This job is awesome

Monday I hung out with Dr. G for the day mostly watching him and him teaching me lots. he is a grrrreat anesthesiologist and teacher. everyone in the hospital loves him. This rotation is going to be wonderful, I am learning and doing a lot [and i get all the free food and coffee i want :)].

Wednesday we worked in the labor and delivery ward. I watched him do 2 epidurals then I did the 3rd. I watched him do a spinal anesthetic before a C section and I did the next one. Its very different to be in a C section on the other side of the blue curtain. Mom is completely awake and you are talking to her the entire time. and then there's dad sitting on the stool trying to look over and you repeatedly telling him not to look because if he passes out there will be no one to take care of him... I still LOVE OB and enjoy watching the birth of tiny humans. its such a crazy experience and everytime i fight the tears when mom and dad are presented with their new babes.

During some small talk with a mom during her C section I asked if she decided on a name, she said she was deciding between Eli and Isaac. I told her I liked Eli.

Later in post op [after the delivery], someone asked the name of the baby.
"Eli" she said, as she looked over and smiled at me.

i love my job

"That's latin right?"

fun is listening to my patient say the word 'proprioception' as she listens and joins the conversation my preceptor and I are having as she lays on the table post- c section.

John is not gay

John: u'll have to introduce me to some hot nurses
me: why not hot docs?
John: nurses have a looser set of morals
me: you think so?
John: i guess i'll go for a doctor
John: but only if he's cute :)
me: wow, slap in the faaaaaaace

Anesthesiology starts tomorrow

back in the OR but on the OTHER side of the blue curtain. My anesthesiology rotation starts tomorrow and with all of the excitement of my EM rotation and the worries of my looming board exams, I have not really given it much thought until now. And now that i am thinking about it, im getting really excited!

I love being in the OR and will get to spend the next 4 weeks there. I dont know my preceptor very well but I hope he will be letting my intubate, give anesthetics, do spinal anesthesias, etc. The excitement and anxiety of the Sunday before a new rotation is a fun but scary one.

Last shift

It was crazy busy and there were tons of traumas but our pods were packed so i stayed behind and helped run them while the resident was busy intubating and putting in chest tubes [my time will come!].

At around 3am I did my first LP [lumbar puncture].

 In lamens terms, I stuck a 6cm needle into the lower back of a women to rule out a sub-arachnoid hemorrhage as a cause of her headache. The spinal cord is not that low so there is no risk of paralization, but its still a tricky procedure. Unfortunately, i didnt get any CSF...only blood. [CSF is the spinal fluid...it should be completely clear...hence the name 'champagne tap' when you get clean CSF with no traumatic tap/blood].
It was my first try so I didnt beat myself up when after several attempts, we got a new needle and the resident tried. Made me feel a hell of a lot better when the resident tried several times and then had to call the attending because we weren't getting the fluid we needed.
next time will be easier, i hope...


Things quited down around 5am and I sat down with the resident and attending and good some great feedback from them. Couldn't be happier about how I ended my rotation at this incredible residency program! *fingers crossed for an interview there this fall!*

Patients

Saw a man with HIV and a CD4 count of 8, he was not going to live much longer :/


[trauma patient comes in, young lady screaming her head off to stop trying to kill her]
"whats your name honey" -charge nurse
"JESUS CHRIST!!!"
[charge nurse turns around. She calmly tells the nurse writing the chart] "Jesus, last name christ"

Lastly, the power of narcotic addiction:
-lady came in at 2am with 'cuts' on her fingers asking for pain meds. we gave her 2 norco and sent her home...she was obviously drug seeking.
-lady proceeded to lay in the parking lot in front of the hospital and got brought in by EMS
-lady demanded Dilaudid. we said no. she angrily left yelling and screaming.
[2 hours later--at aprox 4am]
-trauma alert, auto vs pedestrian. a lady had thrown herself in front of a car on the freeway on-ramp.
-lady comes in on the backboard. we notice...its the same lady.
-lady really wanted Dilaudid. lady also has multiple fractures including in her T spine.
-lady is now paralyzed.

Just some pictures

Helipad

Dislocated thumb, 4 year old

bicornate uterus on CT scan, looks like a heart

double layer lac repair at 3am

VP shunt on Xray

smashed distal 3rd and 4th digits

smashed digits after partial amputation in the ED

"I stepped off a curb wrong" -very very drunk man

the X rays after reduction of his ankle