Saturday, August 19, 2006

Nothin' to do

Today I was expecting to be really busy because my team was on call. Turned out not to be the case. I went in at 7:00 although I only had one patient to round on and our attending wasn’t going to come in until the afternoon to see our new patients. I went to see him (the grouchy guy who had the G tube put in yesterday), he was doing fine so it took about 5 minutes to write a note on him. I talked to his night nurse for a minute, then later his day nurse called me with a question about his medications and let me know that she was going to write up the night nurse because apparently she didn’t give him his antibiotics and let him go without fluids all night. Then I heard a really sad story from the other medical student about one of her patients—essentially his wife was coming in to tell him she was leaving him, then taking off on a plane to go to another state. In addition, the man had called the police last night to ask them to arrest his daughter because she didn’t bring him his clothes in the hospital. He also called her and threatened to call the fire department and have them break down her door. He also happens to be for all intents and purposes disabled, and cannot go home (in another state, not the same one his wife flew to) by himself. I read the nurse’s note giving all the details, it was about 20x longer than any nurse’s note I have ever read. Very, very sad; and very, very bizarre (actually there are some even more bizarre details that I am leaving out). It’s hard to believe that things like this happen in real life.

Around 10:00 we went to see the autopsy on my patient who died yesterday. It wasn’t really as hard to see as one might expect because the body is so completely dead. It’s distasteful, and I definitely would not want to see an autopsy every day, but I didn’t really have any particularly strong emotions watching it—the patient was gone, it was just the shell that remained and we could see what caused the patient to leave by examining the shell. The findings were pretty much what we expected, although they didn’t prove that the patient died of TRALI. The blood bank is going to have to examine the blood that he got, and it could take weeks to hear back from them. Further research: about 15 people a year die from TRALI, it occurs in about 1/5000 blood transfusions, and about 5% of those people die.

After that, we still weren’t getting any new patients, and we had taken care of our old ones, so we sat around eating donuts for a while, read up on medical stuff, had lunch, then decided to check out the new resident’s lounge. No one knew where it was because no one’s ever had time to go there, so we went to the right floor and wandered around looking for doors with code panels. We tried a couple, then found the right one. Hoping (but not expecting, this being the VA) for a nicely furnished comfortable room with a big screen TV, soda machine, cappucino machine, video games, etc, we found more what we expected: a barren room with old chairs, a small TV from the early ‘90s, and a couple year old trashy celebrity magazines. We watched some movie on TV about a surfer who starts figure skating for a couple of hours while the resident, intern, and other student (I ended up being the only male there) read the magazines and gossiped about all these different celebrities and movies I have never heard of. It was very weird, no one hearing them talk would guess that their IQ and education level puts them in the top 1% of the nation.
At last, we got a patient. I interviewed him and did a physical exam, then wrote it up only to find that we were admitting him to Heme/Onc meaning he won’t be under our care anymore starting tomorrow. Leaving me with one patient who’s going to extended care on Monday. At least I got to see a patient though, the other student never did because no more patients were admitted—so basically we kind of wasted a day. While I was writing up my H&P the other student went out to get pick up dinner for everyone. We finished off the day with a blood draw on a really nice lady with cancer—thankfully, I got blood on the first try so we didn’t have to torment her too much. Then we got to go home a little after 7:00 instead of having to stay til 10:00. Boy does time go more slowly when one has nothing worthwhile to do. I guess we should really enjoy days like this when we can.


Post a Comment

<< Home