tv show pet peeve

Picture this scene (you know you've seen it many a time):

A terrible accident has occurred, and now a character whom you've come to know and love is lying in a hospital bed, barely clinging to life (and, I might add, looking remarkably attractive and well-groomed for someone so Critically Ill... usually without even a nasal cannula, much less an endotracheal tube, to spoil the effect).

Suddenly, the rhythmic beeping in the background gives way to an ominous hum, and you know the terrible truth. The heart monitor swings into view to show you the all-too-recognizable flatline.


Instantly, doctors and nurses rush in. What is the first thing they do? Check the Airway, Breathing, Circulation? Start chest compressions? No way, baby, because in medical drama there is nothing more glamorous than the all-powerful defibrillator. One of the (also remarkably attractive) doctors grabs those paddles, slams them on the patient's bare chest, yells "CLEAR!" and the patient jerks violently.


Lather, rinse, repeat. This goes on for a grand total of about 30 seconds (despite the fact that real codes can last more like 30 minutes at times... and do, in fact, typically involve chest compressions) before the Doctor In Charge wipes his/her brow, fights back tears, and says, forcing stoicism, "Call it."

So what is the pet peeve here? The unlikely attractiveness of... well, everyone? The fast-forwarded code blue? The lack of oxygen therapy (or any kind of medical device) on a patient who is evidently Hovering Near Death? Actually, no.

People. Asystole is NOT a freakin' SHOCKABLE RHYTHM!

four things

Thing #1- Hello, smog. Lovely to see you this fine morning as I gaze from the hospital window.


Thing #2- Why do I always manage to spill coffee on myself the mornings when I'm post-call?

Thing #3- The computers in the pediatric conference room are using a 10-year-old operating system. Awesome.


Thing #4- My school-distributed pager has them beat, though, because whenever I change the battery and the date resets, it asks me if I would like to set the year to 1999. Um, no.

five stars

So today I'm On Call. This basically means I'm in the hospital for 24-30 hours, doing admissions, helping out the residents, etc. I don't have to work the entire time, necessarily; I just have to be there. There's actually a room where I can sleep if/when I get the chance. (Incidentally, the reason residents are called "residents" is that they used to be On Call in the hospital all the time. Residents of the hospital, you see.)

And now, without further ado, this is the peds student call room, where I'll be spending the night tonight!

Look! Swanky, no?


I'll also have a desk (of sorts) and even my own sink. What more could a girl want?


I especially like how, if you look closely, you can see where past students have been practicing their surgical knot-tying skills.

(I really do like it, by the way; I'm not just saying that. It makes me feel sort of connected, in a weird way... to all med students, past and future, who have ever sat in a stark call room in ill-fitting scrubs, whiling away the wee hours of the morning practicing the intricacies of surgical knots on leftover sutures donated by some thoughtful scrub nurse... or something along the same lines. Oh, med school. How very un-glamorous you are.)

marshmallow world

View from the Pediatric Student call room in the hospital:


Some of us had to dig out our cars, but even with a Level 2 snow emergency in place, all 10 people on the ward team made it to morning sign-out on time!

(Because kids still get sick when there's a 9-inch snowfall within a 24-hour period. In case you didn't realize.)

the truth, the whole truth, and nothing but the truth

In pediatrics, usually one finds oneself taking the history from Someone Other Than The Patient. Because, y'know, the patient is a wailing 21-month-old. So for every pediatric H&P, it's important to include the line "history given by ______" and it's not uncommon to add a comment on the apparent reliability of said history-giver.

More often than not, the historian's reliability-- or lack thereof-- is pretty apparent. For example:

EMILY:
So, has she ever had any other medical problems?

PATIENT'S MOM:
Nope, nothing else.

EMILY:
Great. [writes this down] And does she take any medications?

PATIENT'S MOM:
Um, no.

EMILY:
Okay. Any surgeries?

PATIENT'S MOM:
Just the biopsy I mentioned.

EMILY:
Okay, good. [makes a note of this, then turns the page] Now I'm going to ask about family history, okay? Anyone in the family have a history of asthma?

PATIENT'S MOM:
Well, she does. [indicates the patient]

EMILY:
[taken aback] Oh... she has asthma?? Um, okay. [flips back to the Past Medical History section and adds this] Does she take any medications for that?

PATIENT'S MOM:
Well, yeah. Singulair, and Pulmicort. And albuterol.

EMILY:
[resignedly writing this down] Do you happen to know the doses?

PATIENT'S MOM:
[looking puzzled] No.

EMILY:
Okay. That's okay. Now. Anyone in the family have seizures?

PATIENT'S MOM:
[indicating the patient again] Well, she had seizures. That's why she's on the Keppra.

EMILY:
[sighing, flipping back to the Past Medical History section again and writing this down] Okay. Seizures. Keppra. Got it.

[after a few more questions]

EMILY:
Has anyone ever told you she had a heart murmur or anything like that?

PATIENT'S MOM:
Yeah, she had one when she was a baby, but not anymore.

EMILY:
Oh, okay. Did she have a congenital heart defect?

PATIENT'S MOM:
Yeah, a PDA.

EMILY:
[remembering the lack of surgical history] Oh, so they just closed that using medicine?

PATIENT'S MOM:
Oh, no, she needed surgery for that.

EMILY:
[not even surprised anymore]

can't we all just get along?

Anyone who has ever gone through medical education has some familiarity with the type of nurse depicted in this comic. (For those too lazy to click on the link, I'm talking about the Nurse Who Eats Medical Students For Breakfast.) I had a run-in with just such a nurse today, which I shall now replay for your enjoyment.

EMILY:

[writing busily in chart while copying lab values from computer-on-wheels]

NURSEZILLA:

[approaching with two nursing students in tow] Oh, THERE it is! We were looking all over for that! I need to use it.

EMILY:

[thinking she means the computer] Oh sure, no problem, let me just log out.

NURSEZILLA:

[impatiently] Yeah, the patient's going down to ultrasound, so I need the chart.

EMILY:

Oh... um... okay... [removes her progress note from the chart so she can finish writing it]

NURSEZILLA:

[grabbing the chart] Is that just your note, or is someone else's on the back of the page?

EMILY:

Oh, right, there is another note on the back.

NURSEZILLA:

[in a tolerantly amused tone, as though speaking to an idiot] See... they'll need that information. We have to make sure allllll the information goes with the patient.

EMILY:

Right, of course. [starts to put it back, then realizes Nursezilla has now opened the chart to a different place]

NURSEZILLA:

[with an air of great patience and long-suffering] Nope, not there. You have to look at what you're doing. [turns to nursing students] See, now if we do things right the first time, then mistakes won't be made.

EMILY:

[fantasizes about beating Nursezilla over the head with the chart, but instead turns back to the computer and starts copying down all the labs... again. sigh.]

more cuteness

My favorite patient this week so far has been a 2-1/2 year old who, whenever I asked him, "Can I look in your ears?" "Can I listen to your heart?" "Can I feel your belly?" would grin and say "No way, Jose!" in his squeaky little toddler voice, and then giggle. And then let me do whatever anyway.

See? This is why I love peds!