I attempted to do my first stool sample today. Since the 77 year old woman was overweight and had sufferend a stroke, I wasn't able to turn her on the side for a rear entry. So, I opted to go in from the front door. The woman also suffers from parkinson and dementia. I explained to her what I was going to do and she gave me her "blessing".
Well, I didn't expect to raise her gown and find a pile of poop! I did a good job of stifling my reflex to dry heave. The #1 rule is: Don't ever let the patient hear you say, "Holy sh*t!" or "Oh, my God!" So...I looked over at my classmate and he was also doing a good job of hiding his surprise, then I looked at my patient and explained to her that I found some diarrhea. And she showed the most surprise of the three of us!
On a positive note, I didn't have to dig very far to get a stool sample.
God bless the nurses that came in to clean her up.
Monday, September 25, 2006
Thursday, September 21, 2006
Surprise!
By noon I was saying, "This is the worst birthday ever!"
By midnight I was saying, "This is the best birthday ever!"
I spent the day with the brilliant PA that made me feel like the stupidest PA student in the whole entire world. No matter what my answer...I was wrong. Wrong, wrong, wrong. I'm so grateful that my classmate has been with me because he's always wrong, wrong, wrong too! Even when we're right...this guy finds a way to make us wrong!
By noon, I had a pulsating headache and considered pursuing a career as a hot dog vendor. I was envying the vendor that sat in the sun and fed the hungry, cute, residents all day. I'd probably have a better chance at impressing a single, eligible, "Mc. Dreamy" surgeon with my hot dog making skills, since I can't seem to master the art of venipuncture. Something that seems so simple...really isn't simple on 85 year olds with rapidly disappearing veins.
Anyway, my plan was to stop by Bogota on my way back from the hospital to eat some birthday dinner with George, Omar and the cutie patootie bus boys. I was totally surprised that my friend, Troy, joined the celebration. Troy lives in San Francisco! I knew he was in New Jersey for business and we made plans to celebrate Friday night...but he arrived a few days early to surprise me. Thinking about it now, still makes me smile.
So, the next day when I saw my classmate I told him that the worst birthday turned into the best birthday. He was happy to hear it. Especially since the brilliant PA that likes to make us feel stupid wasn't going to be there that day.
By midnight I was saying, "This is the best birthday ever!"
I spent the day with the brilliant PA that made me feel like the stupidest PA student in the whole entire world. No matter what my answer...I was wrong. Wrong, wrong, wrong. I'm so grateful that my classmate has been with me because he's always wrong, wrong, wrong too! Even when we're right...this guy finds a way to make us wrong!
By noon, I had a pulsating headache and considered pursuing a career as a hot dog vendor. I was envying the vendor that sat in the sun and fed the hungry, cute, residents all day. I'd probably have a better chance at impressing a single, eligible, "Mc. Dreamy" surgeon with my hot dog making skills, since I can't seem to master the art of venipuncture. Something that seems so simple...really isn't simple on 85 year olds with rapidly disappearing veins.
Anyway, my plan was to stop by Bogota on my way back from the hospital to eat some birthday dinner with George, Omar and the cutie patootie bus boys. I was totally surprised that my friend, Troy, joined the celebration. Troy lives in San Francisco! I knew he was in New Jersey for business and we made plans to celebrate Friday night...but he arrived a few days early to surprise me. Thinking about it now, still makes me smile.
So, the next day when I saw my classmate I told him that the worst birthday turned into the best birthday. He was happy to hear it. Especially since the brilliant PA that likes to make us feel stupid wasn't going to be there that day.
Happiness is...
Happiness is turning 30 and feeling like you're exactly where you're supposed to be in life...and doing what it is you've been put on this earth to do.
Living in Brooklyn and practicing medicine.
T-rex is happy.
Living in Brooklyn and practicing medicine.
T-rex is happy.
Tuesday, September 19, 2006
30
I've been so busy that I almost forgot that I was turning THIRTY tomorrow.
Um, yeah right...I've been counting down the days.
I like the way it sounds though.
I'm thirty.
And nobody believes me....
...so I don't mind saying..."I'm thirty!"
More on turning 30 another time. I have to do a short presentation on Diuretics tomorrow to a PA that has a HUGE EGO and loves to pimp me in front of doctors and med students.
I think I'll wear a big bow on my head tomorrow, so maybe he'll be less of a jerk since it's my birthday.
Dealing with the many personalities of healthcare professionals is a lesson in and of itself.
The patients are the ones keeping me sane!
Um, yeah right...I've been counting down the days.
I like the way it sounds though.
I'm thirty.
And nobody believes me....
...so I don't mind saying..."I'm thirty!"
More on turning 30 another time. I have to do a short presentation on Diuretics tomorrow to a PA that has a HUGE EGO and loves to pimp me in front of doctors and med students.
I think I'll wear a big bow on my head tomorrow, so maybe he'll be less of a jerk since it's my birthday.
Dealing with the many personalities of healthcare professionals is a lesson in and of itself.
The patients are the ones keeping me sane!
Wednesday, September 13, 2006
Typical Day
I wake up at 6:45 and leave the apartment by 7:45am. I get to the hospital by 8:45am. It can take anywhere between 25-50 minutes to drive 5 miles to the hospital! On alternate side parking days, the hospital parking lot is full, so it can take up to 30 minutes to find a parking spot and walk to the hospital. It costs $4.00/day to park in the lot (employee discount) or $45.00 to park on the wrong side of the street!
I meet my classmate outside of the hospital and we drink a cup of coffee and talk about what we learned the day before or what our preceptors told us to read up on. I have a great relationship with my classmate. We were always friendly towards each other in the classroom, but I had no idea that we'd ever get along so well. Although he's only 21 years old, he's very mature and very intelligent. We work well together.
At 9am we report to the Chief PA and he assigns us to our preceptor for the day. Last week I was on the Medicine floor and this week I'm on the Cardiology floor. I had the opportunity to work with the same PA twice last week and I thought she was brilliant. We got along really well and felt very comfortable working with her. I felt like I hit the jackpot with having her as my preceptor.
This week is a different story. The PA on the cardiology floor isn't so friendly. She's just not a friendly or personable person. Surprisingly, she's young...probably around 25 years old. Within a few minutes on Monday, I knew it was going to be a long week. She had the personality of a porcupine.
As a student, you walk a fine line with these preceptors. You are there to learn, yet you don't want to overwhelm your preceptor. You shouldn't ask every single question that pops into your head...you have to pick and choose your questions because they're short on time and you don't want to burden them. And you don't want to aggravate them.
This girl was born aggravated though, so I "killed" her with kindness. I got a kick out of myself and the way I interacted with her. I watched how the nurses and other PAs interacted with her and you could tell that everyone felt the same way. After a few hours of sitting around studying on my own, I asked her again if there was anything I could do. She looked at me and said, "No." And then she went back to working on the computer.
Instead of walking back to the corner of the room where I was studying, I stood there until she looked at me again. I smiled and said, "Well, I certainly don't want to waste any of your time. I can tell you are really busy since you haven't been able to interact with me today. So, I'm going to go back to the medicine floor to work with my other preceptor and follow up on the patients that I worked with last week. So, if you don't mind, I'd like for you to open up the staff room so I can get my things. And, I can call the chief PA if you'd like to get approval."
Needless to say, she walked me to the staff room where I gathered my stuff and told me to have a nice day.
When I returned to the Medicine floor, the PA I worked with last week was happy to see me. My classmate was working with her and she agreed to let me join them. So the three of us have been working together every afternoon from 2-7pm.
It's disappointing that I'm not able to see/do more on the cardiology floor. But most of my patients on the Medicine floor have cardiac problems, so I'm not really missing out. My classmate was miserable last week in Cardiology and now I understand why. It's a shame...but I'm glad that I spoke up and expressed what I wanted to do. Otherwise, I would have been sitting in the corner all day. And I didn't move to Brooklyn to sit in the corner!
Another cool thing is that my classmate and I don't compete with each other. We don't try to outshine each other. I've seen some really negative interactions between med students and it makes me realize how happy I am that I DIDN'T go to med school! My classmate and I are eager to learn yet we take turns with procedures. If he had something cool going on in one room, he'd come and get me and vice versa.
We saw a lot of action today. We observed a woman being intubated in order to keep her alive. We also observed a woman being extubated in order to let her pass away. We observed central lines being placed and were able to remove central lines. We took histories, performed physicals and wrote progress notes. We went down to the Emergency Room to work up an admission. We assisted in a wound debridement...it was bloody and full of pus, I was surprised that I found it cool. Oh yeah, and then there was the stool guiac exam. I let my classmate do it first...I'll get the next one!
A patient that I did a history and physical on in the ER last week was moved to a different floor this week. I've been going there to visit him everyday. He's 84 years old and presented with a diffuse rash that covered his entire body except for his face. Both of his legs were swollen and oozing. He's had the rash for 4 weeks...and the swollen legs for 2 weeks. It's been a couple of days and he still doesn't have a diagnosis. He's a widow and doesn't have any family in the area. Nobody has come to visit him, so I make sure that I see him everyday. My preceptor fears it's a malignancy. Since I am a student and I have time to talk to patients...that is what I do. Today when I left his room he grabbed my hand and thanked me for visiting him.
And that is why I'm doing what I'm doing. That makes all of the sacrifices up to this point worth it. And that's what keeps me motivated. I no longer study to pass a test. I study to help improve a person's life. And I think it's the coolest job in the world.
We finish work at 7pm and by then we're giddy and starving. It takes my classmate 3 hours to get home by train (if I didn't move...that's what I'd be doing too!). And it takes me about 45 minutes to get home. I've eaten the same exact thing every night this week! Black beans with broccoli on quinoa with a salad. I'm too tired to cook anything new. I talk with my roommate for a bit and then I go back into my room and study till midnight.
Then I wake up and do it all over again. I'm happy with this rotation. It ends in three short weeks and then I'm on to the next rotation. It's going by really fast.
So, I'm trying to enjoy every moment.
I meet my classmate outside of the hospital and we drink a cup of coffee and talk about what we learned the day before or what our preceptors told us to read up on. I have a great relationship with my classmate. We were always friendly towards each other in the classroom, but I had no idea that we'd ever get along so well. Although he's only 21 years old, he's very mature and very intelligent. We work well together.
At 9am we report to the Chief PA and he assigns us to our preceptor for the day. Last week I was on the Medicine floor and this week I'm on the Cardiology floor. I had the opportunity to work with the same PA twice last week and I thought she was brilliant. We got along really well and felt very comfortable working with her. I felt like I hit the jackpot with having her as my preceptor.
This week is a different story. The PA on the cardiology floor isn't so friendly. She's just not a friendly or personable person. Surprisingly, she's young...probably around 25 years old. Within a few minutes on Monday, I knew it was going to be a long week. She had the personality of a porcupine.
As a student, you walk a fine line with these preceptors. You are there to learn, yet you don't want to overwhelm your preceptor. You shouldn't ask every single question that pops into your head...you have to pick and choose your questions because they're short on time and you don't want to burden them. And you don't want to aggravate them.
This girl was born aggravated though, so I "killed" her with kindness. I got a kick out of myself and the way I interacted with her. I watched how the nurses and other PAs interacted with her and you could tell that everyone felt the same way. After a few hours of sitting around studying on my own, I asked her again if there was anything I could do. She looked at me and said, "No." And then she went back to working on the computer.
Instead of walking back to the corner of the room where I was studying, I stood there until she looked at me again. I smiled and said, "Well, I certainly don't want to waste any of your time. I can tell you are really busy since you haven't been able to interact with me today. So, I'm going to go back to the medicine floor to work with my other preceptor and follow up on the patients that I worked with last week. So, if you don't mind, I'd like for you to open up the staff room so I can get my things. And, I can call the chief PA if you'd like to get approval."
Needless to say, she walked me to the staff room where I gathered my stuff and told me to have a nice day.
When I returned to the Medicine floor, the PA I worked with last week was happy to see me. My classmate was working with her and she agreed to let me join them. So the three of us have been working together every afternoon from 2-7pm.
It's disappointing that I'm not able to see/do more on the cardiology floor. But most of my patients on the Medicine floor have cardiac problems, so I'm not really missing out. My classmate was miserable last week in Cardiology and now I understand why. It's a shame...but I'm glad that I spoke up and expressed what I wanted to do. Otherwise, I would have been sitting in the corner all day. And I didn't move to Brooklyn to sit in the corner!
Another cool thing is that my classmate and I don't compete with each other. We don't try to outshine each other. I've seen some really negative interactions between med students and it makes me realize how happy I am that I DIDN'T go to med school! My classmate and I are eager to learn yet we take turns with procedures. If he had something cool going on in one room, he'd come and get me and vice versa.
We saw a lot of action today. We observed a woman being intubated in order to keep her alive. We also observed a woman being extubated in order to let her pass away. We observed central lines being placed and were able to remove central lines. We took histories, performed physicals and wrote progress notes. We went down to the Emergency Room to work up an admission. We assisted in a wound debridement...it was bloody and full of pus, I was surprised that I found it cool. Oh yeah, and then there was the stool guiac exam. I let my classmate do it first...I'll get the next one!
A patient that I did a history and physical on in the ER last week was moved to a different floor this week. I've been going there to visit him everyday. He's 84 years old and presented with a diffuse rash that covered his entire body except for his face. Both of his legs were swollen and oozing. He's had the rash for 4 weeks...and the swollen legs for 2 weeks. It's been a couple of days and he still doesn't have a diagnosis. He's a widow and doesn't have any family in the area. Nobody has come to visit him, so I make sure that I see him everyday. My preceptor fears it's a malignancy. Since I am a student and I have time to talk to patients...that is what I do. Today when I left his room he grabbed my hand and thanked me for visiting him.
And that is why I'm doing what I'm doing. That makes all of the sacrifices up to this point worth it. And that's what keeps me motivated. I no longer study to pass a test. I study to help improve a person's life. And I think it's the coolest job in the world.
We finish work at 7pm and by then we're giddy and starving. It takes my classmate 3 hours to get home by train (if I didn't move...that's what I'd be doing too!). And it takes me about 45 minutes to get home. I've eaten the same exact thing every night this week! Black beans with broccoli on quinoa with a salad. I'm too tired to cook anything new. I talk with my roommate for a bit and then I go back into my room and study till midnight.
Then I wake up and do it all over again. I'm happy with this rotation. It ends in three short weeks and then I'm on to the next rotation. It's going by really fast.
So, I'm trying to enjoy every moment.
Tuesday, September 12, 2006
Pimpin
My first rotation is going well. I have been doing so many different things, running in different directions and dealing with so many different types of people....I'm exhausted. I'm working four 10-hour days and then I get three days off. The days go by really fast.
I'm going on day #3 though and I'm beat. But, I'm looking forward to going back tomorrow to learn some more. It's an unbelievable learning curve. Today I did rounds with 5 med students and a doctor. I was the only PA student. And the Doc pimped me like he pimped the others. He was a brilliant doctor and I loved the way he dealt with us. He flat out told me not to worry if I get the answer wrong because I'm there to learn and he doesn't expect me to know the answers to all of his questions. So, I knew some of the answers and didn't know some of the others! But the med students choked up on most of the ones I didn't know either.
I left the experience feeling pretty darn good. I've had one year of medical school...and they've had three.
Enough said.
Gotta sleep!
I'm going on day #3 though and I'm beat. But, I'm looking forward to going back tomorrow to learn some more. It's an unbelievable learning curve. Today I did rounds with 5 med students and a doctor. I was the only PA student. And the Doc pimped me like he pimped the others. He was a brilliant doctor and I loved the way he dealt with us. He flat out told me not to worry if I get the answer wrong because I'm there to learn and he doesn't expect me to know the answers to all of his questions. So, I knew some of the answers and didn't know some of the others! But the med students choked up on most of the ones I didn't know either.
I left the experience feeling pretty darn good. I've had one year of medical school...and they've had three.
Enough said.
Gotta sleep!
Wednesday, September 06, 2006
Self-defense
I wish I had a video camera following me around. I don't have the energy to come up with adequate words to describe what the last two days were like. I feel like this is all make believe. But, it's real. Very very very real.
It's so real that it feels make believe. I wonder how long this self-defense mechanism will last.
I'm seeing really sick patients. The average age of admitted patients in this hospital is 85 years old. Lots of ventilators. Lots of elderly people lying in beds without visitors. Yesterday they were talking and laughing and today they're intubated and unconscious.
Talk about a steep learning curve.
I need to sleep.
It's so real that it feels make believe. I wonder how long this self-defense mechanism will last.
I'm seeing really sick patients. The average age of admitted patients in this hospital is 85 years old. Lots of ventilators. Lots of elderly people lying in beds without visitors. Yesterday they were talking and laughing and today they're intubated and unconscious.
Talk about a steep learning curve.
I need to sleep.
Monday, September 04, 2006
Rip Tide
I'm starting my first rotation in Internal Medicine tomorrow. I guess I should be nervous. But, I've been too busy moving into Brooklyn and getting settled. I took a nice tour of Brooklyn today. It took me 3.5 hours to go 10 miles.
Yes, 3.5 hours to go 10 miles.
There was a West Indian parade/festival today. I knew about it, but I didn't think that it would close down half of Brooklyn! It was unbelievable. I felt like I was in the Caribbean. A police officer actually asked me why I was in that area. I told him I was trying to find the hospital and he said, "You're the first blonde I've seen all day!" I had to laugh. It really was insane.
So, I spent the entire afternoon in the car. I found the hospital, the parking garage, the administration building and the chief PA's office. I'm going to give myself 90 minutes to go 5 miles tomorrow morning! Just in case there's another parade I don't know about!
I was drained after the driving debacle but headed out to the nearby park for a run. I trailed about 10 feet behind another girl and she unknowingly took me for a tour of the park! It was great since she unknowingly brought me back to where we started! I took a couple of looks behind me to make sure I wasn't being followed!
So, I'm pretty tired at the moment and trying not to think about tomorrow. I got about 5 freak out phone calls today from my classmates. I just laughed at them because most of them are within a 20 minute drive of their house! There is one classmate that does have the same rotation as I do. He was told to meet at the same time, so we'll see each other. That does make me feel better. He's only 21. I would be freaking out a lot more if I were 21. But, since I'm about to turn 30 (ahem, in 2 weeks!)...I'm trying to manage my anxiety by thinking about the crazy things I conquered in my early 20's. If I can get off an airplane in Tokyo and manage to live there for 2 years without any Japanese language training...I SHOULD be able to survive in Brooklyn.
Basically, I'm just trying to go with the flow...while avoiding the rip tide!
Wish me luck.
;)
Yes, 3.5 hours to go 10 miles.
There was a West Indian parade/festival today. I knew about it, but I didn't think that it would close down half of Brooklyn! It was unbelievable. I felt like I was in the Caribbean. A police officer actually asked me why I was in that area. I told him I was trying to find the hospital and he said, "You're the first blonde I've seen all day!" I had to laugh. It really was insane.
So, I spent the entire afternoon in the car. I found the hospital, the parking garage, the administration building and the chief PA's office. I'm going to give myself 90 minutes to go 5 miles tomorrow morning! Just in case there's another parade I don't know about!
I was drained after the driving debacle but headed out to the nearby park for a run. I trailed about 10 feet behind another girl and she unknowingly took me for a tour of the park! It was great since she unknowingly brought me back to where we started! I took a couple of looks behind me to make sure I wasn't being followed!
So, I'm pretty tired at the moment and trying not to think about tomorrow. I got about 5 freak out phone calls today from my classmates. I just laughed at them because most of them are within a 20 minute drive of their house! There is one classmate that does have the same rotation as I do. He was told to meet at the same time, so we'll see each other. That does make me feel better. He's only 21. I would be freaking out a lot more if I were 21. But, since I'm about to turn 30 (ahem, in 2 weeks!)...I'm trying to manage my anxiety by thinking about the crazy things I conquered in my early 20's. If I can get off an airplane in Tokyo and manage to live there for 2 years without any Japanese language training...I SHOULD be able to survive in Brooklyn.
Basically, I'm just trying to go with the flow...while avoiding the rip tide!
Wish me luck.
;)
Saturday, September 02, 2006
Welcome to Brooklyn
Wow...I'm writing this from my apartment in Brooklyn! The last few weeks have been crazy...I have tons of stories to write about...but I'm short on time. It took some time to remember how to relax, but once I got there...it took some time to get back in the swing of things!
And, I am definitely back in the swing!
It's Sunday night and I start my Internal Medicine rotation Tuesday morning at 9am. That's all I know about the rotation. The chief PA wasn't that friendly and didn't offer any other information. So, I just said, "See you Tuesday!"
I'm trying to stay calm. I am excited about it, but I really can't believe it's happening. So, I'm just going to go with the flow. I felt the same way when I first moved to Japan. Everything is foreign. Everything is new. And nothing makes sense!
And I did fine. (and that's what I keep reminding myself)
But, it would be good if I could actually find the hospital! It's only 5 miles away from my apartment...but I'm beginning to realize that 5 miles in the NYC metro area is way different than 5 miles in Suffolk County! So, tomorrow I'm venturing out to find the best route. I have options. Car, bus, subway.
I tried to get there today by car, but there was a festival on the street that I needed to go down. So, I tried to go down a different street but got caught up in "one-way" streets so I retreated back home.
So, that's my mission for tomorrow!
And, I am definitely back in the swing!
It's Sunday night and I start my Internal Medicine rotation Tuesday morning at 9am. That's all I know about the rotation. The chief PA wasn't that friendly and didn't offer any other information. So, I just said, "See you Tuesday!"
I'm trying to stay calm. I am excited about it, but I really can't believe it's happening. So, I'm just going to go with the flow. I felt the same way when I first moved to Japan. Everything is foreign. Everything is new. And nothing makes sense!
And I did fine. (and that's what I keep reminding myself)
But, it would be good if I could actually find the hospital! It's only 5 miles away from my apartment...but I'm beginning to realize that 5 miles in the NYC metro area is way different than 5 miles in Suffolk County! So, tomorrow I'm venturing out to find the best route. I have options. Car, bus, subway.
I tried to get there today by car, but there was a festival on the street that I needed to go down. So, I tried to go down a different street but got caught up in "one-way" streets so I retreated back home.
So, that's my mission for tomorrow!
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