Wednesday, July 17, 2013

"Turn your head and cough, please!" Day 3

Today was a busy day. I was so exhausted I had to take a 2 hour nap after work.

It's not even because I was so busy with patients per se but Dr.W and I are responsible for the patients on the half ward on the 5th floor and the urological patients on the 7th floor on the OBYGN/URO ward. Additionally we helped out in the clinic today (2nd floor and in the main building) and Dr.W is an avid smoker (tsk tsk tsk) which meant about 5 smoking breaks on the other side of the building on the main floor. We were constantly going from one place to the other. I should really wear a pedometer. I'm sure I got a lot of miles in today. In addition, my muscle soreness from Yoga yesterday started to kick in.

Anyways, as always up bright and early. Rounds were fine as was the morning meeting. Dr. W and I took care of business on the ward; blood drawn here, paper work done there, tried to get in touch with other doctors. It's amazing how much time is spent on not primarily medical procedures. We had to find an internal medicine doctor for one of your patients and it probably took half a day until the responsible one was found and actually showed up! Then it was a crazy mix of running all over the place and getting various things done. No lunch was had. I survived off of a granola bar and two chocolate milks that I grabbed off the ward and a little pack of gummi bears that the nurses gave me. Dr. W seemed fine with his coffee and cigarettes. Told him he was on a cliche model diet :)

Here some highlights of the day:

Honestly one of the best feelings in the world.
We were able to tell a patient who had a very large kidney mass (which in 90% of the cases is cancer) that she fell under these 10% and didn't have cancer. She immediately jumped up, hugged Dr. W and teared up. It was an indescribable feeling to know what joyful news you are about to give a patient. It's like waiting for someone to open a present because you know how happy they will be.

Would you like to talk to someone?
Obviously doctors don't have all the time in the world to constantly talk to patients. I think the average time a patient sees a doctor is about 3 mins. Nonetheless, a lot of doctors just aren't compassionate enough to care (which baffles me when they picked this job but apparently they still only see the disease and not the patient). One of our patients really had a lot happen to her. She has a feeding tube, can't keep anything in her system, came for one thing but there is always something that is keeping her from leaving. In addition, she has an infection which requires her to be alone in a room and for us to always come in with protective wear and face masks. I usually don't go into the isolation rooms during rounds to save on clothing but I did over hear her saying she wanted to talk to a therapist which the attending either decided to ignore or didn't understand that she meant a psychologist and not a normal doctor. When I went to draw blood she told me she felt like giving up. That is something you never want to hear from people. It just sad. So I talked to her a bit and realized A) how much she appreciated my time but also B) that I wasn't enough and also didn't have all day. I told her I would talk to the nurses and have them get a psychologist or even better a pastor or religious figure to come talk to her. She told me that would be so great because she just needed support in this hard time. So I did just that. Asked about 3 more times during the day if that person had finally shown up and finally the late shift nurse said that she would get on it. Next time I see a case like this again I will call the hospital pastor myself. I didn't want to overstep my position and go behind the nurses backs because as I said earlier, you want them to be your friends. Long story short, a little bit of my time can back a big difference in a patients life. A little compassion never hurts.

Coming to you live from the patients bladder!
We performed a cystoscopy (looking at the bladder) on one of our outpatient patients. It was very interesting to see the bladder live and in color. Usually men aren't a big fan of the exam because well,....a camera is inserted through the penis. I personally can not comment on the painfulness or unpleasantness of this procedure but welcome you men to imagine what that might be like. Don't worry, they get a numbing gel inserted first....we aren't that cruel ;)

You don't puncture the amniotic sack when the baby is coming!
Oh lordy lord. One of our outpatients was interesting and complicated to say the least. The whole time she told us things I just wanted to give her an anatomy book. Let's just say I don't think she was aware that there is a seperation of the the urethra and bladder to the vagina and uterus. Her theories were quite absurd as were her reasonings. Just as a little taste, we needed to get catheter urine from her and she told us she had to pee first since the bladder was full. When we told her that was good because we needed a urine sample (which btw she wanted to give us, we didn't really need it) she said that doesn't work because the urine is already on its way (I don't think she is aware that there is only a very small distance the urine can go from the bladder as a women, men have a few more cenimeters, so if its "on the way" its actually already out) and that you wouldn't puncture the amniotic sack if the baby is on its way. sense what so ever.

It was a full day but that's good. Saw a lot of patients got a lot done. Tomorrow I am hoping to help with a pretty interesting operation. Come back tomorrow to find out more :)

Baci, V

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