July 15, 2008

• grr. arrgh! grrargh?

  Keeping track of multiple patients is tough.

  Even with only taking one patient a day, I am still carrying a caseload of around 6-7 patients. And everyone needs a follow up. I have to call pathology to check biopsy results for one, follow up on the egd results of another, make sure the primary team knows our recommendations for a third, and call the morgue to find out what happened to a 4th over the weekend.

  And those are just the inpatients! Just because someone is discharged doesnt mean that the paperwork for them ends, oh no. You still have to apprise the attending and primary teams of any labs or procedures carried out while they were here, in case those results necessitate a callback to the hospital.

  Not to say that I am not enjoying myself however. My weakest area during my medical rotation was creating a differential and plan, and while I am still far from being perfect (that’s why medicine is called “practice” right?) usually i manage to nail all the significant issues on my problem list. Now all I need to do is learn how to speed myself up so it doesnt take me 2 hours to consult, examine, and write the note on a patient. Baby steps, baby steps.

  SO what are some of the things I have seen thus far? Well, as always in an attempt to protect patient privacy and not get horrendously sued by HIPAA down the line, here are some of my pts

  1. A 43 yr old female with 3 weeks of black watery diarrhea and coffee-ground emesis (both of which indicated a bleed that takes a longer time to traverse the GI system, else it would be red) While we are still waiting on the biopsy results, crohns or ulcerative colitis are both on the differential, as well as an infectious process

  2. A 25 year old patient male with a habit of swallowing things. The man is an office supply store unto himself and has been scoped over 20 times to have things removed such as pens, pencils, paperclips, and even a sock. Sadly, one of the paperclips in the past perforated his bowels, necessitating a colostomy bag, so due to his penchant for eating desk supplies, this guy will be pooping out his stomach for life.

  3. Hematemesis-this basically means blood in the vomit, and at least in this particular hospital, that reason for consult usually means an alcoholic patient.

  My usual day at the hospital is from 8am to about 7pm by the time I leave, so the lack of posting you may have noticed is due mainly to the fact that I get home, eat, play with my puppy, and go to bed without the time to leisurely read or post on xanga like I normally do

  Oh yeah, and I still have to write my personal statement. Rhetorically speaking, why do I want to be an ophthalmologist? Somehow, i dont think, “I just do, okay?” is going to be a satisfactory answer. Perhaps checking my backlogs will provide a clue, but even so, I have no “ah-ha!” moment of patient interaction that did it for me. I just feel an affinity for the field, but trying to articulate that or come up with some hokey story for a program director to read is even harder than pulling teeth. At least teeth are obvious. The patients I tend to remember are the ones who amuse me, like the gentleman who popped out his glass eye, or the ones who irritate me, like the woman who tried to argue with me that her eyesight was fine while she was facing the wall.

  Ah well, my deadline for a first or second draft is july 25th. If I dont have a personal statement up on here by then, no matter how terrible or poorly written, I expect nothing less than a severe tongue lashing from those of you who read this on any regular basis. Cmon, force me to write something, I know you have it in you. We can all motivate each other! w00000

  til then, well, shazbot.

  • 3:50 pm
  • 5 Comments