ECG Action!

It's wierd how you can try to change the name of a thing. Like you can make everyone call tissues 'Kleenex', and then it ceases to be tissue and becomes Kleenex. Or how people in the South call soda 'Coke' - but then again, that is the South. Anyway, someone is trying to get those small oranges to be called 'Cuties', and this is my contribution to that campaign.
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Simplified Algorithm

They're big on oral tests in the Emergency/Trauma realm. Two in two weeks. I'm pretty good at saving hypothetical patients with non-hypothetical algorithms. The sorts of cases where I can just wave my hand, say that I'm administering 2L warm lactated ringer's, and it is so. It makes one feel at once both powerless and in charge - ruler of a tiny, imaginary realm. Kind of like playing Legos...
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Marketing III

I had this thought when we were infusing someone's bladder with methylene blue to check for surgical damage. There wasn't any, but it's neat to watch the foley drain thing fill up blue. Unusual, even.

I just want to capture that brand of fun!


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Dreamcatcher

Still putting tubes into larger tubes. And then drugs through the tubes. Truth be told, I wish I was more consistent at it. I'm good at getting the drugs thorough the tubes - I kind of like using syringes. And I'm okay at the native tube using parts, ie masking. But it's still a little bit of a toss up whether or not I'm going to be able to get that intubation or catheter. I suppose you probably need to do about 100 before you feel secure about it.


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Marketing II

There are special syringes for use with glass ampules of drugs. The idea being that in cracking open the drug vial, you might accidentally crack off some tiny splinters that could maneuver through the needle, into the syringe, and then into the patient. My resident pointed out, correctly, that not only are bits of glass not good in your bloodstream, they are not good almost anywhere.

Or, at least, the minuses outweigh the pluses.


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Captain's Log

I used to call myself premed. Then I was a medical student. Soon, I figure I'll be a resident.

The barber has no clue what any of these classifications mean.


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An Observation

I've noticed that some of the patients don't like the mask. I think this must be a claustrophobia thing, which I get, even though it doesn't really cover your eyes. Just a face/pressure thing. I would think, however, that the positive valence associated with that 'PVC toy store' smell would mean that my generation would be more accepting of the mask.

More testing to follow...


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Puppies!

I like the OR well enough. The parts I really didn't care for was the part where I had to stand the entire damn time. Anesthesia folk not only get to look at the patient's face when they want, but they also get stools. So that's super awesome. Mainly, I've been sitting in the stool and brainstorming ideas about things that might be fun to do when I'm not otherwise occupied. On the stool.


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Outmassed

I have determined that I am currently in the midst of, and nearing the end of, a platinum weekend. Not only do I not work, but I also have nothing to study for, as I am finished with the last round of NBME shelf tests that I will take ever. So that's pretty sweet. Naturally, I am filling my time with constructive ventures that will bolster my resume and better prepare me for interview season, my internship, and beyond.

Kidding! I've been playing Mass Effect 3 (a game made by a studio run by some physicians) - and it's super-fun. I'm going to save the galaxy!


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Football II

I don't care for soccer. The field is way too big - so there is a ton of running around and not a lot of scoring. And the rules favor that whenever you get within 6 inches of a player on the other team, you go down to the turf and fake an injury until somebody hits you with magic spray. And there's a lot of shouting.

Want to make it better? The clock should count DOWN. Anyone who seems injured has to go sit out for 5 minutes. Make the field way smaller. And if all that doesn't work, put one guy on each team who can use his hands...

...to hit people.


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Psi

A lot gets imbued on the humble ψ. I'm not sure there are any other fields where the whole thing can be subsumed into a single Greek letter. If you suspect 'supratentorial' issues in your ER interview, you pretty much just put a ψ in your notes, and underline it repeatedly as more supporting information comes in. Conversly though, if I suspect gallbladder causes, I don't just put ∑ or something. Maybe I should, the surgeon is going to do his whole own assessment anyway, just as we trust the ψ folks to do.

I guess the bottom line is that other fields need to pick out their own letters.

...And adopt the same hours as the Psychiatrists.


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Conflagration

Match Day was last week tomorrow. Acceptances spread like wildfire in a blaze of mutually-acceptable position paring.

I'm really glad I ended up in that one profession where I don't really have to worry about finding a job, I just get matched in after some interviews and dinners. I imagine this is what the goal must have been in a bunch of communist societies that didn't work.


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After Party

If I had to say, the predominant event scheme for yesterday's festivites, with respect to awareness and state of consciousness was green and inebriate, respectively. Theme in tow, I'm working on my own series of St. Patrick's PSAs. And by series, I mean just this one.

I actually also have a 'Post Match Day' Drawing all ready to go as well, but seeing as how I've already missed that day, I figure it will hold until Thursday.


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Scatological Punctutation

Paper Chart. Electronic Chart. Different Electronic Chart. Hybrid System. Paper Chart.

I'm back on paper charting now, so naturally, I have a lot of time to think about the individual characters. I can't just type 'em out.

??????

See, that would have taken like 4 seconds with paper. Plus, I tend to make a lot of mistakes, and if I misspell 'ERROR' above my strikeouts, I'm not really sure what I'm supposed to do with that. It really is a pickle.


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Laundry

I was supposed to do laundry today and I forgot. That is all.


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Everything is Great...

The hospital has a channel, this is the real hospital with the sick people, a channel where it just shows pleasing nature images set to calming music. Nobody would ever choose this channel, because it is boring as frak. But it ends up on your TV a lot when you have altered mental status. I guess some care worker figures that if you're going to be unconscious, it would really suck to be unconscious and bored.

A similar finding is when somebody's grandkids or daughter has recently been in the room. I really don't think that some 82-year-old veteran cares that Kelly Ripa is in Hawaii. Maybe he would have, but if not - he's not thinking right.


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Fun With Folstein

The exam in psych is very different than the exam in neuro - which is odd, given that the mind is so close to the brain topologically. In neuro, we periodically unload an entire 80-point exam to tease out some sort of minor sensory impairment. In psych, if we want to do something that requires a stethoscope, a special medicine doctor who rounds separately takes care of that.

A constant between the two exams is the Folstein Mini-Mental Status. There are a number of things I would like to do to freak out the medical student as a patient. This would be one of them. The best part, even if I drew exactly that, I'd only lose a single point.


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The Pun is Mightier...

Done with Neuro, starting with psych. A lot of the symptoms I see are very similar. The major difference is that now it takes the better part of a week to turn an MRI around, whereas we were tossing them out like candy on Neuro wards.

So far so good though. No cuckoos or anything.


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Hemi-Nares

For about four weeks last month, I did not breathe out of my right nostril. My favorite nostril. A consolidation of mucus had set up shop in such a way as to impede the passage, rendering it airtight and largely useless. I had thought briefly about trying to take an icepick to the front of my face in an effort to create a drain - but it seemed like that would be playing right into the... Thing's... hand.

Anyway, the fire alarm went off the other morning and woke me up abruptly, and a quick inhale burst the thing out. When I say 'burst the thing out', what I felt was some ancient evil had stirred from the deep dark. It was kinda icky, but I feel better now. This is the triumphant return of a two-nostril breather!


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High Phrase

I'm doing a brief stint in Neurology. It is sufficiently brief that nobody really takes the time to think of specific tasks that are good for students to do, because they don't really expect us to be around long enough to count on us. So mostly I get to do a lot of exhibition exams (that would be like an exhibition game in baseball, not any other meaning of the word associated with a convention hall or nudity). We also have a lot of symposia. This is where everyone sits around a table and draws things on the whiteboard.

It helps us learn.


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A Maze... with Ghosts

I think this pretty much captures the crux of it.


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Se7en

People with working nervous systems can do all sorts of wondrous things. Talk, walk, differential calculus - you name it. One thing you ought to be able to do is recognize a number if I draw it with my finger on your palm. Unless I do it confusing. For example, 6 and 9 are tricky if you don't know which way I'm drawing it. We were also specifically told to steer away from 7 - I can't imagine why.

Bottom line, if you ever hit your head and are reduced to blind guessing, don't guess 6, 7, or 9. Full disclosure, I usually lead with a 4.


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Farm Phree?

Another edition of notebook drawings today, as I'm still trying to corral my limited time into effective studying for the shelf and an ess-load of financial aid silliness that remains to be documented. Did you know that taxes have to be filed every year?

That said, I have now completed my last FAFSA ever (barring any freakouts) - which kind of feels like a bubble bath for the part of my brain that gets headaches when confronted with such chores.

The drawing came from our intersession on professionalism. We were promised "a slide or two on dealing with pharmaceutical companies". The above slide did not appear. Come to think of it, I can't really remember the ones that did. Suffice it to say, don't take their cash. Or pens. And if you do, tell everyone about it.


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Options

Too busy to actually draw things pretty - I have needed to multitask. So here's one I did while ostensibly listening to someone else talk. Basically, I think we as a species are giving up on our placentas too early. Might it be that there's still some use left in it? It sops up nutrients for the better part of a year, who says it can't go for a few more? At the very least, I think people should be given the option to try it.


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Connusumate Professional

Pretty tired today - still recovering from a behemoth of a call night. I think I delivered, helped deliver, or watched 7 deliveries. I say 'think' because I'm really having trouble remembering what happened between midnight and 02:00. There were a lot of H&Ps involved... I remember that much. In any case, the take-away lesson is that if you feel like you're in labor during the Superbowl, just go to the hospital. Don't wait until after the game. We have TVs.

We recently took a day off as a class (psych - we still had to preround) to talk about professionalism. Above is what I drew on the back of one of the feedback forms. I stand by it. Han would have gotten the job done last night, even if it meant not sleeping.

Or hiding in his cargo bay. Wait, could any of my L&D problems be solved by hiding in a cargo bay?


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