ER Tip of the Day #2

"If you know the technical name, dosage, route of administration, and timing of your pain medication and are 'allergic' to all pain medications except Percocet, Dilaudid, and Oxycontin.....your ER doctor just might think you've done this a few times." :-)

ER Tip Of the Day #1

In honor of the start of my ER rotation today, I'm beginning a new short series of posts entitled "ER Tip of the day." In these posts I will attempt to share various short bits of practical, every day wisdom with the rest of the world so people just like you can avoid potentially hazardous, ER-worthy situations. Consider this your warning... :-)

Tip #1:

If your girlfriend attacks you with a kitchen knife after a small argument, it may be time to find a new girlfriend....or invest in some plastic silverware.

True Friendship

"When we honestly ask ourselves which person in our lives means the most us, we often find that it is those who, instead of giving much advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a gentle and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares."--Henry Nouwen


It's one thing to be friendly to someone. It is incredibly easy to be with someone when things are going well. It is enjoyable to share the sunny moments in life with another person. Who doesn't want to laugh and smile while life is going well?

However, it is an entirely different issue to go willingly into the darkest places with a friend. There is something to be said for the person who is willing to truly SHARE the pain of another person. I'm not talking about sympathy, listening, or even offering advice. There is something so completely God-like in the person who realizes that they cannot fix your current situation or heal our current hurts, but sits with us in that dark, cold, and desperate place.

I have been blessed with so many amazing friends, two of which I consider to be my best friends. It has only been recently that I have realized how deep these friendships run. I recently found myself suddenly in one of the darkest, loneliest times of my life. The details are not important. What is important, however, is the response of these two friends. In a time where I couldn't see the way out and was constantly riding a rollercoaster of emotion, these two friends came alongside me and supported me. They had no advice to offer, no quick fix solutions, no cure for my current situation. However, they were simply there for me...they truly felt my pain...they were truly walking through this time in my life with me, not just watching from a distance. They were my only connection to hope for a future beyond the current situation. They were truly the face of Jesus in my life at a time when I needed it most.

God has since answered many prayers and brought me through the pain to a much more beautiful place filled with hope and alive with so many possibilities for the future. Through the difficulties and pain I have begun to learn a new way to live. Through it all, however, I was able to lean on two very amazing women who were my support when it felt like everything I had held on to before had crumbled. I am embarrassed to say that it took a situation like this one for me to realize that I was so blessed with two amazing friendships. I hope and pray that everyone has friends like these. In life it's not a question of "if" hard times will come...it is simply a matter of "when." It is in these times that we most need our faith in God and a few solid friends to show us the face of God when we're not able to see it for ourselves.

Ecclesiastes 4: 9-12
9) Two are better than one, because they have a good return for their work:
10) If one falls down, his friend can help him up. But pity the man who falls and has no one to help him up!
11) Also, if two lie down together, they will keep warm. But how can one keep warm alone?
12) Though one may be overpowered, two can defend themselves. A cord of three strands is not quickly broken.

A quick recap

Since it's been about 5 months since I posted anything on here, here's the quick highlights of the last few months. :)

• December--Peds ER; good traumas, good residents, snotty nosed kids, the 2 month sinus infection that followed-->Definitely not cut out to be a pediatrician.
• January--Internal Medicine; lots of crackheads (literally), crazy naked inmate holds 2 patients hostage on my night on call, open heart surgery at the bedside (same week, different call night), writing the same progress note over and over, 7 different attendings, more CHF/COPD/DM/HTN/CP than I ever want to see again in my life...Definitely not cut out to be a medicine head.
• February--OB/Gyn; do you even want me to describe what I saw this month?? Saw the "miracle" of birth...I thought it was gross. Got to scrub on some cool surgeries...retract for hours on some not so cool ones. Definitely not cut out to be a Gynie Girl.
• March--Psych; Worked 5a to 7p several days a week, got to see prison psych, unmedicated schizophrenics, and more ADHD kids than I could keep count of. My attending was practically manic but hilariously sarcastic. We got along well. Enjoyed the month despite the hours....Still, not cut out to be a shrink.
• April--Pulmonology (AKA, "And, how long have you smoked?"); worked with two of the best attendings yet. Saw more than my fair share of lung cancer, chain smokers, pneumonia, pleural effusions, and acute respiratory failure. I learned a lot, and had fun, but still....I don't want to go into internal medicine.
• Mid April--sat down and really thought about what I want out of my life and my career...finally decided AGAINST surgery and returned to the original plan of emergency medicine. I'm really excited about this and I haven't had any doubts since making this decision. :)
• April 23-25: Washington DC! I got the opportunity again this year to head out to Washington DC for DO Day on the Hill. There were about 16 people from my school that were able to attend and we were part of a group of 800+ students, doctors, and residents that lobbied for healthcare related issues with our representatives and senators. I also got two full days of sightseeing in DC in which was fun as well. It was nice to get away for a few days, but I also loved coming back home to some peace and quiet.
• Monday--I start my ER rotation! I'm nervous and praying things go well, but also very excited for this rotation. It should be a blast and hopefully will solidify my decision to head into ER. :)
• I have 2 more months in my 3rd year and then I'm officially in my last year of medical school! It's flown by and in 12 short months I'm going to be a doctor! Crazy...and terrifying all at the same time.
• Melissa Key's wedding is in just 5 weeks! I am so excited. It will be so much fun!

Well, there you go...my life in a nutshell. Many more things have happened I'm sure, but these are the big highlights. I'll hopefully be writing more later. :)

Discovering my inner surgeon...

On Friday I finished my first general surgery rotation. This last rotation was 4 weeks long and it was just about the most amazing thing I've ever had the opportunity to do. Despite getting up at 4am for a month straight, having severa 30+ hour days and practically living at the hospital, I loved this rotation. I was a little nervous starting out on this rotation, but once I figured out my role and what I needed to do to learn and do well on this rotation I really started to enjoy myself.

I got to see some amazing procedures and learn from some fantastic surgeons. My favorite surgeries were exploratory laparotomies. These surgeries are usually emergent and done to basically explore the abdomen and figure out what's wrong with the patient and then fix it. I know this may sound gross to some of you, but the patient is opened up basically from the bottom of their ribcage to their pubic bone and then you just take a look around! (It's a lot more complicated than the description I gave but you get the idea.) It was amazing to see the human anatomy in this living, breathing person; it was also pretty cool to see what could go wrong and then watch the surgeons correct it.

This rotation was over all to quickly and left me wanting to see more. On the last day of my surgery rotation, my surgeon told me that #1--I should consider becoming a surgeon and #2--any time I had some free time on another service to definitely come and scrub in on cases with them. I'm really hoping I'll be able to take her up on that offer so I can see if surgery really is for me! I am still surprised by how much I loved this rotation and even more surprised that I'm considering spending the rest of my life doing this! Hopefully I'll be able to figure some things out in the coming months.

This month I'm on Pediatric ER which is basically a vacation month compared to surgery. I have 12 eight hour shifts spread over four weeks, 2 ambulance ride-alongs, and a scattering of Grand Rounds and random lectures that make up my month. I was running some errands this afternoon since I wasn't scheduled to work and I felt like I was playing hooky or something from work! It's weird being free in the middle of the afternoon on a weekday! I'm enjoying getting caught up on some sleep and some other things this month though.

Mostly I'm very excited that in just 2 1/2 weeks I get to go HOME!! I haven't been home since early August and I'm ready to see my family and spend some quality time with them.

I hope you all are having a great Christmas season and each get to spend some time with your family and friends! Merry Christmas and Happy New Year everyone!

Ch..ch..changes...

OK...I'm just really bad at updating on here. I'm sure only about 4 people read this anyway, but for the few of you that are interested, I'm really going to try to update this at least every once in a while. Since I haven't had much time to myself lately, this may just be the best way to catch up with the most people.

A lot of things have changed since the last time I wrote on here. Today was my last day of family medicine. After eight weeks in clinic I feel like I have learned a lot, but more importantly I have gained a lot of practice and confidence in interviewing, examining, and talking with patients. The patient interaction is one of the most important things to master and I really feel like I'm on my way to developing my own style which is great.

I am pretty glad that family med is over though; I really enjoyed the doctor and staff that I was working with and they were all great teachers. However, family medicine is not really my "thing" and I'm ready to move on. I am starting surgery on Monday morning (EARLY; about 4:30am I think) and I'm a little intimidated by I'm also excited to start something new. I've met my attending and my resident and they both seem great so I'm excited for the next month. I'm also looking forward to being back in the hospital. The clinic is great, but I love being at the hospital.

I have so much to learn on this rotation and a lot that I'm sure I'll need to relearn, but I'm excited to start.

After 1 month of general surgery I start peds ER in December which I'm really excited about. If you've known me for more than 5 minutes, you know that I absolutely love the ER life, and so I'm excited that I get to do this for my peds rotation. I'm also excited that in less than 2 months I get to go home and see my family! I love it out here in Toledo and I'm learning so much but it's hard to be away from your family for so long. I'm excited for Christmas because it's one of my favorite times with family and it should be a great break for me.

Well, I'd write more but I really should be studying up for Monday morning. I'll try to keep updated on here with any fun stories!

MSF Refugee Camp

Hi everyone! I just wanted to let you all know of a really interesting opportunity coming up. Doctors Without Borders is touring throughout the U.S. during September and October and setting up mock refugee camps in selected cities. This week they are in Chicago (Wednesday 9/19--Sunday 9/23) and are setting up camp in Grant Park. It's a free exhibit and I've posted some of the information from the website below.

Even if you're not in medicine or not interested in international medicine, this is a great opportunity to get out of your bubble and see what conditions millions of people are forced to live in each day. If you are anywhere near the Chicago area in the next week and can make it to this exhibit I think it will be a great experience.

Information from the website:

In September and October 2007, Doctors Without Borders/Médecins Sans Frontières (MSF) will be taking its outdoor educational exhibit A Refugee Camp in the Heart of the City to Milwaukee, Chicago, Minneapolis, Houston, and Dallas.
Guided by MSF aid workers, visitors are asked to imagine that they are among the millions of people fleeing violence and persecution in, for example, Afghanistan, Colombia, the Democratic Republic of Congo, or Sudan.

The exhibit is made up of materials used by MSF in its emergency medical work around the world, including emergency refugee housing, a food distribution tent, water pump, health clinic, vaccination tent, therapeutic feeding center, and a cholera treatment center.
It addresses questions such as:

Will I be safe?

What will I eat?

How do I find water?

Can I get medical care?

Where will I live?

Learn more about the issues refugees and internally displaced persons (IDPs) face with this interactive guide.

The exhibit is free and open to the public. If you are planning to come with a group of 15 or more please schedule a group visit for your city: Milwaukee, Chicago, Minneapolis, Houston, or Dallas.
Individuals are welcome without reservations.

For more specific information on the Chicago site, go to their website at:http://www.doctorswithoutborders.org/education/refugeecamp/chicago/