Memorial Day Weekend, and back to the brain.

I had an enjoyable weekend with some much needed time off from things around here. Much of it was just sitting around not doing a whole lot of anything, which is good in it's own right, but I also got to go down to East Bernard to party with the Kreneks and Jaseks (my girlfriend's family). They were celebrating two 40th birthdays at once and had quite the affair with barbeque, beer, and country music and dancing. It was quite an "interesting" experience.

I also had dinner and such with my folks yesterday including steaks and twice baked potatoes. We also made some chocolate chip cookies. It was all very very yummy and I'm about to go have warmed up left overs.

Back in the hospital today, it was our residents' last day before switching over to a new hospital. We'll have a new team to work with tomorrow so that should be interesting. One of my patients today has ALS which is pretty sad. For those of you not that familiar with Amyotropic Lateral Sclerosis, it's also known as Lou Gehrig's disease, and it's a devestating degenerative nerve disorder that destroys your voluntary movements eventually leaving you paralyzed and unable to breath, or move anything. My patient today just had some weakness, but was otherwise ok. He's still in amazingly strong spirits and is keeping a great attitude about the whole thing. Much better than I think I ever could in his situation.

Where was the hippocampus again?

I feel like I'm in a different world now. Spending three months in surgery is completely opposite from the "medical" world, which I got thrown into this week on Neurology. I'm back at the VA hospital and it's been going ok so far. I've just had to shift gears and ways of thinking of things. On surgery, you concentrate on the most obvious problem, do things only related to that problem and then move on quickly. On a medicine rotation like Neurology, you pretty much have to concern yourself with every little thing going on in the patient, which gets complicated. Thankfully, most of our patients have neuro complaints (obviously) so even then we're still narrowed down to a fairly small area. It's fun though. I really like the neuro exam. It's fun to do and think about. I don't like how most of the therapy and treatment that is involved in neurology is mostly palliative though. Meaning you can't really do much to cure your patients, you just do your best to help them understand what's wrong with them. I'm pretty sure I couldn't do that kind of work for a living, but I'm certainly glad there are people out there who can.

Surgery Core Rotation completed

Whew! What a load off. This past week hasn't been much fun at all trying to get my studying and reviewing done for this monster test we had today. Today was our Surgery Core Rotation Shelf Examination. Meh, I think it went ok. I was just hoping for a pass in this course anyways. I don't really have any intentions of going into surgery so doing exceptional on this test wasn't really a goal for me. I think I did ok though. We'll see when grades get back. I check on some of my evaluations that already have though and for the most part they're really positive. That's good then.

Up next... Neuology..

I can breathe again

Well I'm finally beginning to feel like myself again since being sick for most of this week. It wasn't a very fun week and having it be my first week at Ben Taub certainly didn't help much either. However the past two days have been considerably better. Yesterday we did two "prostatectomies", which are complete removals of the prostate gland, usually from prostate cancer. The surgeries were fast paced and fun to help with, especially since I got to really help the scrub nurse with passing instruments back and forth. It doesn't sound like much fun, but with things flying back and forth and the two surgeons litterally yelling for things faster than you know what's going on, it was really fun and exciting. (medical nerd speaking I know). The surgeries were long, but the time flew by and the day was over before I knew it. It also meant we spent minimal time in the clinics which so far I can't stand here at the Taub. It's not so much the clinic aspect, but the administration which is horrible. Nothing is where you need it when you need it, and it's that way all day long. So I was happy I didn't have to deal with that.

Today was Thursday so a half clinic day/half afternoon lecture day. But it got started off with a 7 am comedy session almost. Every morning at 7 we have our subspecialty lectures, and this week has been all ophthalmology. This morning was ophthalmic trauma and emergencies and the professor was hilarious, sometimes at our expense but we were all still laughing our heads off, and at 7 in the morning that's quite the accomplishment. We were talking about injuries that can happen around car batteries and Drano, specifically alkali chemical burns, and he was just having a ball with the people who didn't know how to jump start a car, or even how Drano works. So then we got to talking about a patient who claimed to be whacked upside the head with a 2 by 4, he had several gashes across his face and a place where the hair was taken off his eyebrow. He was trying to get us to come up with a way that a 2 by 4 can "shave" the eyebrow off of someone, since being beaten that way usually doesn't leave injuries such as that. Well once clueless classmate answered rather reluctantly that maybe he was using a 2 by 4 that was somehow dripped in Drano, and of course this brought out instant hilarity from everyone in the crowd. After the lecturer himself stopped laughing he then claimed "Why stop there, why not have a 2 by 4 dipped in Drano, set on fire and soon you could have plague, death, famine and pestilence and the rest of the Four Horsemen come and take the other eyebrow." It's probably one of those things where you had to be there, and it being 7 o'clock in the morning, none of us were really in our right minds, but we just nearly about died with laughter. It was at least a good way to start off the day. Clinic went much better too. Still had some problems communicating with the patients, but it was pedi urology day so it was at least fun. And of course we got out at a predictable time too which is always nice.

A tissue?... anyone?

There's nothing like getting pimped for two straight hours while you're nursing the full onset of a cold.

Today I started my last service in my 3 month block of core surgery. After our usual 7 am lecture, this time by none other than classroom favorite Dr. Frank Kretzer, I got my first real introduction to Ben Taub County General via the Urology clinic. Granted, it wasn't General Surgery or Emergency Center at the Ben Taub, but it was still a good indiction of how different things are from a county hospital perspective, compared to a state of the art computerized facility with automated robots going from place to place.

Everything is done by paper charts. You have to seek and find if you want to know any lab values, or even if the patient had labs. Most of the time you can't even read what's in the charts, or even understand the patient. And none of this helps when you start off the new week and a new team, and a new location with a new cold. I felt it coming on last night and knew what I was in for. I was just still in denial that I could hold it back. Well now I'm on Nyquil and Dayquil and hoping I can just make it through the days. So oh well, I'm hoping tomorrow goes a little smoother since I know more of what to expect, and I'm going to try to get some more rest tonight to help with the cold. I need more sleep than I got last night, that's for sure.....

ENT done

Today was my last day on the Ear Nose and Throat service at the VA. I actually wish I could spend more time on it as I really enjoyed it, and a lot of the stuff I learned is really practical if I do end up going into something like Family Practice, or a Rural clinic setting in general. Plus the residents were really fun to work with. It helps when they lavish all us students with high praise too :-)

Today was really busy though. I think we ran through 50 clinic patients in our normal hours. Two of our residents were involved in surgery, leaving just one for the clinic. But it all worked out extremely well. We had three of us students helping out and we were able to work through the patients pretty well to help her out. So all in all, I really enjoyed these past weeks, and I may actually consider coming back to help out again as a SubI for fourth year or something. We'll see. Now I just have the weekend to look forward to before I start Urology on Monday at Ben Taub.

Birthday Dinner with Friends

A good friend and classmate celebrated his 24th birthday tonight so we threw a little bbq dinner at his place for him. I knew ahead of time that we would have plenty of chicken to work with so I decided to try some new things. We were going to do half in bbq sauce and half in teriaki and I wanted to come up with some kind of funky garnish or salsa to use as well. Kristi came in for the occasion too, so we had some fun grocery shopping. We picked up a pineapple, some mangos, red onions, honey, guava nectar and some cilantro and used all those ingredients to make this tropical salsa which actually turned out pretty well in my opinion, especially on the Teriaki chicken. We also had corn, and a banana split cassarole dessert and overall the evening was quite a success, and a lot of fun to be had as well.