Saturday, April 21, 2007

Videos and noses

Yesterday a sales rep for glidescopes came by. The glidescope is a plastic device with a camera on the end designed to replace the standard metal laryngoscope--it was actually pretty neat, but since the anesthesiologists were trying it out it prevented me from intubating people, so I kind of hate it. It is particularly meant for difficult intubations, but apparently some prefer it for even standard intubations since it is gentler on the patient's mouth--one doesn't need to pull upwards on it like one would a laryngoscope.

The highlight of the day was when I successfully intubated a patient nasally. An oral surgeon comes on Fridays, and since he obviously needs to have access to the patient's mouth he can't have a tube sticking out of it. There were two patients, the first I did not succeed on, but I got the second. To intubate someone nasally, you first dilate one of the nares with a series of progressively larger rubber tubes, then you have someone assist by advancing the endotracheal tube through the nose. Then, you use a laryngoscope in the standard fashion to visualize the vocal cords and guide the tube between the cords with a pair of McGill forceps while the assistant advances or withdraws the tube per your instructions. I was very happy, I didn't think that I would even get to try nasally intubating someone, much less succeed.

The nice thing about this rotation is that I feel like a normal person. I don't have to worry about studying when I get home (though that needs to change this week as we do have an exam at the end of the month), and weekends are totally free. Yesterday evening I was going to meet some friends at a park by the lake, and I still had time to spend an hour going through Barnes and Noble beforehand. I bought John Piper's "Desiring God" which looks very good, as well as a collection of some of Bram Stoker's books. I have always wanted to read "Dracula" but never have. I was also trying to find "The Language of God" which apparently is a book by the man who ran the human genome project defending faith in God, though I believe he is a theistic evolutionist and not a creationist. I couldn't find it, but did find lots of books in the theme of "The God Delusion" by Dawkins. I started paging through one to see what the author's arguments were, but had to put it down as I was beginning to visibly shake my head in disgust and was on the brink of actually making loud uncomplimentary comments and as I was standing by myself in the middle of the store I didn't want people to think I was high on something. Also in that vein for a lark I went by the alternative health section and picked up a book by Kevin Trudeau who essentially claims that the government is covering up the fact that all human illness and suffering can be solved by taking an herb--and he does it in the most irritating informercial-style possible. Again, I did not look at the book too long since another minute would have resulted in my flinging it across the store.

I found out my fourth year schedule yesterday. I'm quite happy with it, I got pretty much everything I wanted when I wanted it. The sequence will be: trauma surgery sub-i, vacation/step 2, breast disease (with surgery program director), nephrology consults, away rotation (which I still need to set up), ER (in November, so hopefully I can schedule shifts around interviews), two months of vacation/interviewing, then pediatric sub-i (we had the option of internal medicine, peds, or family; if I could have done internal medicine at the VA I probably would have ranked that first, but since I was at the VA last year my sub-i would be at the school's main hospital, and as sub-is we have much more autonomy at Children's where we really are treated as interns). My last serious rotation will be inpatient cardiology in March, then in April I will have radiology (also known as radiholiday--we have to show up, but have no actual responsibilities), and May will be "Preparing for internship".


Anonymous HV said...

Sounds good, especially the "away" rotation! Hopefully it works out.

12:29 PM  

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