a quickie: not literally but then really

that’s in reference to the post and then my run.

the ob shelf was horrible.  i have no idea how i did, but it certainly didn’t feel good, especially considering how hard i studied.

looked at my time for that 5k from june 14th - i ran about 9:48 minute mile.  today i ran 4.1 miles at about 9:15 minute mile.  See - it totally was that guy talking to me.  I ran a longer distance in a shorter amount of time per mile.

well, another 5k this weekend i think if dave would ever get back to me.  dbag dave!

our closest neighbor returns

if you have lived here on hile, than you know better than anyone else who that is - however, with my being rather vague - you (as in rachel) will simply go ‘doh’ and slap your hand to your forehead.  i am speaking of mama robin as i call her, who, as far as i can remember, has made her annual summer vacation home above our back deck light.  every year, after she leaves, we don’t bother to clean up her old nest, hoping to help her out a little next year.  just in case, we also leave all her and her babies’ bird poop.  you just never know.

today was especially exciting though - today the babies were born!  and at the risk of having my eyes pecked out, i pulled out one of our island chairs and snuck some pictures.  and by snuck, i mean under the horrified eye of mama robin, who occasionally swooped in to intimidate me.  thus - to share the joy, i have attached the following pictures of these super cute, yet very alien looking baby robins. 

ob

unfortunately for you dave - there is no punctuation in that abbreviation.  ob or ob/gyn or obstetrics and gynecology or delivering babies and looking inside vaginas.  whichever you prefer.  out of sheer laziness, i will mostly call it ob - but often when i speak of ob i am refering to labor and delivery or l&d.   i am currently on this clerkship, and i am definitely enjoying it.  it offers something that none of the other fields offer - clinic, l&d and surgery.  you get all three, and there is probably no other profession in medicine with that much variety.  like every job, medical specialties are repetitive, so you better like what you do, and i have been having fun on ob. 

mind you, not initially, but mostly because i had no idea what i was allowed to do and what i wasn’t allowed to do.  like is it okay to go into the pregger in labor’s room and stick my fingers in her vajay to check for cervical dilation - something that is standard to do every 2 hours?  the answer?  yes, so long as the pt has an epidural and another person is in the room.  makes sense - otherwise you’re the creepy medical student that sticks their fingers in no-no spots.

the highlight of my time on ob came when i was on night float (worked at night for 4 days) - which is when women deliver.  as a medical student, the one thing you want to see is a delivery, yet the one thing that consistently happens is babies delivery during lecture or once you leave.  awesome.  hence the purpose of night float.  on my last morning, i had the opportunity to deliver a baby which was nuts (for the record, i almost typed witch).  my heart was probably going the speed of the baby’s.  it was just amazing.  the babies are of course slippery and pretty gross initially when they come out, but after about 5 minutes, they are just beautiful. 

i’m not one of those people that gets redonk when i see a baby, but i doubt there is anything so beautiful as a newborn baby.  they are so tiny, and instantly consoleable once placed in their mother’s arms.

it is amazing that something that is so long (labor) ends with something so quick (delivery).  those babies just shoot out of there once the head is out.   the whole thing is still a blur.  I look forward to when i’m on l&d again so i can have another go.  i have also held the newborns when they come out of the uterus right after we do the c-section. 

overall, i still have no idea what i’ll do with my life, but i never expected to like ob one bit.  i really thought looking down there would be uber-gross - and it’s not like i love it, but i don’t really think anything of it.  and not to say that might not be gross (aka std central), but give ‘em some antibiotics and it’s all good.  er is still a top contender, but i still haven’t decided.  i’ll basically be looking into an ob elective in the month of october, just after my er elective - it will be easy to compare/contrast the two.

bitch please

how ironic that this would follow an article on drug seekers.  this afternoon i saw a patient who came in for gross hemoptysis (coughing up blood in chunks).  I read over his records and he had been there two days prior for the same complaint (usually doesn’t bode well in terms of what the patient wants.)

however, i look at some of his stuff (and his complaint is legitimate) and find he has possible bone cancer, and the man is missing an arm.  bearing all of this in mind, i tell the doc about him, and the patient at multiple points had asked for pain medication (bone cancer or any cancer = pain, lots and lots of pain).  so, a new nurse comes on the shift, and because of his long wait, the patient is cranky.  he sort of takes it out on the nurse.  she comes up telling the doc that the patient wants pain medication.

“is he a drug seeker?”

“yes.”

my jaw just about dropped.  i wanted to slap this woman.  i’m sorry, but were you hit by a train, only to lose your arm?  do you have some GI cancer that has spread to your bones?  are you coughing up blood?!  then shut the hell up.. you don’t know why he’s here, you didn’t ask, don’t answer that question you cynical bitch.

this isn’t a common occurrence, but boy when it happens…if i were the attending in that case, i would have probably gone back and said something to the wench.  like, before you tell me a patient is a drug seeker based solely off your pride and cynicism, maybe talk to the damn patient.

pain

drug seekers… most of the time, these people are very difficult to tell from people with real pain.  today, i had a blatant example of one.  and it’s not what you would expect - i usually picture a young guy.  not this one, it was a little old lady.  so how do i know?  well, here are the basics.

she comes in telling me that she fell, tripping over some carpet while trying to get a lamp.  she fell on her knee.  her knee hurts.  i physically examine the knee and i am pressing hard.  she doesn’t even flinch.  ooooh but it’s an 8/10 for pain.  well, because this woman is over 55 (thus, at risk for fractures), i need to xray her knee, knowing full well she doesn’t have a fracture, and she probably didn’t fall.

xray is normal.

i go in the room -

“well you xray appears to be normal, but i can’t be sure.  i am going to wait until the doctor i work with takes a look because i may be wrong.”

“oh, my ankle hurts too.”  as she points at her ankle.

“oh, really.”  i start pressing her ankle with no flinching.  “does it hurt more than the knee?”

“oh yes, definitely.”

i tell the doc i work for about this.  the pt is now clearly seeking drugs in my mind.  he goes in the room now.

“the xray is normal.  you just have some arthritis.”

“oh and my hip hurts.”

“what helps take care of the pain for you?  tylenol? motrin? vicodin?”

“hm…vicodin.”

peace out lady.  we give her the infernal vicodin and boot her.

there’s your tax dollars at work people…and to think - you want to make healthcare free for everyone.  because clearly it’s being effectively used now.