Tuesday, February 11, 2014

Sniff, cough, cough, cough, sniff.....ugh

I'm going to have to keep it a bit shorter today. I am full blown sick. My cough hurts, my nose is stuffed up, my chest is hurting and my whole body is weak. Oh well. That is just how it goes when you have a period of positive stress (under negative stress the body is less likely to become sick because it is worried about surviving) so after moving to my own place (and being super content with the decision) and being really happy in peds, it hit me. I'm sure the little kiddos in peds also had a role to play in all of this. Anyways, enough pity party...

As I mentioned yesterday, I was not looking forward to today. It ended up being a lot less harmful than I thought. The morning meeting was nothing but normal. My nice doctor from my 26h shift was there and immediately picked me to work on her ward. 

We had some coffee and discussed the patients there. I did the admissions physical examination and history for two patients. I immediately starting collecting the information I needed for my doctors letters. Afterwards, I headed to the library and finished typing them and looking up information relevant to their diseases. 

In the afternoon, back on the ward, a resident took pity on my pitiful state. She said she would sign the papers that needed signing and I could go home and get some rest. I told her I definitely wanted to present my patient to her otherwise I would feel like I cheated the system. I presented the patient I had worked on, answered a few questions and got my evaluation and signatures. 

I grabbed a quick bite to eat, unwilling to cook something at home, and went home to bed.

It is the best timing for me right now to be sick (if I must be sick). With night shifts and traveling starting the end of the month, I'd rather have my body go through all this crap now.

I look like death though, so no pictures. Besides, I still don't have my new phone so I wouldn't be able to post anyways. 

I am in the lab the next few weeks. If something interesting happens, I'll be here reporting. Otherwise dear readers, I will be flying to Ghana on March 16th! I don't know how quickly I'll have a working connection but I will be reporting as much as possible. I'm super excited. Maybe I'll post a little prep post for Ghana. So just tune in every so often and see if there is something new!

Thanks for sticking with me the last two weeks. Hope you enjoyed!

See you soon! Stay healthy!



Monday, February 10, 2014

Talk to the elbow, you aren't worth the extension. How the last 36h pissed me off.

The last 36 hours have been an emotional roller coaster. The one you get off of and never ever want to get back onto. I am dumbfounded by so much.

Let's take it back to yesterday when it all started.

I got to the hospital around 8:30 although I didn't have to be there until 8:55AM. The instructions where to go to the delivery ward and introduce ourselves to the midwives. I try to go into situations with an open mind and give people a fresh clean slate but I've had so many bad experiences with midwives that I was already not looking forward to this first meeting but put that aside. 

So there I am standing in front of the ward looking for the doorbell. In the same moment a midwife walks up behind me, opens the door and asks if I'm there to see them. I introduce myself as the 26h block student. She told me to take a seat in the midwife room.

So there I sat. I quietly read my little OBGYN booklet. After about 15 minutes I heard the familiar voice of a girl who studies with me. I was so happy to hear her come. The rest wasn't exactly making me feel welcomed.

She showed me around a bit before we both ended up sitting on the couch again being quiet. While we were on our way to the changing room initially, a person walked past us. Since I was in the middle of a conversation with my student friend, I didn't really pay attention who it was. When we were back in the midwife room, we were almost lectured about how we should always say hello to a midwife......um, sorry, it wasn't written on your forehead! The doctors look like the nurses and they look like the midwives here. Everyone is wearing scrubs. Ugh.

During the morning midwife meeting, my friend and I sat there quietly. She eventually left and I sat there. Luckily at some point a few doctors arrived. I introduced myself again. This was something I did throughout the day for about another 5-6 times because of the changing shifts.

The midwife took me to one patient who was starting to go into labor. Soon after that, other doctors for the shift showed up and we had a little meeting in the meeting room. The doctors decided they wanted to see the patient I just saw. I felt it was unnecessary for another person to storm in there with them because they were enough of an entourage already. About 10 minutes later I do end up going into the room. And there is a baby already born!!! Well gee, thanks for letting me know. It's not like I'm here to learn or see anything. Ugh. 

I was shocked to see how bad a birth can rip up the anatomy. It didn't look nearly as bad once the doctor was done sewing it all up again but dang.

The rest of the day (which seemed to take forever by the way) was spent running from one ward to the next, drawing blood, putting IVs on and answering pagers. (FYI I also made it to pager status and had my own :) I had a nifty picture that I sadly can't post. You will find out why later) We didn't get a break to eat until almost 4PM. I should have had more than a banana for breakfast. 

Up until lunch I was already boiling over. I don't want to trash talk anyone here but the atmosphere between the workers there was unbearable. Asking a question was a big drama with everyone except one doctor. I tried to do as much as possible without asking because I was so fed up with the down right nasty response I would get. I was about to throw it all down and leave.

Lunch was relaxed compared to all that.

After lunch (more like linner), we had a few outpatient cases and ward work to get done. At some point we had a pregnant lady who came with her husband and child. Children aren't allowed on the ward. This family spoke mainly English. The midwife asked the doctors if they spoke Genglish. Well how convenient. I ended up becoming the personal translator for this family. From that point on the one midwife absolutely loved me. I even watched the little kid while the husband was with his wife. Such a little cutie.

We were busy until almost midnight. I was almost falling asleep while standing. I was finally in bed at midnight and slept until 6. 

The morning was filled with drawing blood and getting patient information together for a doctors letter that I still have to write. I heard that there were 3 cesarean sections planned. Although my shift was almost done in a few hours and a new student would be on his way, I got the doctor I liked to get me into the delivery room. First up was my family. I stood in the delivery room waiting for the husband. It seemed no one really cared if the dad was there or not! I asked if someone had called the dad. The whole team looked at me crazy and one nurse asked if we were waiting to operate until the dad came. I left the room and went to ask the others if the dad had been informed that the operation had been moved up. The doctors looked at me as if I had asked them something completely absurd! "Call the Dad? Why would we do that?" Ummmmmm.....so he can be here for the birth of his child maybe?! Seriously, what is wrong with you people? I didn't ask you to personally go pick him up in a limo and carry him up the stairs to the room. Is no one thinking about the situation for the family?

They told me to ask the midwives (of course it's always a tennis court with the questions here). I found one of the younger midwives and she told me the dad was sitting outside the ward. When I asked why he wasn't in the OR, she informed me he had brought the child. I told him the night before to organize someone to watch after the kid so he could be there for the birth. Regardless if he should have organized this in advance since it was a planned C-Section or not, he should be with his wife and see the birth of his child! I immediately ran out of the ward, told him I would watch the child and he should go watch his second child be born. Luckily the little kid took a liking to me. Yes, I sacrificed not seeing a c-section although I wanted to but I'll see multiple ones in my life....this father might only have this one left. 

Do I think too much for others? Am I completely crazy? I feel the upmost priority is obviously the health of the mother and child but it just seems natural to want to do everything possible for the father to be there too (again, even if he should have been better organized with the little one. Still, I'm an extra, they didn't need me there).

I stayed to see the next c-section which was twins. My favorite OR nurse from the urology department was working in the delivery room today. At least one more person I like. It's always fun to see the babies come out so quickly. The longest part is sewing everything back up. 

After that operation and 27 hours in the hospital I finally went home.

Since I recently moved, I had to go to the municipal building and inform them of the move. I went to the grocery store after that. Had my phone in my hand for sure in the grocery store. I get back home and my phone is gone! It is my biggest nightmare (not health or family related) to loose my phone. It holds so much valuable information, memories and other things that I would be devastated loosing it. I called around, I drove back and forth, retraced tracks, everything. Phone was gone. When I called initially it still went through, when I called about 45 minutes later it was turned off. Ahhhhhhhhhh! It was a goner. I know it's a first world problem. I am fully aware of this. It's not the phone necessarily that I'll miss, losing the value is stupid, buying a new one and paying it off over two years even more so, but it's the videos of my god child, the pictures of some dear friends and I that I hadn't had the chance to download yet, that are the things that make me want to cry.

I went and ordered a new phone. Guess I'll have to be even more money conscious. But it is what it is. I reported it to the police but I doubt I'll get it back. 

On top of all this crap, I'm sick. I think the kids in peds really infected me. 

All in all, really crappy last 36 hours (there was the occasional nice moment). I'm really not about bashing people but that department needs to work on a more harmonious working with one another. I have 10 hours to do tomorrow. Not looking forward to it. If I have learned anything, it's that I am absolutely sticking to never becoming a gynecologist. Too many women in one area. I would go absolutely insane. 

I will work focused on getting my letters written tomorrow and see that the people don't make me mad and then it will soon be over. The participating people should really reflect and see if that is the kind of reaction they want the student to have after working in their department. I'm not asking for coffee, candy and hugs....I am asking for a respectful working environment. I really don't think that is too much. We are students on a completely unfamiliar ward. We are not there to bug you or be in your way, in the best case scenario we are there to learn and help. So don't treat us like crap and don't use us to fight your wars. Just a thought.

I would have loved to post some fun pictures along with this post but seeing my phone was stolen....thank the thief or the person who found it and decided to just keep it.

Maybe a miracle happens and tomorrow is great. 


Friday, February 7, 2014

Wow, I made it all the way to Friday without being asked that question! Last day Peds!

Awww man, last day.

We got a few more admissions over night. We spent the time before rounds checking up on some kids and looking at the new kids. I checked the findings to see if my patient had any new values. 

Rounds was hilarious today. I don't know if everybody took an extra dose happy pills but we were cracking jokes and having a good ole time. At some point the doctors talked about an actress that was on the screen in one of the patients rooms. They were all super excited about her and not knowing who the heck they were talking about, I asked. They all stared at me like I had just asked them who Obama is. The one resident even gave me the "talk to the hand" gesture. The attending said he had thought about letting me go early and giving me the top score as an evaluation but after revealing my lack of knowledge over this apparently very good looking lady, I would have to do overtime and would only achieve a subpar score. Haha. I looked her up later and it turns out I do know who she is, I just didn't know that that was her name.

The attending came into the work room later and asked me if I was related to David. Wow. I made it all the way through to Friday without anyone asking me! New record. I told him that we are distantly related. He thought that was pretty cool. He left the work room and about two minutes later a nurse walks in and says, "so guess what I just heard." Well gee, that didn't take long. She told me they were singing "I've been looking for freedom" out in the work area. ....of course they are. Haha. I mean I think it is all very entertaining.

(Wow, made it all the way to Friday without that question)

After lunch I had to sit around a bit waiting for the attending to have time to quiz me a bit and give me my final evaluation score. I was so ready to answer just about every question about inflammatory bowel disease. In the end it was short and sweet. Even with my lack of knowledge about the actress, I got the top score.

I went home to get some sleep assuming I had a night shift to go to. I don't. There was a glitch in the planning system. New plan is to get some work done at home and maybe bake some cookies. We shall see.

The week in peds was so much more than that I expected. I was really lucky with my ward and team though. I'm also a strong believer that your own attitude contributes a lot to the experience as well. It was fun, I would have no problem going back on Monday. Now it's time to get ready for two days OBGYN and then really go in on this doctor thesis. 

I think the kids may have made me sick though, I've had a tightening feeling in my throat since this morning. I hope not!

Have a great weekend everyone! I have my 26 hour shift on Sunday. Hope I have a lot of interesting things to report on!


Thursday, February 6, 2014

"Oh that is not necessary. We aren't the surgeons!" Day 4 Peds Ward

Oh it's been quite a long but good day. Let me get yall caught up.

I really must say that I enjoy showing up for work at 8:15 apposed to 7am. It is a world of a difference. Not every specialty has that luxury however.

We got a few new kids over night and I was appointed a kid that apparently fell and hit its head. I looked at the admissions report and headed in with the resident to interview the parents and child and do a physical examination. He was up and doing just fine. After a thorough questioning, we examined him and had him do all kinds of neurological tests. It's fun in peds because you often have to demonstrate what you want the kids to do so not only does the patient look like a fool but so does the doctor jumping around on one foot.

Rounds went a little longer today because we had multiple things to organize for some of the kids. I like rounds though. I think its because of the great team on the ward. Everybody is allowed to say something without having the feeling that you are constantly criticized or only there to observe.
(A little more neutral today but I have my zebra phone!)

By the time we got around to my patient, I presented his case to the attending with ease. Granted a patient that fell doesn't have the most difficult case to report on but it still feels awesome to just throw out a good report and get positive feedback!

After rounds I worked on finishing my doctors letter. We got a whole bunch of new findings back from the lab that I didn't even notice it being 11:30 already and time for the morning meeting. I ran up the two flights of stairs only to enter the room almost empty with a few other students in the last row. Everybody else was just starting to arrive.

I've mentioned the situation with seating arrangements in the hospital before. In the surgical departments, the students are the ones that sit way in the back...always. It is quite the faux pas to sit in the row where the residents or even worse the attendings sit (although I accidentally did that my first elective). The pediatric doctors are much more relaxed about it but at this point, we students are so drilled in finding that spot furthest away from the front. Later in the day, I got up from my seat to move back in a MRI findings meeting when some doctors walked in and some students and I had taken up a row. The doctor was almost shocked at my action and said, "Oh that is not necessary. We aren't the surgeons!" Thought that was sweet.

(I need at lease one of these a day. Very fitting I think)

After a quick lunch, I was back on the ward putting my final touches on the letter. When the resident sat down to go through it with me, I was afraid she would think it was terrible. She even started the conversation saying she is a total grammar control freak. Greeeeeeeat. 

In the end though, I really did a good job. There were only minor things here and there that she wanted formulated differently. All in all though, we didn't change much. Yay! Might sound stupid that I am so happy about that but I am not afraid to say that one of my weaknesses is the German grammar (I'm sure enough people reading this are cringing at my English grammar as well). German is hard! 

I interviewed and examined another patient with the same resident from earlier. Another boy that hit his head. He was doing just fine as well. You wouldn't have thought that he was brought into the hospital the night before with the ambulance. Again the same gymnastic routine of neurological tests was performed.

After a bit more work here and there, I was done for the day on the ward. I headed to the library to work on some translation work with another student for an attending in the hospital.

Since my uncle is on vacation, I went and had dinner with my aunt. We went to a very good greek restaurant. We ended up chatting for 2 hours while eating. We had just finished up and were close to leaving when the chef cook came and sat down at our table. We ended up chatting for another 2 hours with the guy! We discussed so many topics and it was interesting how we all contributed stand points from our respective fields. The obvious being good nutrition and medicine. We also discussed the work ethic of people today, differences between countries (since we had representatives from Greece, the USA and Germany at the table), the towns development over the years, TV documentaries....really everything! It was a really nice evening. Now its off to bed though because I have my last day of peds tomorrow and then a night shift. If I'm lucky, I'll get out a bit early and will get a few hours of sleep in.



Wednesday, February 5, 2014

"Here is a tractor and now I have to go cook some building blocks"....oh kids. Day 3

The more time I spend on this ward, the more I like it and the more I think I'd be a great pediatric doctor. The only aspect that I would miss is the operating room. I could of course be a children's surgeon but then I'm basically only in the OR and don't have the daily encounters that I do right now. So at this point I am still sticking to my plan of becoming an urologist and eventually specializing on the little ones. 

The patient I had planned to interview this morning and present in rounds was at the ENT doctors when I got to work. Apparently the case was a bit more difficult than I thought it was going to be. Instead, I interviewed a 2 year old and his mother because they were admitted last night. The little bugger didn't want to drink the last few days. He was doing a lot better already this morning.

I got all my infos together and went to the patient again with one of the residents to do a physical examination. 

By the time rounds rolled around I was good to go. We went through all the rooms with the same entourage from the last few days. A few more interesting cases, including some rare diseases where admitted.

My presentation was as breeze. A lot easier than I thought it would be. The rest of the rounds was good as well.

My new task was to write a preliminary release note for my patient. I finished up before heading to the morning meeting.

After lunch, I finished up a few things on the ward and started to check in on some of the kids. I played around with some of the patients. They are just so adorable. I feel so at ease on this ward. The staff is friendly, the kids are fun and the parents are, for the most part, very friendly.

I had to leave a bit earlier today to be able to teach English.

The time is really flying in this week long internship. 

I could easily work in this department for a while. But I've got a lot of other things I need to get done.....so the kids will have to wait. Hopefully I'll see a lot of kiddies in Ghana!


Tuesday, February 4, 2014

"Hey, don't give me that look, I didn't do anything!" Peds day 2

Day two with the kiddies. I woke up rather refreshed and ready for the day. The weather has become a bit milder so the walk over to the hospital was actually quite pleasant.

My usual wardrobe includes copious amounts of neutrals and earth tones. It's just something about working in peds that makes my clothing selection look like a skittles rainbow produced it.

Never would I ever run around this colorful unless it was for the kids. 

We had a few new kids to look at on the ward this morning. I spent a lot of time dictating my doctors note though. I'm trying to study up on my patient as much  as possible to be as prepared as possible on Friday. 

The morning was as it was yesterday. Getting to know the kids, checking on the ones we know, then rounds with the attending and off to the morning meeting.

A few new diseases came in today. A lot of the time the kids have some kind of infection though. There was a precious little infant there with such a stern look on his face I almost felt guilty as though I had done something wrong when he looked at me. It was entertaining, 

Even after just two days, you can really start bonding with the little critters. 

After lunch, I finished up what I could on the doctors letter and brought the tape to the secretary. The afternoon was a bit monotone. I looked through multiple patient files, read a few things in a textbook and did everything possible not to look bored. There were a few conversations with the psychologists regarding some of the kids. 

I was allowed to leave a bit earlier today.

I already picked a patient to interview tomorrow morning so that I can present her to the attending during rounds. 

I'll have to leave a bit earlier tomorrow as well because I have an English class to teach.

I'm really enjoying the time on the ward so far and don't mind having to get up in the morning to go to work. Always a good thing!

Baci V

Monday, February 3, 2014

Guess who's back! One week Pediatric Medicine!

I just lost my whole post...:( here we go again.

Well another semester is over and another break full of things that need to be done has started.

This week I'm on the pediatric ward!

I was appointed the general pediatric ward. I showed up at 8 to find another med student and an intern already there. The first day on a new ward is always a combination of chaos and boredom. Chaos because you have no idea who does what, where things are and how things are done specifically. There is always a timeframe (usually on non-surgical wards) where everyone is busy working on their own things and as a newbie, it is difficult to find productive work. This time is usually spent reading and rereading charts in order to look occupied and try to remember as much as possible about each patient.

The morning was spent getting to know all the patients before the grand rounds started. Mondays is grand rounds day. We ended up being a huge entourage of chief, attending, residents, intern, students, nurses and psychologist going from room to room. The kids were quite cooperative though.

I like peds as a specialty. The peds ward is like no other. The kids were racing on little carts. The lungs were listend to in the "pit stop" before they were able to proceed with their race. Kids are running all over the place, yelling, drawing, playing, etc. It is quite the fun environment. The kids tend to be quite cooperative. The bigger problem is usually the parents. Usually they are rightfully concerned but sometimes they just really make life unnecessarily hard for the doctors. All part of the job.

We had kids with all sorts of diseases on the ward today ranging form infections to chronic diseases to circumstances quite bizarre (but can't be discussed due to patient confidentiality). Let's just say it's never monotone.

After the morning meeting with all the pediatric wards, we students took a lunch break.

Back on the ward, more specific work was done. I was given a patient for the week. My responsibilities included finding out what diagnostic work up still had to be performed, looking for findings and starting to compose the doctors letter.

We are required to present a patient to the attending during rounds and on Friday we will have a sit down with the attending to further discuss our patient and be asked a few questions.

So what am I up to the next few weeks?

This week peds. This Friday I have a night shift. Sunday I have a 26 hour shift in the delivery room(I am hoping a lot of babies decide to be born in that time). On Tuesday I have a 10 hour OBGYN shift on the ward. The rest of February will be filled with a lot of lab work. I really need to make some progress on my doctor thesis if I ever want the thing to be done. I have three more night shifts towards the end of the month. In March I will go to Ghana for a month to work there. I am quite excited for that adventure.

I will be reporting about peds, OBGYN and of course Ghana! So feel free to stop by and see what I am up to. I appreciate your interest and time reading this! 

Hope you enjoy!