It's not our fault!

Science has proved that it's not our fault! I mean, who can disagree with genetic proof?

Don't know how I feel about this:

well, I am very for the patient's right to refuse treatment, as that is something that we all should have a right to do. A doctor should not be allowed to make health decisions without consulting the patient. However, in this case, I want to know when the parents went to medical school. How do they know that their child is cured? Shouldn't they let, at least, that decision be made by the doctors? It's not that they don't want their girl cured, they do, but they just argue that their daughter is cured. I personally don't get it. They want their daughter to be healthy, but refuse to agree with the professionals who tell them that their daughter's cancer isn't gone. How bizarre.

My apologies

To those that have noticed that I have been slacking lately, I dedicate this post to you. My summer has picked up quite nicely, and over the last week and a half I have spent 5 twelve hour shifts in the ER shadowing doctors. While I have seen many fairly interesting cases, I have also seen my share of idiots. Some of the problems that people come into the ER with are absolutely ridiculous. On my last shift, a mother brought her 12-year-old daughter into the ER when her daughter's finger started to twitch at midnight while she (the daughter) was cooking herself some hot pockets. My first question would be "Why was your daughter UP at midnight cooking something? Shouldn't she have been asleep?" My second question would be "What the hell do you want us to do about it?" So she's having a muscle twitch. EVERYONE does. It will go away. Thank you for costing the county $350 because you probably don't have insurance. I sometimes feel like I should sit out front of the ER and hand people their signs as they come in. Oh? You were drunk and decided you would try juggling knives? Here's your sign. Another girl had been to the ER two weeks prior to her most recent visit because she was in a car accident and had snapped her clavicle (collar bone). This was a legit excuse for being there. She was given a sling and told to rest it. On the night that she came back, she had decided that she wanted to play some basketball and took off her sling and started to shoot, well, lo-and-behold, she broke her collar bone again. IDIOT. Here's your sign.

I have also seen some very interesting traumas come in. Lubbock's UMC (University Medical Center, the hospital assosciated with the medical school) is the only Level 1 trauma center located in west Texas, so it serves most of west Texas and eastern New Mexico. This means that we see alot of life flight patients. One of the most recent ones was a father and son who had gotten into an argument. The father got upset, and pulled a .22-caliber rifle on his son, shooting him 3 times. Nothing says "I love you" more.

SKIP THIS PARAGRAPH IF YOU DON'T WANT TO READ THIS GROSS/GRAPHIC STUFF. Probably one of the grossest things I have seen while down there was an 18-year-old female who was involved in a one vehicle car accident. This woman was between 450 and 500 pounds. It took about 8 people to lift her and move her from the EMS gourney to the ER bed. we then had to ROLL her to get the back board out from umder her and test for spinal injuries. We knew coming in that she had at least one broken ankle because when we were looking at her foot, we could see clearly the tibia and fibula. Her foot was attached to her leg only in a fashion that could be compared to the head on Nearly Headless Nick from Harry Potter. Just sinews and tissue holding it on. When we had rolled this woman onto her side to check her spine, we had noticed a fair amount of blood in between her legs and over her ass. Since a rectal exam is part of ANY trauma assesment, they had to check for rectal bleeding, which was negative. The doctors then asked if she was on her period, to which she replied "no". So the doctors then had to do a vaginal exam to try to find the source of the blood. It took two people to roll the fat on her legs back (one for each leg) while one of the doctors was trying to fold back her abdominal fat to actually find her vagina. This was utterly disgusting. To top it off, she had a giant genital wart. As one of the surgeons that was part of the trauma team later mentioned, she had to get this genital wart from SOMEONE, and he kindly mentioned that "where there are pigs, you know there are pig-fuckers." The next part of her injury assesment was to find out the kind of internal injuries that she had. Unfortunately, she was too large to fit in the CT scan machine, so they couldn't tell if she had internal bleeding. They also had to bring in an extra powerful x-ray machine, as the standard one wasn't powerful enough to go all the way through her body. They had to take her up to surgery to put in an IV line because none of the nurses could find a vein in the ER. One of the ER docs asked if they were going to go ahead and staple her stomach while she was there. (He did not mention this in front of the patient)

One of the coolest (but very sad) things that I got to witness was a 17-year-old female who was sitting in the back of a truck going 35 mph. The truck turned and she flew off, hitting her head. When she came into the ER she was unconscious. A quick CT scan showed that she had internal head injuries and blood was on the brain. One of the neurosurgeons came down and let a third year drill a hole into her head so that they could insert a device to measure intercranial pressure. The procedure was absolutely awesome, and I got to watch!

Perhaps the most unrewarding part of the ER job is that there is not much conclusion to the most severe patients that come in. As the ER docs' job is solely to stabalize until the specialist can take over, the ER doc usually doesn't get to follow up with most of the more traumatic patients that come in. There is essentially no finality to it, unless they hear about the patient through the grapevine.

I have 2 more shifts in the ER to have fun with, and then I get to spend 2 weeks with Anesthesiology. Hopefully they will let me intubate some patients and perhaps do a little stitching.