Monday, March 24, 2008

bad jokes

"A Pharmacist handing a prescription to a customer: 'Take one of these every four hours, or as often as you can get the cap off.' "

Friday, March 21, 2008

telling it like it is

So this week was my first week of letting myself say, "I'm going into surgery."(yes I have issues) And I am not going to lie---there was actually a wave of relief when I said it out loud. I was always an indecisive child, but when I would finally make a decision, I'd get a sudden rush of just feeling right in the world. And I would know that I made a good choice. Saying it out loud, well, was kind of like that.

Over the next couple of days I let the surgery idea sit. I wanted to get to the bottom of why I can't commit to it. And I now know why I hide from surgery. Here's the brutal truth.

1. I am scared of the hours. I'll be honest, I am a morning person. Most of my friends find it very annoying how much of a morning person I am. But I also like my wind down time at home, maybe with friends, maybe alone. So I while I'm not scared of the mornings, I wont make it without my personal time. Plus I dont want to be alone for the rest of my life. What kind of husband and/or kids could put up those hours?

2. The idea of associating with surgeons with the rest of my life is unsettling. Surgeons don't always treat other people nicely (understatement of the year) and I dont want feel like I need to defend them because I am one. I know there's an awful story for every type of doctor out there, but surgeons seem to have a lot of them.

3. I am afraid surgery life will make me become angry and mean. This is a continuation from #2. But its true. I worry about getting hard. I am usually a pretty bubbly person. I dont want to lose that.

4. My dog will hate me. (as will my parents, sister and brothers) Being on call every 4, 5 or 6 nights means my dog will have to chill at home alone a lot. I would definitely feel guilty about that one.

I know I am supposed to make this decision for myself. Its supposed to be what I like to do. But all these other things start messing with my head and then I sorta loose sight of what I want. My good friend, C, reminded me of the first C-section that I scrubbed into. I had completed surgery 6 weeks prior. As soon as I scrubbed in and stepped up to that table, I got a rush of excitement and then a sudden peace like I was supposed to be there. I felt amazing. Lately, going through medicine, I had forgotten all that. Thank goodness C reminded me.

Saturday, March 15, 2008

"Because the underwear is pulled up from the back until ... it wedges in."

Being in outpatient medicine means you get to experience a day-in-the-life-of each specialty. Last week I was at rheumatology clinic which usually means a lot of arthritis and back pain. I got to see this interesting case of ankylosing spondylitis--which is basically an arthritis of the spine which will lead to fusion of the joints. Its pretty painful and debilitating.

I went into the patient's room with my attending, who is this bubbly middle age woman who is so awesome that by the end of the day you actually consider rheumatology as a field to go into. After introducing the patient to the doc, the doc wanted to show me some key features of AS. She had the patient stand with his back facing her while she attempted to untuck his dress shirt, which was tucked into his pants a top a white undershirt. She freed the dress shirt, but the white undershirt was really stuck in there and she just kept pulling and pulling and had it almost to his arm pits when we both suddenly realized that she had grabbed his tightie whiteys, and instead was giving him the largest wedgie ever. Meanwhile the patient did not utter a single word, as if this was a standard of care and it occurred at every doctors appointment. Both the doc and I turned bright red, apologized and gave it our best shot at keeping the laughter to a minimum.

For future clinics, I apparently need to work on keeping the laughter to a minimum.

Tuesday, March 11, 2008

the answer is in the urine

On a recent camping trip my friends and were discussing a book that I had meant to bring with me called "Why do mean have nipples?" Its a fascinating book, about all the crazy things patients want to ask their docs, but are too afraid to bring up until their third martini. And before you ask, no, I'm still not sure why men have nipples.

The discussion lead to why asparagus makes your pee smell awful. Well low-and-behold, the second question is aimed at answering that!

"Asparagus contains a sulfur compound called mercaptan. This is also found in
garlic, onions and in the secretions of skunks. The signature smell occurs when
this substance is broken down in your digestive system. Not all people have the
gene for the enzyme that breaks it down, so some people can eat all the
asparagus they want and never stink the place up. One study in Britain found
that 46 % of British people produced the odor, while 100% of French people
tested did. Insert your favorite French joke here__________________-."

Sunday, March 9, 2008

we need a doctor joke

A patient complained to his doctor, "I've been to three other doctors and none of them agreed with your diagnosis."

The doctor calmly replied, "Just wait until the autopsy. Then they'll see that I was right."

Friday, March 7, 2008

Time after time

When I envisioned being a doctor, I dont think I really realized how time consuming it would be--in almost every field. I pictured going into work, doing some things for a little while (aka helping people) and then leaving it all behind and going home. But until last year, I also thought doctors made about $50,000.

When you talk to the last generation of docs, they are shocked we new docs want a life outside of the hospital. They were bred to live and die by that hospital. While somehow, someone, told us or showed us a life separate of the hospital, and all of a sudden we wanted it. Who wouldn't? This also means, we new docs will always be the less dedicated, less interested, and less helpful if we actually slept 6 hours and maybe went out to dinner. Which is always interesting when the old docs start bitching about how many times they've been divorced.....

But I have to say that even though we've been told or shown this outside life, the old docs and the hospital do a pretty good job of sucking us in anyway. I just finished two months of inpatient medicine. Two months of being on call every 5 days, working 6 days a week, spending ridiculous time at the hospital. As much as I fought it, I got into a pattern and it was just a way of life. This week I switched to outpatient aka the sweet life. I told a non-medical friend how happy I was to get 2 days off each week when they replied, "You mean like the rest of us? You're excited to be normal?" Yeah, I'm excited to be normal.

Monday, March 3, 2008

Becoming a patient

I recently had the opportunity to experience our health care system from the eyes of a patient. Lets just say, it wasn't pretty.

The other morning I was finishing a shower, when I started feeling really hot and lightheaded. Worrying about passing out, I got out of the shower, and called to a friend who happened to be over. I walked back into my bedroom, sat on my desk chair (my dog happened to be sleeping on my bed) and tried to take some slow deep breaths. Whatever was happening, was progressing, and I remember saying "Please don't be scared." I then slumped back into my desk chair, went unconscious and had about a 15 second seizure like activity. All of which, I have no memory of. I woke up and, although scared and very embarrassed, was doing alright. But to be on the safe side, I went into the emergency department to make sure.

They were able to get me back really quickly (one of the perks of being in the medical field!), but they set me up in a hallway bed which was a bit annoying since I know a lot of people who work in the hospital---Emergency docs, surgical residents, med students, medicine residents, psych residents, etc. All were stopping to ask how I was doing, very nice, but embarrassing. Luckily I was put next to a very entertaining psych patient who kept me and the family all entertained while I waited 5 hours for blood work, urine tests, EKG, Chest Xray, Head CT and a neuro consult. After all that I was diagnosed with a syncopal episode which lead to a seizure---a very lucky diagnosis because it means I can still drive. (if it was a seizure event I wouldn't be allowed behind the wheel for 6 months!) The bill?? Still undetermined until I hear from my insurance company--but I'm interested to see what that'll cost me.

All in all, not a fun experience. But those folks in the hospital took good care of me. I know its not that way for every patient, but I hope it is for most.


Hey everyone---

Check out Surgeperiences 116 @ other things amanzi! My blog about Slash was added to the list---thanks for including me!