Bet you can see where this is going
The other day we had a consult for Gyne service from the Emerg.
So naturally the medical student goes first.
Apparently the chief complaint was some sort of discharge from her vagina, which only started recently.
I asked if there was pain, blood, odor, and was getting nothing on that.
Trying from a new angle, I asked if there was anything new that she was doing around that time.
Turns out she started having unprotected sex with her boyfriend and the discharge only happens afterwards.
Was at the gym with a friend who is now a first year resident. We’re in the middle of our work out when he notices someone else come in.
He turns to me, “That’s a friend who’s a Orthopaedics R1”
He goes up to him, “hey Joe (not real name), aren’t you on call?”
"Yah but I checked the board, there is nothing for another half hour at least and nothing on the ER intake is for Ortho. I can squeeze a quick work out in."
I guess I shouldn’t be surprised, the gym is a block from the hospital and well, it’s Ortho.
O Captain my captain
If you’re like me and currently going through medical school, chances are you were a child of the 80s/90s. Which meant watching a lot of Robin Williams growing up. It’s not often I give pause regarding celebrity deaths, but his made me sad.
It’s sad to think that Robin Williams’ issues got the better of him. He was Genie, Keating, Peter Pan, Alan Parrish, Sean Maguire, and Patch Adams…to name a very few.
He made me laugh, he made me cry, he made me marvel at his shear amount of talent, such as his monologue of flatulence while depicting a colonoscopy on his Live on Broadway show.
And now he makes me think. Hard. On the issue of mental health. Again. Even behind the brightest of smiles and infectious of laughs can hide turmoil. Like the old joke ends…”But Doctor, I am Pagliacci!”
Mental illness is something silent, something scary, and something hard to understand. I think it’s hard to convey as well. Rarely does it enter the discussion until a big death like this and rarely does focus stick. I don’t think we want to think about things we can’t understand easily, so we end up making the whole issue taboo and then things just fade from attention. People who are truly suffering often suffer silently and alone. I can’t say anything at all of Robin Williams’ mental state, but if he was suffering silently, then others can be too.
Of course this blog is about medical school and mental well-being, depression, and burn out are all such real issues. We all know it. Yet again the unease and taboo creeps up and the walls come up.
I guess if there’s any lesson that can be gleaned from is the crushing nature of depression, substance abuse, and destitute nature of mental illness. I aim to remember this great icon in the characters that he breathed life into.
Take care of yourselves and each other.
Anonymous said: How hard is chemistry in your opinion
Hard. It was the Bane of my undergrad experience.
Especially Analytical chem.
I don’t even know how
In the Gyne Onc OR today, there was a very large pelvic mass that needed resecting/debulking. This required a total hysterectomy. It involved the colon so we did a partial bowel resection with primary anastomosis.
The attending (very old, weathered surgeon) tells me, “I always get a little bit nervous on these cases because one of my first experiences as a resident was working on a surgery that required this type of repair. The result was less than ideal as it was very technically challenging.”
I asked him what happened.
"I still don’t know how it happened exactly but the patient got very, very sick post op. Like around post op day number 3 we started to notice feces coming out of her vagina."
Turns out the sigmoid colon got sutured to her vaginal canal following the hysterectomy.
Can’t escape it
Met up with a friend (who just started Internal medicine residency!) who I haven’t seen in a while over this weekend. We suggested that we could catch up while going for a hike on Sunday morning. Sounds good, I like hiking and the outdoors.
Before we left this morning he asked if a few of his Internal Medicine colleagues could join in, which was fine because well, more the merrier.
I should have thought it through more because the hike ended up instead of us catching up, the group of residents presenting cases to each other “to make the trek go by faster”.
I guess I should just count that as studying.
Today I went down to radiology to ensure one of our surg onc patients gets a CT later in the day. Saw some cold pizza in some half empty boxes from lunch rounds the day before.
No hesitation. Ate it. Hell I’m on call tonight and didn’t have time to pack lunch/dinner when leaving at 5am this morning.
Tasted so good.