quotes

"finished call shift with a delivery. when it was over, i stood there thinking, "no way did that baby just come out of that small vagina. that was weird."
-Vince

"Jaw saw my first vaginal delivery! Holy shit!!!!"
-Sarah

"‎12 hour shifts Mon-Fri, 6 hour shift on Saturday, plus a couple 30 hour call-shifts = My Internal Medicine clerkship just started. (not to mention that I still need to study outside of work) — at Downey Regional Medical Center."
-Ryan

Chris: Sounds like a pumie question, except she'd have traveled to Indonesia and got bitten by ticks and mosquitos in every state. I'm going to go with C.

Bobby What's the answer!?

Danny: They forgot the meth addict in the woods that bit her.

Dorothy: answer is F. the meth addict

Kelsea: I know what they want me to say, but this is the real world and you always gotta be most careful of the ones that look the cutest. Thus I'm gonna put E. Chipmunk, just on principle.

Carrie: That is too much!!! I pick the skunk! :)

Beth: this looks to me like a case where you'd want to get to the root of the problem... who hunts chipmunks then makes their 5 year old girl gut them? and the whole bat in the girl's tent situation....maybe dad is the meth addict....

Vanessa: Yes, I think it's F, call CPS and get the kid out of there. Is selling these tiny animal pelts the family's main source of income?

Sarah: chipmunk ghosts.

Amanda: glad to hear someone's getting the necessary camping preparation at a young age..

Nikki: Camping will definitely suck for her! Who gives a 5 year old a knife and asks them to gut cute furry animals?

Dorothy: answer is C by the way...

Andrew: i would have also answered C but if it was a pumie question the answer would be G herpes.

Julia: dorothy...so does this mean you are set for shelf exams if you know the answer to this question? time to stop studying? yes?

Adam: is that the Polish Adventurers Club version of the exam???

Today we had our OB/GYN and peds OSCE exams. My first was a 27yo women with abdominal pain and the other was a lil girl actor playing an 11 year old with a cough. There was another actor in the room playing her grandmother. They both went well and now im back to studying for my 2 exams tomorrow.

Speaking of studying [on facebook]:

Laura to Sarah: is it thursday yet?

Sarah: seeeewww close. and by thurs you mean wed night? and by wed you mean freedom? and by freedom you mean bot shenanigans?

Dorothy: seriously. im really over this. especially because by wednesday you also mean dorothy's vacation starts!!!!!!

Laura: i just took a break to cover my step up to med with a paper bag.... someone is definitely needing some craft time obviously... ?

Nicole: Haha a "break" huh Laura? I'm dying. I'm done. Ima quit doing everything now. Oops guess I should go to my OSCE first before throwin in the towel?

Kelsea: Brian and I may have just spent the better part of an hour discussing the best way to fake our own deaths and flee the country. Brian was even ready to sacrifice his teeth to be left in his burnt down house....dentures aren't so bad...?

Dorothy: tell brian to stop bitching and just ask Gaga to pay his tuition off and then go on tour with her as a backup dancer

Sarah: he can burn our house down. The water bill is getting too expensive. I'll help with the teeth...

Kelsea: Haha Dot, yeah I suggested that a while back, (minus the back up dancer part, but he could at least be her pool boy...)

Kelsea: And Sarah, we opted for a plan that leaves less evidence...but if either of us disappears randomly just wait a few years for the postcard, probably in code with an beach address some where in columbia or the south pacific...

Kelsea: er colombia...

Laura: please kidnap me on yer way down kicka... for reals.

Nicole: Okay ladies, new plan for us tomorrow-- we are gonna go with the teeth idea as well. EXCEPT, instead of leaving them in Sarah's burned down house, we are going to leave one tooth at each station at hospital day tomorrow in place of our signature. Thoughts? Hopefully everyone has 17 teeth, because 16 will not be sufficient, per our last email.

Laura: bahahahaha, rollin cinna!

A preface, we have a shelf exam from 8 to 10:30 then have this mandatory hospital day from 10:30 to 12:30 and then we have our other shelf exam from 12:30 to 3. so they expect us to mingle and pretend to be interested while we should be eating lunch and relaxing a bit between exams.....

an email from school today:

Dear OMS,

As you know, Hospital Day is tomorrow and attendance is MANDATORY. Attendance cards will be available for you to pick up at the reception/guard desk on the first floor of the HEC when you first walk in the front doors. You will need to obtain signatures from at least 16 of the exhibitors who are here for the event.

The attendance cards will have more instructions on them, but we would like for you to keep the following points in mind while you are meeting with the sites that are on campus:
- Do NOT forge any signatures on your attendance cards. Students who do so will meet with the Student Performance Committee and risk being pulled off of rotations.

- Please remember to act professionally when obtaining signatures on your attendance card. Do not walk up to the site representative and ask for a signature and walk away. Make sure that you ask questions and show interest in their programs. Many of these sites are traveling long distances to come talk to you about their rotations and residency programs.


Cards can be turned in to the COMP Administration offices on the 2nd floor of the HEC by the reception desk. A drop off box will be available for your cards after Hospital Day is over.


20 minutes later we receive another email:

UPDATE!

Students will need to obtain 17 signatures, not 16.




17, not 16. what a JOKE

First Block COMPLETE!

well, my first 12 weeks of rotations are over and i have ended up back in the same room on the 2nd floor of school in 'my' study room. Back to the usual study-a-thon for my two shelf exams.

For each specialty rotation we have a nationally standardized exam. Each exam is 100 questions in 2 hours and the formatting is the same as our board exams. So i will be taking my OB/GYN and Peds shelf exams this coming Wednesday and being the good student I am, I am spending Saturday night in a little room that has no windows with my buddy Sarah studying.

The good part is that once Wednesday hits, I wont have another exam for 12 weeks :)

oh yeah, and my next rotation is VACATION. so starting Wednesday I am freeeeeeeeeeeee

The last week of peds was much more exciting than the previous ones. The fun parts included the intern we worked with, our attending, and the ridiculous moms we dealt with. All week we rounded with the Dr. C, the doctor that I originally hated/feared from the outpatient clinic. She pretty much shows no emotion except for a random joke every once in a while. But even so, she is easy to work with because she goes fast and gets done early.

The last week of newborn nursery we had a lot of mom’s who used drugs in the past or during pregnancy, a ton of teen moms and some other pts who were in jail at the time of giving birth. Each one of these patients is not allowed to leave the hospital until a social worker clears them for discharge.

The most extraordinary case of the week was a 32yo G24P6 female. Let me break that down...this 32 year old woman had been pregnant 24 times [Gravida 24] but only given birth 6 times [Paridy 6]. Go ahead and let that sink in for a minute....

I was the one to see the baby and present the case to the attending and i was looking forward to subtly add that into the history and seeing what her reaction was... When we got to my patient during rounds it went something like this, “ In room X we have Mrs X who gave birth to a full term AGA male last night via NSVD. Mom admits to alcohol use and 1 pack every 4 days of tobacco use during pregnancy. Mom is G24P6 and her labs were all negative except for GBS which was positive and 3 doses of antibiotics were given during labor.” Then I stopped after this sentence and looked up and Dr. C just looked at me with a puzzled face. “G what?” We all sneakered and after I repeated myself we went on to have a conversation about if this was really possible or not. We all agreed it probably was if she got pregnant twice a year since the age of 15 or so....that or she just lost count because really, who keeps track of their pregnancies, abortions, and miscarriages...

This week we had a lot of sick kids in the nursery, not sick enough to be in the NICU but enough to make rounds last a lot longer than usual. At a certain point during rounds this week Dr. C said “ok, any healthy normal babies here right now? i guess they dont make that model anymore, most have discontinued it.”

On Tuesday we had a set of twins born via C Section, a boy and a girl, and then Wednesday we had another set of twins. Ron got to go into the delivery on Tuesday and then on Wednesday we were on rounds and the intern’s pager went off [its actually a little speaker that they use in the OR to inform everyone that needs to be there. A nurse is heard over a little speaker the pediatric intern has on their scrubs saying “Pediatric and OB teams please come to OR number X for a twin delivery..[etc]” its pretty cool. I heard the speaker go off and i immediately got excited and asked if i could go into the C section...only problem was that my patients were next and i had to present them to the attending. i was so freakin bummed when the intern said, “no you should probably stay here and present your patients and then if your done you can come after.” I was so antsy and finally after rushing through my patients Dr. C said “go, go to your C section,” i couldnt tell if she was mad or really didnt care [again, she shows no emotion] so at first i was very hesitant but then Torey [another medical student] encouraged me to go so I did and i am very glad i did. I ran down the hall to get to the OB department and after putting on my hair net and surgical mask i walked into the OR to find at least 14 people in there-- 3 on the anesthesia team, 3 on the OB team operating, and the rest were nurses, respiratory therapists and the pediatric intern, NICU attending, and some others. The babies had just been born before i came so i didnt get to see them come out but I did get to see them get worked on. Both were very small and needed help breathing for the first few minutes of life. Right after birth they were wrapped up in what looked like a plastic bag to keep them warm and after they were stabilized and swaddled up, the intern took one baby at a time to go visit mom for a second and then there were both taken to the NICU in their baby warmers. I found out in the NICU that the mom was actually carrying triplets but one of them had died in utero about 1 month prior and the mom had been in the hospital for the month before this delivery. The fetal demise was born third and right after birth was taken out of the OR where it would go to the morgue to get an autopsy. The other two babies ended up being fine and later did i find out the mother had a history of meth use....

Two other interesting cases happened at the end of the week. One was a baby that was born and about an hour after delivery we were doing the newborn exam on her and she seemed to be fine. Her physical exam and vitals were unremarkable but yet she was totally unconsolable in the nursery. She just wouldnt stop crying. I remember this baby because I was studying in the nursery and mom called me asking me how my day was going and she could hear the baby in the background crying and said, “something is wrong, babies dont cry unless there is something wrong.” I laughed at this saying she was just being fussy and that she was fine. Then when I came in the next day we learned from the overnight intern that the baby was with her parents but still was being fussy and wouldnt stop crying. I thought it was pretty ironic that mom was right but it ended up that the baby was fine. We did a work up for a couple different problems that we thought she might have but everything ended up being fine. So thats good even though we never figured out why she cried so much....hope she lets her parents sleep at home.

Lastly, I will end pediatrics with this pearl of a story. I dont know too much about the mom and baby because she wasnt my patient but i heard about her during rounds from the staff. Ron had a newborn born to a mom who was a little...off. He said he would ask her questions and she would just look around the room and talk about random things. He said he got an odd vibe from her and let the intern and attending know during rounds. Also, this mom was refusing for her baby to get a neonatal blood screen [a screen every baby gets in the first days of life to check for genetic diseases that can be fatal if not caught early...and if they do have one they can be harmless if given the proper medications/diets]. While talking about this patient, the charge nurse came up to use and said she needed to speak with us about her. She wanted to let us know that the mom was saving the babies diapers and expressed that she was doing so so that later she could smear the poop on her body because it is good luck. All of our jaws dropped and the only words out of the attendings mouth were “Psych consult.” It was hysterical. Social services had to get involved with this case also and I actually dont know what ended up happening with this mom because she was still in the hospital when i left on Friday.

So thats it, peds is done and I could not have been more wrong about my interest in it. I am glad i found out early on in my 3rd year rather than later on. I now know that I need something fast paced in my daily life and even though this will likely be more stressful and tiring, I have come to realize that even though i hate stress and being tired, its something that keeps me going. I am a fast paced and outgoing person and I need to be challenged and most importantly, I need to know that my work is important and making a difference. When i was on OB I saw a difference right there and then. Wether it was a delivery, a surgery, or just a clinic visit. I saw the work I was doing was making a difference. In pediatrics you dont see the ‘fruit of your labor’ sort of speak. It may sound shallow but i need to be reminded of the importance of my job since i have sacrificed so much to get to this point. Thus right now I am still considering going into OB/GYN and I am also thinking about going into Emergency Medicine. Who knows, maybe the years of watching ER has subconsciously persuaded me into the field.


The past week we had our didactic week that happens after every 12 week of rotations. We came back to campus to do our OSCE’s, take or shelf exams [which sucked] and then have ‘plenary’ session for the upcoming specialties we were rotating on. Basically, it was a stressful Mon-Wed and then 2 days of relaxing. Next up, I have 4 weeks of a well deserved vacation. I have not taken time off since last summer and I have never needed a mind break more. Going straight from second year to board studying to 12 weeks of a demanding rotation schedule, I am going to enjoy and relax as much as i can for the next 4 weeks. Then its off to Portland, Oregon for my elective. I will be working in an outpatient family practice clinic and living with a good friend of mine who is also doing a rotation up there.

4. more. days.

screaming babies are getting old. C sections are fun cause right after they yank the baby out we get to be the first ones to clean them off, suction out all the gunk, and annoy them until they cry really loud [helps them to clear out their lungs and breathe better]. dont get me wrong, its a beautiful thing to see new moms and dads with their babies, but i need to be busy or else i get bored quick. maybe emergency medicine really is for me?