TIA No Joke for a Neurologist

Well, today was like no other day. I got to the hospital at 4:30, so I could pre-round before my attending showed up at 6am. Things were going smoothly until we got to a Neuro consult on a patient who should have never been there. We had canceled the consult the prior day, which was made by another minion, but that won't stop the non-readers from doing it. Reviewing chart orders is a tough concept to grasp, especially when they change. Anyways, when the giant found out that some little minion had carried out the consult he decided to intervene and discuss the matter with the Neurologist. After conversing about the situation, the giant told the other that it was just a TIA and should not be worry about the situation. However, this did not go over well with the neurologist who did not think that TIAs were a laughing matter. I guess he didn't know that TIA actually means Totally Inappropriate Admission. I of course was leaning against the wall laughing my ass of as the situation unfolded. Seriously, I must be in some need of enjoyment since I found this situation the highlight of my day.

Practicing in the Jungle

I have finally arrived at a Hospital. A place where humanity and decency are left at the door. My day begins way before the hint of sunlight. A time when the monsters are sleeping, nurses are friendly and attendings are sleeping. I scurry through the paperwork of the day before and make my rounds to check on the few patients that I have before the sun shows her face, because I know that when it does all things will change. The hospital is a backwards place. So, thanks Upton Sinclair for your book on hospitals.

One Toke Over the Line Sweet Jesus

Today's lesson was that some people must really lead extremely stressful lives. My prize patient of the day came to me accompanied by her 2 yo little girl. It was time for the mom's routine physical examination, even though she had seen another physician one month prior. I guess you can't get enough medical care, when you are not paying for it. Anyways, I find in her chart that she is experiencing anxiety attacks, and when questioned about it she explains that she has the attacks a couple times a week. Later on, while I am trying to get more of an accurate history, she divulges that she smokes EIGHT BLUNTS a day! I then politely ask, "How the hell can you be having anxiety attacks when you are high enough to walk on the moon?" She then proceeds to tell me about how people make her mad and then she has to rest for a couple hours, because she thinks if she doesn't she will pass out. Seriously, it must be one tough life for an eighteen year old these days who gets free health care and all the other wonderful benefits our government deems necessary to the "under privileged." I figure it must really be demanding and time consuming for her to thank all the people who are working everyday to afford her a life of being "comfortably numb."

Saving Lives and Sharing

So, today started out pretty slow. There were no patients for two hours, which isn't horrible because it allowed me to do other important things like: send emails, check stock and catch up on the constant reading. Around noon the office exploded with patients, and I got to actually use some of the information I have been reading in journals. It was kind of nice to know that I was not wasting my time. The steady stream of sickies slowed down around 3pm when I got my prize case of the day. The patient was coming in for refills, but little did he know that his BP could send Richard Branson to outer space. I finally got to practice some real medicine, and not that boring physical paperwork mumbo jumbo. While saving this man's life, he is having me discuss what the medication is that he should be taking and why he should. He wants to know if it is harmful to his kidney's or liver. I promptly respond that if he doesn't start taking his medication routinely that his liver and kidney's won't be bothering him, and that someone else will be exceedingly happy that he was non-compliant. I think that might have gotten to him, but if not at least I tried. If not for him maybe for the next guy to get to use his organs.

Have You Seen My Lost Hour?

I have been noticing that my days are getting shorter. I must be misplacing an hour or two a day, because I know I used to be able to do a lot more. I am still working about the same amount of time, but I keep finding myself pushing back some of my usual activities to the weekend or days that I don't work. It must be my job. This whole healing business is getting in the way of keeping up with the latest movies, books and frankly life itself. So I think I should put in for another job, however I don't know if the banks would let me. Anyways I think the thieves of my time might be the gnomes, since they have quit stealing my socks (thanks to my new wife's patrol).

Gotta Love the All Knowing and Cynical Attending

You gotta love a cynical guy who tries to make a difference. They are just hilarious to watch as the day progresses. We had a different attending who's outlook on life and medicine was that of pure disgust. It was great. The patients were incompetent, the weather was too cold and boy did he hate being a doctor. His main goal in life was to make it to some beach and chill for the remaining of his days. But, until then he was trudging through the sea of coughes, HTN and Diabetes. All I could do was smile, because he reminded me and what I will probably be like in ten years (lets be realistic 3 years). He was just a hard working guy in a broken system that doesn't reward the ones that try, but gives a golden crown to the sloths. So, who can blame any of us for the way we turn out.

Snake Oil Lectures and Dinner

I attended my first lecture dinner the other night at one of the finest steakhouses in the city. The lecture was on Asthma, but my main focus was on the free steak that I didn't have to pay for, cook and then clean up. I was the youngest free loader by at least fifteen years, but that did not stop me from enjoying a few mixed drinks and chatting about worldly events before the festivities. The first course was delivered and a waiter asked permission to place my napkin. I normally would decline the request, however the previous drinks had dulled my senses and the next thing I knew a guy had his hands in my lap. I guess luxury has its costs. The first course of the meal went without any interruptions, until the speaker began his informal lecture. And, it was at this moment that I realized I was going to be silent for the rest of the evening. While everyone else was taking part in the discussion I was making notes and looking stuff up. I had spent the morning reading the necessary chapter in harrisons', but at dinner I had only a vague idea what they were talking about. Anyways, the rest of meal came and went and I enjoyed every free bite of the one hundred dollar meal I was given.

Ignorance, Guinea Pigs and Test Monkeys OH MY

I have never been fond of the masses, and it is my belief that people are somewhat intelligent and reasonable if you are able to interact with them one on one. Well, that is complete shit and is definitely thrown out the window now after encountering a woman who spouted stupidity like water from a hose. My biggest problem was I couldn't find the handle to turn off her faucet.

I was doing routine school physicals on a family of five. Four children and one "spiritual" mother who was very "learn-ned" in the ways of keeping her children "healty." On one of the girls I prompted the mother that we needed to start her out on the new HPV vaccine. This shot series costs around 600 dollars, but because she was one of the privileged salts of the earth it was going to be free. After mentioning the new course of action, I was badgered with these strange sounds coming from the mother's mouth. All I could make out was: "I ain't no test monkey," "We ain't going to be no guinea pigs for you," "I gotta do da researched first" "Why some white doctor gotta tink just cause we black he can snob us," "See kids this is how yous suposed to handle peoples." So, I stepped back from the situation and proceeded to reevaluate. I decided that the time for me to laugh was soon but not at this moment. So, like any great doctor of the ghetto I finished my work with the family, and turfed them to some other guy to make is 20 dollars for an office visit.

Snake Oil Salesmen

Today's focus is on the wheeling dealing cure-alls I am introduced to everyday, along with their pushers. These snake-oil salesmen approach you, and tell you about all the great things their wonder pills do. They have been known to cure cough, colds, runny noses, asthma, pregnancy, diabetes, HTN, droughts, and create mountains out of mole hills(little blue pills). With their slyness they approach handing pamphlets and gifts, which I take cause free stuff is great, trying to persuade you into dishing out these wonder drugs. But, little do they realize that I don't know the difference. So, I just shake my head and try to act like I know something, and wait until the day comes that when I do know what they are talking about. At that time I will only be nodding so that I can continue to check out their nice toys. Seriously, do the big drug companies think I care about their pretty chart or the pretty girl interrupting my day with free gifts.

Can you hear the voices too?

A lady comes into the clinic, and appears as your typical ghetto person. She is missing most of her teeth, broken sentences, and a list of complaints. It was her first complaint that really got me. Suicidal Thoughts. When I heard that my head snapped to full attention. I put a big gold star by her name, and was like congratulations. You are my first crazy patient. She then proceeded to tell me about the voices, and having them wake her up and talk to her all day. So, like any good dumb doctor I scurried off to my supervisor and reported that I thought there might be a problem with this patient. It was my first TURF, and I was proud.

The next day I was practicing in another clinic which I didn't really think was the ghetto, but I was wrong. A nice twelve year old Mexican girl comes to see me. I carefully skimmed the chart for the notes of previous Ghetto Docs' and to my surprise our little girl had quite a high libido. I was able to inform her about her newly acquired friend N.G. and run another pregnancy test. She was a little disappointed there would not be child in nine months, and I told her she probably should shy away from sex for that period of time too. Or, at least until she became a teenie bopper.

The Road Less Travelled (probably a reason)

Today I started out and decided to take a shorter way to the Ghetto Clinic, and of course I got a little off track. I kept driving thinking that sooner or later I would come about and find my way. Anyways, I was thinking I was making great time. Along the way I began to notice housing and buildings were beginning to become a little shady. Also, the usual bum and street workers were looking at me with what seemed to be bewilderment. Finally, I figured out that I might need to find some route out of there was when the bums started directing traffic, and people listened. This definitely wasn't an area I belonged. So, like any mid-westerner deep in the ghetto I locked my doors and began to drive really fast. I figured even if I were to get pulled over the cop would probably say "WTF" and give a nice escort out. I did finally make it to my clinic, and had another productive day of practicing to be a doctor.

Making Girls Cry

Day 2 of healing the common masses lasted longer, while increasing my patient load 400%. Eight unfortunate souls had the poor luck of being guinea pigs for my shots and blood work. Out of all my patients I made most of the girls cry today. The first was a 2 yr who came in for her immunizations. She came into the office smiling at me until I pulled out the two shots. Then she started wailing. Later on, I have a very sad girl in her mid-twenties. All I had to do to her was ask questions, guess I can even be rough with that. Oh well, I am going back to the Ghetto tomorrow to do immunizations. So, hopefully I won't make to many of them cry.

First Day in the Life

Damn....Was the first thing that came to mind when I saw the Ghetto Fabulous healing house that I was to begin my rotations. There were several firsts today along with my first patient, who didn't speak any English. The first was after dropping off some mail in the local blue box, I heard a gun shot and jumped. After coming down, I looked around to see if anyone was dead and there were two small black kids laughing at me. I felt tough. Later on, I got to meet a 17 yr. old girl with her lesbian partner. They were there to get her baby up to date on immunizations. During my lunch break, I decided to hope in my truck and drive to Micky Dees. Another time i felt safe standing next to a cop, who proudly wore his bullet proof vest for all to see. I had a nice tie from express to protect me, thanks to Dawn. After reviewing my day, I thought it went pretty well, except for the fact that I'm the best medical care these people are going to get.