When you go to the ER for medical care and are discharged home, almost every ER will send you home with “discharge instructions.” In a perfect world, this would contain information that is actually relevant to the patient’s medical condition and cover what was done in the ER, the results of lab tests and imaging studies, and “return precautions” – when to come back to the ER. Continue reading
Medicine
BUFF and TURF
I am now done with my ICU month. I would just like to reiterate, again, that being on 30-hour call every third day for an entire month is total and complete bullshit that ruins your body and soul and no one should have to do it.
I have also been advised by legal counsel, also known as one-half of the Bringers of Life, that in my previous post I apparently ran a small risk of getting in trouble. I am not sure why; perhaps this is because I reference in somewhat pointed terms that one of my hospital sites (the Not A Real Hospital one) is run about as efficiently as a traffic jam. Continue reading
Protected: Stories From An ICU Black Cloud
The Nights Watch
Hi. I have just completed a stint of night shifts – twelve in the last fourteen days – and I feel like a moldy, rotted potato.
As I write this, I’m trying to “flip back to days” for a regular day shift tomorrow, as the cruel scheduling gods have elected to grant me one day of work during normal people hours (albeit on a Saturday) before switching back to a third week of uninterrupted nights. Continue reading
Night Float
I am back in the Cardiac Care Unit this rotation. If you recall my earlier tribulations from my previous CCU block, this means I am once again forced to Constantly Replete Potassium. I have never really forgotten how much I hated the CCU – all other rotations are judged in relative fractions of CCU terribleness – but I had, at least, airbrushed out the violent rage induced by being interrupted every eleven seconds about electrolytes.
(This post is, in fact, not about electrolyte repletion, although there will be frequent references. You may all breathe a sigh of relief.) Continue reading
Rules for the House of Pain
There is a Bible in medicine for interns. Published in 1978 by an intern doing his first year in internal medicine, The House of God is a cynical and hilarious look at the dehumanizing, cruel, and sad life that is residency. Continue reading
I Took Step 3 And It Was Stupid
So I know the last time I wrote, it came off a little bit angry and a little bit sad. I said things like “none of this matters,” and “bloated, terminally diseased healthcare system,” and mentioned Wharton’s Jelly again.
I am happy to report… that I took Step 3, the final step in the general medical board exams. And it was stupid. Continue reading
It’s 3 AM And I Wanna Go To Bed
If you’re wondering why you haven’t heard from me in awhile, it’s because I went directly from the Potassium Repletion rotation, which I absolutely despised, onto internal medicine wards. I am not sure why it is called a “wards,” rotation, but basically it’s the same thing I did in med school – rotating on an internal medicine team. I actually finished my “IM” rotation two weeks ago and have since been on an obstetrics service catching babies, but that’s a story for another time.
I’m behind. Residency is hard. Leave me alone.
Awaiting Return of Bowel Function
As I wrote last week, I am on a surgical service, trauma, at the moment. And my day is governed by, and revolves around, poop.
It is astounding how much of my daily well-being on trauma is influenced by the ability of someone else to poop. I think about it literally all day. It is often the first question I ask patients in the morning and the last question I ask them before I go home. It sits on my constantly-growing, frequently changing TO DO list I carry with me as the only constant: “Check on BMs for Patients A, B, F, W, P.” Continue reading
Putting In Orders
Although most of my medical school classmates have already begun their formal residency rotations, we here at the Necessarily Anonymous Emergency Medicine Residency have yet to officially start. This is, depending on your point of view, either because our residency is warm and fuzzy and wants us to have a high quality of life, or they lack so much confidence in our abilities that they feel it necessary to train us up for an entire month. Continue reading
crashing resident 