Internal Disaster

Granted I have not been at this game for very long, but there seems to be a general lack of common sense among many of our patients. The seasoned attendings swear it is just getting worse. A blight of stupidity.

If your child has a fever, and you take him to the Emergency Department and he/she gets given some Tylenol, which breaks the fever and you even go home with a prescription for Tylenol (which will be free to fill as the child is covered by Medicaid), why in the world would you not simply give the child the Tylenol as directed? Why would you return to the ED 12 hours later, have the child be doled out another dose of Tylenol by the triage nurse, sit through over a three-hour wait to even get seen by a physician, and then get mad at me when I give your runny-nosed, now afebrile toddler a popsicle, and discharge him home 10 minutes later? Sicker patients get a higher priority. And, I am not about to admit a well-hydrated tot with a cold to a hospital already short of beds because a parent can't follow simple instructions!

What more can I do? We can't physicially hand out medications because there's no way to stock supplies large enough to cover everything prescribed. At some point, parents have to have the responsibility to go to the pharmacy (several of which are open 24-hours) and get the prescription filled. (Or in this case, they could shell out the $5 for the medicine since it's over-the-counter, instead of spending their money on cigarettes and manicures.)

I know that I have ranted about this before, but the situation becomes all the more frustrating when the pipes in the dirty utility room start backing up and overflowing into the lobby. The whole waiting room had to be evacuated because of noxious fumes, so what we were left with was hallways of impatient (and mostly, non-sick) people corralled off and harassing nursing staff about the wait time. If I had a sore throat and was in a waiting room with dozens of people in front of me to see the doctor, and the room had to be cleared because of a hazardous exposure, I would just go home, or better yet, walk the block-and-a-half around the corner to the hospital next door, which is physicially attached to ours.

People, there wouldn't be any wait time if you only came in for emergencies.

The Name and Blame Game

If one was such a fan of great philosophers to go as far as to name their child after Socrates, shouldn't they at least spell it right?

The other day, I took care of a vomiting toddler named Socratiez, or Socks for short.

The all-time record for stupid names goes to my colleague, who saw a kid named Shithead. It was supposedly pronounced Shi-tay-ed. And no, they weren't recent immigrants. Some things should be illegal.

The Houseguest

My friends will tell you that vacationing with me can be exhausting. Sometimes I try to cram so many activities into such a short time period that you may just need a vacation from your vacation.

My friend, J, was on her Spring Break and flew in for a few days. Here's a brief summary:

Day 1:
- Pick up J at airport--they've actually lost her luggage!
- Give 5 minute tour of my house.
- Off to dinner!
- The Other Boleyn Girl - Confusing pentagon-shaped headgear.
- Ice cream sundae break!
- Watched "The Lake House" while waiting on J's luggage.
- Awakened at 1:30 am by airport van carrying lonely suitcase.

Day 2:

- Irish pub for breakfast (skipped the green beer since driving)

- Nearly got kicked by an Irish dancer.

- Oh Canada!

- Sampled some Canadian wine.

- Hit major city at rush hour, dined in the sky.

- Turned around and drove back.

Day 3:

- Unrelenting rain.

- J sleeps in and rests while I go to ACLS class .

- Show off my city.

- Drive up for dinner with Army Guy.

Today:

- Deposit J back at the airport .

J and I were college roommates, and although our lives have split in different directions from our pre-med days, it was good to catch up with her minus the kids an husband for a few days of just being old friends. For 72 hours, I was 20 again.

Home Again

I am back in the Pediatric Emergency Department. While things at the Veteran's hospital went smoothly (It is nice having computer access to records of primary care and specialist visits.), the patient volume was so much lower than it is at my hospital. While I miss the luxury of actually being able to leave on time with all of my charts dictated, time passes much more quickly when you are busy.

Over the past few shifts I have had some pretty sick children, mixed in with all of the usual fever and vomiting cases. The other morning started with a child hit by a car. She came in already intubated, so there wasn't too much to do, but the poor thing had fractured three out of four of her extremities. She'd been hit so hard that she had huge gashes across her chest, and her liver was lacerated. She's still in the ICU fighting for her life, but she came through surgery ok, and hopefully will come of the vent soon. Then there's been the gauntlet of medical stuff... asthma, sepsis, scarlet fever, meningitis exposure (!), appendicitis, etc.

And perhaps my favorite, the accident-prone: lacerations, shoulder dislocations, finger amputations, nailbed injuries to repair, all requiring lots of sedations. I have said this before, but I really like the straight-forward stuff: clean it, sew it, pop it back in place. As long as the rest of the department is settled down, it is really satisfying to have a quiet 20 minutes of irrigating, prepping and doing a quick suture job.

It's good to be back.

Step By Step

I am back to pushing myself to go further and faster at the gym. There is a 10-mile race coming up in several weeks that I would like to be able to complete. I still don't know my schedule for race day, but in the meantime I'm increasing my miles, despite my complaining feet.

Do you know what amazes me? Why do people think that they can just step right onto a treadmill that is still going? I have witnessed this several times over the past week, and its fairly amusing to watch. If you hop off the treadmill for a quick break, to get back on it, you need to get on by placing a foot on either side of the moving belt, and approach it from the far end or at least middle, so that you have a step or so to adjust to the speed.

Instead, I have witnessed several people just try to leisurely step onto the end of the rotating belt. What invariably happens is that they awkwardly sway, and try to spread their arms out to catch their balance. However, by that time, it's too late and the treadmill has already deposited them back on the floor. So far, I haven't seen anyone face-plant, but I keep picturing it.

When you're already at the end of the running session and trying to keep up your pace, it's awfully hard to keep a straight face when the Weeble-Wobble to your left just got thrown on the floor!

Not Springing Forward...

Not watching television has its downfalls. This past Sunday I had no idea that it was time to "Spring Forward" for Daylight Savings Time. Arizona doesn't do Daylight Savings Time, so I am not used to this custom. However, at least in the Fall I had overhead people talking about the changeover, so I didn't miss out. This time, I just didn't know it was coming.


I was so clueless that luckily I still didn't realize it up until arriving at work and seeing the hospital clock, so there wasn't any time to get all panicky.


I am one of those crazy back-up alarm folks. Every night I set my alarm clock--which has a back up 9-volt battery for power in case of an outage. On top of that, I use my cell phone as a back up alarm. You would think that the thing would update the time automatically, just like it does when you enter a new time zone on a long car trip. No such luck.


Luckily, when I did get to work there was only ONE patient in the department (A Daylight Savings Miracle!), and the attending that I was scheduled with honestly didn't care about my faux pas.

Downhill

The conference was a lot of fun. This one was scheduled a little bit better with three hours of lectures early in the morning, followed by a six-hour break to enjoy the resort, and then another three hours of lectures. On the first day, the sun was out and there was fresh snow from the night before. We all went downhill skiing. This year it went more smoothly than last time. I still tend to do a lot of snaking back and forth across the trail, snow plowing most of the way to slow myself down. One of my friends calls herself a beginner, but she's at a much better place than I am. However, we went all the way up to the summit and skiied down twice, sticking only to beginner trails. I still managed to fall twice on each run, but it was a lot better than last year. My main problem is when I look down, I get this lurching sensation in my gut that I am somehow going to fall off the face of the Earth, so I stick to just watching my feet. Supposedly, one can see three different states from the top of the mountain, but I couldn't discriminate one state's snowy pines from another's.

The second day I had planned on trying cross-country skiing or snowshoeing, but unfortunately it rained all day. Instead, I booked a Swedish massage at the resort spa. I had never had a massage before, and all of my muscle aches from skiing were immediately gone after the massage, but they did come back in about two hours.

Another neat thing about the resort was that despite there being tons of snow, their pool was outdoors, with a plastic-flapped indoor entrance. The thing was heated to bathwater temperature so that it was constantly steaming. It was an odd sensation to be standing in the pool with your hair and eyebrows forming icicles while the rest of you was nice and toasty. Interestingly enough, the city where this resort is located has a bunch of light pollution laws. Although this meant that the resort couldn't offer night skiing, it was cool to float in the pool or sit in the hot tub in the evening and be able to actually pick out constellations.

I was able to meet up with Ru for dinner on the last night. She was gracious enough to entertain me for several hours and we found perhaps the world's best Bowling Alley hot chocolate. With there being only two single females in my class, I wound up being roommates with McNeedy, who despite being at a ski resort and away from work, still managed to find things to complain about incessantly. I probably let it bother me more than I should have.

After dinner, I stayed up with the boys playing poker. We had brought enough alcohol and munchies to stay in our rooms for most of the conference (burgers in the restaurant downstairs were $16!). We just played for pocket change, but I doubled my original $2 and left with a heavier backpack.

The last morning we ended up leaving right after the lectures were done. I had hoped to sneak in more winter sports after the conference, but again the weather wasn't cooperating. On the drive home, the rain suddenly turned into soggy fistfuls of slush, and then pelting hail. We turned a slick corner to find that the SUV that had passed us about a mile back was now lying on its passenger side. We pulled over to check it out. Luckily, everyone was able to climb out on their own and refused an ambulance.

Today I was sad to drag my carcass back to the hospital, although it was just for a few hours with a radiology review. The conference was a good educational mix-- including orthopedic, pediatric, radiology, and toxicology topics in addition to a hands-on ultrasound workshop. I think I may have even found an article to present at journal club this month!

Mini Break

Tomorrow I am off to a winter conference with my fellow residents. It is a bit of a drive from here, and we're stocking our hotel room with plenty of party "must-haves". The conference involves a mountain, some snow (hopefully no broken legs!), and reportedly some educational lectures here and there. I am hoping that I will also get in a chance to see Ru for a bit. The other day I was mildly depressed at hearing a local ski shop offering a mid-winter sale. This can't be mid-winter, I am sick of it already!

Army Guy is currently on a mini-deployment in Kentucky. His battalian goes to Iraq in November... I am trying not to worry about it too much at this point, as this is the third set of orders he's had in the less than a year that I have known him. Apparently, they go to two different bases and run simulation missions before being deployed. He's a little stressed out because as a platoon leader there's a whole bunch of pressure on him for his squads to perform well. This one's just for a couple weeks.