical team (social workers, pharmacists, pulmonologists, pediatricians, dietitians, etc) and all of them were very open to teaching me as a medical student. I also tried on the vest used for CF therapy - it is basically an inflatable vest that is attached to a machine by two large tubes. The machine pumps air into the vest at varying frequencies and intensities and knocks the mucus loose from the lungs. CF patients usually do 20 minute sessions of the vest twice a day. I tried it on briefly when I was dicking around with the other students and it was kind of fun, but then later that day when things were slow I decided I would try it on for 20 minutes to see what it was like for the CF patients since none of them seemed to like the vest and I couldn't understand why. After 7 minutes, I had to take it off - it wasn't bad for the first minute, but after a while it got really uncomfortable because I could feel my throat rattling around in my neck and the puffs of air kept on making the vest hit my stomach. It was also kind of hard to breathe and I had to take huge breaths.

Another interesting thing happened to me this week. I arrived as scheduled to the clinic but the attending wasn't there yet, and after sitting there doing nothing for 20 minutes I decided I would go see patients. I saw 3 patients before the attending arrived and probably could have seen all 5 of them if I hadn't decided to stop after the hour in anticipation of his arrival. For some reason the whole team made a big stinking deal about the fact that I had seen 3 patients, and the clinic coordinator said that I was the fastest medical student they have ever had. I'm not sure why it would take longer. I think it's really easy to build rapport with patients during the course of the history taking and physical exam. It's not like you have to do everything in sequence, there are a lot of things you can do in parallel. Anyway, it was reassuring to know that people thought I was doing a good job because I honestly have no idea what I'm doing half the time. One of the moms also told me that she usually hates medical students and that I was the first one she's ever liked. I'm not sure why she thought that since her baby cried the entire time I was examining her. I should have asked.

So in summary, it was an awesome week...but come on, we all know that this means next week is going to be a shitty week. Haha.

Tuesday, July 7, 2009

I didn't learn anything from the attending I followed today. He was a cool guy, but I wish he put as much effort in teaching as he did in making jokes. I feel like medical education is so random - it depends on who is teaching you, what medical team you're on, etc. One day last week I did physical exams on 17 babies. Today I did physical exams on ZERO babies. Instead, watched him do abbreviated exams on 5 newborns. Lame.

FYI - some definitions:
  • Medical Student: that's me (a person in medical school, which lasts 4 years for a traditional MD degree). Already has a bachelor's degree from college.
  • Intern: a person who has graduated medical school and has earned the MD degree (I would be "Dr. Muss" at this point). This is a one-year program where you are practicing medicine with supervision.
  • Resident: this is where you do training for your specialty (pediatrics, general surgery, dermatology, anesthesia, etc). This takes at least 3 years depending on the specialty. You are still supervised at this point.
  • Attending: training is done and you are a "real doctor" who is entirely accountable for the care of patients (no more supervision)
I started noticing today that one of my classmates acts exactly like Andy Bernard from The Office. Kind of looks like him too.

Also, I was not picked to get tickets to Michael Jackson's funeral. Not like I would have been able to go, but I would have had tickets.

Monday, July 6, 2009

My recent past has come to bite me and now I can't sleep because I'm worried but I can't do much about it because I'm busy with school. I wish it would just end. I would also like to stop getting emails from the bitches. Sometimes I regret it. At least I made some really good friends.

Nothing really special today. People call me "Dr. Chris" because they don't really know my name (it only shows my first name on my badge). All the nurses are attracted to my med school classmate who is my "rotation partner". They asked me this morning if my "dreamy and beefy classmate" is coming in this week. I'm pretty sure this is med student harassment, although technically I guess there's nothing wrong since the nurses are not the ones evaluating us. FYI, the nurses in the newborn nursery are BY FAR the most attractive. They are all skinny, blond, tan, have great bodies and faces, and do their hair. It's kind of weird. I wonder if nurses in different areas have different personalities, just like doctors in different fields. I've had 5 people tell me this past week that I would make a great pediatrician.

On that note, I also had my first denial from a patient. I was pretty excited to see the patient because we had the same name, but when I got in there the mother wouldn't let me touch the kid, even after I explained that the attending was going to come in after me and check everything. Come on, your kid had a rash and is 5 years old. It's not like I'm going to break anything if I perform an examination. She did seem kind of neurotic though, I can't say I was surprised after watching her interact with the attending.

Thursday, July 2, 2009

I'm really enjoying this rotation. I've done a bunch of check-ups on newborns, seen a birth, and seen tons of kids. I think I am a clinic person - I really enjoy meeting everyone. They all have different personalities and I find it very interesting. The difference in development between different kids of the same age is also very striking. Some random things: (1) I've come to realize that "Addison" is probably the most popular girl's name these days (2) I love humongous moms because they are able to pin their kids down on the exam table with their big torso so I can look in their ear. It's kind of cute. (3) Where are these legendary hellish parents? I haven't met a single high strung, overbearing parent yet! They're all very nice.

This week I also some dad wearing a baseball cap that said some obnoxious word on it (sorry, HIPPA!). He was in the newborn nursery and I was thinking to myself, what a douche, why is he wearing that stupid hat. It was also a little confusing since he was dressed in a preppy style and one wouldn't expect him to wear a hat with that printed on it. It bothered me all day until I figured out that was his new baby boy's name. Kind of unexpected. I guess this story would make more sense if I was able to tell you what his baby's name was...

I got sent in to obtain a history for "body odor" today. No one else wanted to touch that case so I got it. As soon as I walked into the room, I saw a large lady knitting. She looked exactly like that classic bearded lady in the Netter's picture that they always show in lecture for PCOS. I walked into the room and that was the first thought that popped into my mind. You guys would be proud of me though, I did not have a laughing attack although we've made fun of that picture so many times in lecture (the link doesn't do it justice, you need to be able to see it in detail). She was a foster mom and she brought two African American children with her. I spent the first 5 minutes trying to get a history from her and it was incredibly difficult - she kept on knitting and was honestly not interested. The things she did say about the children were said in a very hateful tone, and I honestly thought she resented the children. It was a shame because they were so affectionate - they were very sweet children and very friendly. I went back to tell my attending and mentioned my concern about the foster mom. No surprise, when we went back in there with the attending, the foster mom was acting like the most concerned, sweetest woman in the world. I wanted to punch her in the face. It's so obvious she's in it for the money.

Also, I want to say that I hate the younger nurse with the pink scrubs. She's the only one who's a bitch, everyone else is super nice. There's always one.