Feb 9, 2011

Top 10 Study Spots

A list of the top 10 most interesting/unusual/weird places I have studied medicine (none include a desk):

10. At the summit of a ten mile hike (the EKG book fit nicely into my Camelbak).

9. In the middle seat of an airplane. Not too original except for the fact that the seatmates on either side were looking over my shoulder and commenting on the subject material. Topic: platelets. Window seat guy: "I'm on Plavix." Aisle seat guy: "What are platelets? Is that a disease?"

8. On a ski lift. But it was hard to turn the notecards with my ski gloves on. And even harder to stuff the notecards back in my pocket, get a pole in each hand, and scoot to the front of the seat in time for the lift to end.

7. In the bathtub. But the water made the ink run on the notecards.

6. On the toilet. (Sorry).

5. At the pool, both in a chaise lounge and on a floaty in the pool, but ran into same problem as #7.

4. In my kayak, floating in the middle of the back bay, toes dipped over either side into the water.

3. Sweet Tomatoes (a soup/salad buffet restaurant). If I came for a late lunch and studied long enough, I could dish up dinner before leaving!

2. On my cat. Not with my cat, on my cat. He made an excellent bookstand...the reading angle was perfect. And he didn't even seem to mind.

1. On a date. With my (very) patient husband.

The Day That Wrote Itself

There are days that it takes me a while to formulate what I want to write. I think about it while I run, feet in rhythmic movement, a moving meditation of words. Other days are easier; I sit down and words flow.

Today, this blog wrote itself.

I saw fifteen cardiology patients today. Here are eight of them:

Patient #1: Denial
Me: "Do you have trouble sleeping at night?"
Patient: "No. I've taken Xanax at night to sleep for years. I'm not addicted, just used to it."

Patient #2: The Generous Risk-taker
Doctor: "Your stress test and angiogram showed that four of your bypass grafts are blocked and your heart is severely damaged. You need to be very careful or you will need a heart transplant."
Patient (reeks of smoke): "Well, can I go up in a hot air balloon to 4000 feet?"
Doctor: "You really want to go up there and do a self-induced stress test in a basket 4000 feet up with no medical personnel to help you?"
Patient (thinking): "That's a good point. Would you like to come?"

Patient #3: The Medicaid Fraudster
Patient (with $400 purse, BMW keys, and 3 pack-per-day cigarette habit): "Doctor, I know my cholesterol is worse than before since I stopped taking my meds. I can't afford my medication and Medicaid doesn't cover it for me. I need a generic."
Doctor: "Oh?"
Patient: "Yeah. That reminds me, my boyfriend and I are buying a hot air balloon. Would you like to come for a ride sometime?"

*note: I do not know what is up with hot air balloons today. Apparently they are the thing to do for cardiac patients in Arizona.

Patient #4: The Undersharer
Patient: "I have chest pain."
Doctor: Asks all manner of questions related to chest pain symptoms
Patient (20 minutes later): "I work for a company that transports museum exhibits. A few weeks ago, I was at work and was pinned between a wall and a 1200 lb crate that rolled into my chest."
Me: "Is that when the chest pain started?"
Patient: "I think so."

Later X-Ray showed 4 broken ribs

Patient #5: Another Undersharer
Me (taking history): "Have you ever had any heart problems?"
Patient: "No."
Me: "Any murmurs, stents, valve replacements, high cholesterol, high blood pressure, or chest pain?"
Patient: "No."
Me: "Have you had any surgeries?"
Patient: "No."
Me: "Any problems with your lungs or breathing?"
Patient: "Well, I had pneumonia after my quadruple bypass three years ago."


Patient #6: The Neurotic Oversharer
*contrast this to patients #s 4 and 5.
Patient: "Doctor, I know you told me to to worry about my myocardial bridge, but I am concerned."
Doctor: "The myocardial bridge is nothing to worry about. Your angiogram showed that it is not significantly occluding your coronary artery, and since it is a congenital condition, it will not get worse."
Patient: "Well, I've been looking into research to get it fixed. There are all kinds of new experimental procedures."
Doctor: "You don't need it fixed."
Patient: Produces 6 page, typed, single-spaced paper detailing his research on the subject, complete with references in parentheses and a works cited page.
Doctor: "This research is for bridges that cause artery blockages. You don't need any intervention. And, this experimental procedure is only done in New Zealand."
Patient: And while I'm here, I want to talk about my blood pressure."
Doctor: "O-kay..."
Patient: "It's just out of control. I take my medications, but every time I put my cuff on, I get so anxious and just watch the numbers creep up and up."
Doctor: "How often are you taking your blood pressure?"
Patient: "Roughly, um, (thinks)....maybe 25 times a day?"
Doctor: "I think you should do it just a few times a week, when you are relaxed and not stressed."
Patient: "I also think my blood pressure is causing me to have erectile dysfunction."
*note: by now I am zoning out and am as bored by the patient as you probably are at this point.

Doctor (later, to me): "That guy is really annoying. I think I'm going to fire him from my practice."

I don't blame him.

Patient #7: The Surgical Clearance Patient
Patient: "I need cardiac clearance for a surgery that I'm supposed to have on Thursday."
Doctor: "That's in two days! I'm not sure we can clear you that quickly, especially if you've had any heart problems in the past."
Patient: "Please, doc. I really need this surgery ASAP."
Doctor: "Well, what is it for?"
Patient: "It's with an ENT doctor."
Doctor: "For what?"
Patient: silent
Patient's wife: "Well, I bought him a nose hair trimmer for an early Valentine's gift. But he had so much darn hair that I guess it wrapped around the attachment and...."
Patient: "It's stuck up there."
Doctor: "What's stuck up where?"
Patient: "You know. The nose trimmer attachment. It's stuck way up there and I need the surgery to remove it."
Doctor: "We'll do your cardiac clearance as soon as possible."

Patient #8: The Med Student Abuser
Me: "Can I listen to your heart and lungs?"
Patient: "Sure. I'm all for helping students learn."
Me: "Sounds good." (Listens and then puts stethescope down on the exam table next to patient).
Patient: "So you're learning how to use this thing, huh?" Picks up stethescpe and whirls it around, just as I lean into check his pulses.
Stethescope bell hits me in the temple.
Me: "I'll just go get the doctor for you."


Feb 1, 2011

10 Things

Here is a list of 10 things I wish I had known upon entering medical school:

10. Eat, sleep, shower, and poop when you can. Cuz you never know when the next time you can is.

9. It IS possible to have a life during medical school. Many of my friends were able to get married, have babies, adopt a dog....BUT...

8. Realize that medical school will not always allow you to spend time with them, or even to live with them.

7. Patients die. It's (probably) not your fault.

6. Sleep is not necessary to live; nor is it required to make life and death decisions.

5. You'll learn to study all the time. Examples include, but are not limited to: notes wrapped in a baggie in the shower, EKG book while at summit of ten mile hike, flash cards while at the DMV/hair salon/post office/public transit/red lights/bathroom/other "unavoidable delay."

4. Shoe requirements: 1) Really, really comfortable. 2) Blood/other body fluids wipe off easily.

3. You'll get sick. A lot.

2. Many days you'll wonder why you went into medicine. And then you meet a patient that reminds you that...

1. Medicine= love. Love your patients. Love yourself.