Wharton’s Jelly

As I mentioned last week, I’m currently taking a hybrid classroom/clinical duties course centered around immunology and the immunocompromised patient. I’ve just finished a week on the stem cell transplant unit, where most patients have received a bone marrow transplant to treat leukemia. In general, these patients come to the hospital for one of three reasons:

  • To get their bone marrow transplant;
  • Their leukemia relapsed;
  • They developed an awful complication called graft-vs-host disease.

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We Need To Talk About Your PET Scan

This is not funny, so if you’re not in the mood for some serious, come back later.

Yesterday was my last day of inpatient medicine for the entire year. I have two weeks of outpatient clinic left and a shelf, but for all practical purposes we’ve completed our clinical year. It’s terrifying to think that in a typical curriculum, I’d be applying for residencies right now. Oh god.

The night before my last day, my team admitted a gentleman, whom we’ll call Mr. P. He came in after hours with a months-long history of difficulty peeing and some blood in his urine. Why he chose to address this in the ER in the middle of the night, I have no idea.

(I have, of course, changed many details here for privacy reasons.) Continue reading

Round and Around We Go

Just in case you were wondering, I hate rounding with a broiling, incandescent passion.

Unfortunately for me, I’m on my medicine rotation, where rounding is not just a part of the day – it’s THE day. For those of you not indoctrinated into this hateful but necessary practice, rounding is when the “team” – the attending, the resident, the intern, the idiot,* and sometimes other people see all the patients on the list in the morning. You should take the word “morning” with a grain of salt, as sometimes rounds can begin at 6 AM and stretch well into the afternoon. Why this occurs will forever baffle me. Continue reading

A Lexical Update

Halfway through last year, I wrote “Commonest Erythematous Palpation,” a post illuminating some of the ridiculous medical terminology doctors use every day. As second year draws to a close – I’m just five weeks from the end of my last rotation, not that I’m counting or anything – I thought I’d provide you with an update with a more clinically-focused bent.

See, last year we learned all these fancy words, but it was like learning formal Spanish when most people in the real world use slang. It’ll carry you in a pinch, but people think you’re an idiot. Continue reading

Divergent

Iiiiiiiit’s SOAPBOX TIME PART TWO!

Let’s start with a throwback to my surgery rotation.

Allow me to describe, briefly, the scene before a minor surgery. Like a lipoma excision, or a skin graft. The room is sterilized about fifteen minutes before the patient is wheeled back; no one is allowed in without a mask. Once the patient comes in and is put under anesthesia, they’re sterilely draped. You can’t even touch the lights without a special sterile holder, and anyone near the sterile field has to wear a ridiculous-looking full-length gown and specially-sized gloves. Continue reading

Soapboxing

A change from the usual today.

On Friday, the Washington Post published an interesting profile of a cardiologist in Arizona named Jack Wolfson. Dr. Wolfson has made a name for himself recently as a physician who encourages his patients to not vaccinate their children. Also, he goes on TV a lot now to talk anti-vaccine stuff, even as children in the southwestern United States have measles.

MEASLES! Continue reading