June is Gone

June is gone and I have little to show for it, other than a wedding ring. My pictures haven't come back yet, so I can't show them off for all you losers who didn't come to the wedding. I didn't change my name (for professional and lazy reasons) and I'm wearing my engagement ring as my wedding band (unless I'm at the hospital, in which case I don't wear any rings), so a lot of people don't know I just got married. Or care.

At the hospital, you say? Why yes, didn't you know, I just began my MS-3 surgery rotation at a large county hospital. For 2 years now, I've heard the war stories from this place. Professors would say "you'll never see a presentation this severe unless you're at [County Hospital]". The other day, we had a case of tophaceous gout. The guy came in for something else; the gout was an incidental finding. Tophaceous gout is so advanced that the urate crystals are making rocks under the skin, for the (happily) uninformed. I'd also like to add that gout attacks (prior to tophaceous) are extremely painful.

We covered the ED (ER to the layperson) on Monday night and saw some wild shit. I saw a trauma call on a patient who rode his bicycle into a parked Metro bus while intoxicated. My fellow med student on call had to sew up a man's arm while a patient in the next bed shouted threats to an unknown party and about 7 police officers and sheriffs rushed in en masse. I saw a laparoscopic cholecystectomy (I got to "drive" the camera--woo!) and a toe amputation. I attempted to suture during said lap chole, but my pitiful knots came untied (I've practiced a lot since then, I swear), right in front of an attending and the chief resident. I've inserted a Foley catheter (fortunately, the patient was under general anesthesia) and palpated inguinal hernias. I've learned how to scrub into a surgery, so I get to walk around with my hands in the air like Turk. It's also a great way to exfoliate your hands and arms, so I have extra strength hand cream stashed everywhere.

When we started this rotation, someone told me that at the county hospital, our short white coats essentially make us doctors. In a way, it's true. Those white coats open any door, even the ones that say "Do not enter--restricted". The only doors they DON'T open are the doors to residents' call rooms. The heirarchy of lowly student, intern, junior resident, senior resident, chief resident, and attendings is strictly enforced here. One mark of how low we are on the totem pole is how far away our student call room is--it's on another floor--while the chief resident's call room is right outside the operating area. Often, we are simply referred to as "Student" by staff, attendings, etc. Perhaps I should include the fact that above the medical student is just about everyone else in the hospital, including (but not limited to) nurses, nurses' aides, scrub techs, janitors, cafeteria workers, etc. I don't necessarily work hard to suck up to attendings or residents (I'm just my usual cheerful self) but I consciously suck up to nurses and the like. I say "Yes ma'am" and "Thank you so much for your help" and "Are you sure I'm not in your way? Because I can move if I am", etc. Nurses are the LAST people you want to piss off, as they have to do nasty shit like removing Foley catheters, collecting specimens of every type of excretion the human body can throw out, bathing patients, emptying bedpans, etc. Maybe I just don't like pee that much, but I certainly appreciate what nurses do for us. I will kiss every last nursing ass if it keeps me alive while I ask retarded questions like "How do I turn on the BP machine?" or every damn time I have to ask "Where is the chart?"

I actually get to sleep in until about 5:30 tomorrow, so I'm going to take advantage and watch some TV tonight! Woo! TV! No thinking! No butt pus!