how quickly we forget

So after putting in a load of laundry and starting up the Roomba (my birthday present from Jack... which I love), I was preparing to wash a massive amount of dishes.  And I was thinking idly to myself how cool it is to live in such a time when machines can do chores for us.  I mean, back in the day, women would have to drag out their washtub and clothesline to do laundry, and it would take all day.  And most people still clean their floors themselves, with a broom or a vacuum cleaner, and it takes just way too long to be fun.

And then as I turned on the faucet, I thought, "Man, wouldn't it be nice if there were some kind of machine that could wash dishes, t..... oh.  Right."


(Also, here:  have a video of my Roomba in action, and be suitably envious.)

sentiment

Apologies for the long hiatus (if anyone is reading this). Just here briefly to post this image, which is so true, and random, it makes me laugh.

whoops

So does this mean if I didn't bring a pet, I won't receive service? Wish I'd known that ahead of time...

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!

whoops

Wow, I am a blogging slacker.

To make up for it, here are some cute videos of my adorable two-(almost three!)-year-old niece.

Lucy speaks Spanish:



Lucy sings the Beatles:



Lucy shows us how to get down:

oh hey

I'm totally going to start greeting people like this.

nerd humor

A new medical joke, as related to me by my resident today:


So a bunch of doctors go duck hunting. Before long, a huge flock of ducks flies overhead.

The family practitioner looks up and says, "Looks like a duck... sounds like a duck... let me just check with a specialist."

The internist looks up and says, "Looks like a duck... sounds like a duck... I'd better go look it up just to be sure."

The psychiatrist looks up and says, "Looks like a duck... sounds like a duck... but does it know it's a duck?"

The pediatrician looks up and says, "Looks like a duck... sounds like a duck... aww, but he probably has little baby duckies and a cute little mama duck waiting for him at home..." then puts the gun down and bursts into tears.

The surgeon looks up and immediately raises his gun and shoots. Then he turns to the pathologist and says, "Go make sure that was a duck."

Safety First!

If you are going to fly in an airplane, the TSA wants to make sure you will be safe. So they conveniently provide pamphlets for every passenger, full of detailed pictures illustrating various safety tips. However, as these pictures don't come with captions, I thought I would explain some of them here. FOR YOUR SAFETY, you understand.

First of all, you should know that there are some things that are FORBIDDEN on airplanes.

Remote control cars, for instance. I know how tempting it may be to bring your favorite battery-powered vehicle, but we must insist. None of this.

Record players. No record players allowed, not even if you use eraser-pink headphones.

Also-- and I know this may be difficult for all you evil supergeniuses-- you're not allowed to bring your favorite walkie-talkie-computer-communicator-device for relaying orders to your minions (no matter how cleverly disguised it may be with "TV" emblazoned on it in large letters).

And finally, no lighting your cigarette before you get to the bathroom. For goodness' sake, people, at least wait until you're inside the lavatory. The door doesn't take that long to open.

Once we've got that settled, here's a diagram for the benefit of everyone who hasn't been inside a car since 1950:

Okay, now that everyone understands the basics, it's time to cover What To Do If The Plane Crashes.

First, there are several possible reasons the plane might crash.

This picture explains that the plane might crash if it only has one wing:

While this picture illustrates what happens if the pilot overshoots the runway and, instead, careens into the air traffic control tower. Unfortunate.

Now. If you think the plane might be crashing, and you have a baby, it's important that you smash the baby's face into your bosom, as illustrated here:

If, on the other hand, you are accompanied by a dysmorphic midget man-child with a beer belly, feel free to help him with his oxygen mask.

On the other hand, if you ARE a baby, things are a bit different. First you have to make sure to aim a good kick at whoever might be messing with the straps on your life jacket:

Then once you escape from those interfering adults and get into the water, you'll have a brilliant idea that will allow you to save everyone.

Okay. But suppose the pilot manages to skillfully crash-land the plane, and everyone's okay? How do you get out of that flying tin can?

Well, first look out the window to make sure there are no SCENES OF DESTRUCTION outside.
Thunderstorms, forest fires, and giant piles of razor-sharp icicles are some common things to look out for.

Next, if everything looks okay out there, you can attempt to open the door. However, your efforts will be in vain, and you'll likely get really angry, like this guy:

But all is not lost! All you have to do is hold your arms out in front of you and clap your hands, and the door will open!
Hooray!

Once the door is open, get the @*&# away from there. None of this staying around to help people. That thing could explode.
See that arrow? It means RUN. The guy in yellow knows how to follow directions. The guy in blue does not. Obviously he did not thoroughly read his TSA safety pamphlet.

deep in the heeaaaart.....

...of Texas, people. Texas.

We traveled this past week to go take Step II CS, the last part of our Big Bad Board Exam. It's just like an OSCE (which is a test where you interview/examine a pretend patient), only there are 12 pretend patients so it's an all-day thing, and it costs around $1000 to take, and it's a licensing exam so it's nationally standardized and really important. And also, in Houston.

This is how we knew we were in Texas:
Very... direct. ("That's not a threat, y'all. It's just a statement of fact.")

(Also, the test went fine.)

mystery

Every day I walk back from the metro station through the Navy base to our hotel. And every day I am mystified by this:


Yes, it's some kind of door into underground tunnels (like a sewer manhole or something).... which always, 24/7, has copious amounts of steam billowing from it.

I mean, seriously, what is going on down there? I've tried and tried to imagine it, but I just can't come up with anything. Giant, terrifying basement laundry facilities? Secret mad scientist labs? Steam-powered generators with amazingly huge leaks in their pipes?

The best, though, is the accompanying sign:


What? You mean I shouldn't enter the BOILING UNDERGROUND WELLSPRING OF DEATH?? Oh, I'm so glad you said something, I was going to jump right in.

I also like that the danger apparently isn't related to the frightening amount of scalding-hot steam which would presumably fill the tunnels. No, the danger is that it's a "confined space." Claustrophobics beware! But the rest of you, just get your permits and climb on in.

battle of the geeks

Okay, now remember how I said in the sidebar over there that you would soon find out how much of a Nerd I am? Well, now is that time.

See, there's this show called Star Trek: The Next Generation that I have always been totally enamored with. No, I'm not a Trekkie, I have never been to a Convention, I don't own any pointy Vulcan ears and I don't speak Klingon. But the show? It is awesome.

Now, it has recently come to my attention that there is, apparently, among the Super-Super-Way-More-Nerdy-Than-I-Am-Nerds, a huge rivalry between fans of Star Trek and those of Star Wars. Now, I like Star Wars. I do. They're fun movies which were pretty darn innovative when they were first made. (I'm not going to bother making fun of the newer three, because hello, original Star Trek series? Cheesy.) But I still maintain that The Next Generation is superior to the older Star Wars movies. Let's compare characters.

1. The Main Protagonist

Star Wars: Luke Skywalker.
I don't have anything against Luke. But honestly, at the beginning, Luke is kind of whiny and annoying. Then he mysteriously becomes an entirely different character (I know, I know, he's channeling The Force) and he kind of loses all personality and is a little boring. Sorry.

Star Trek: Jean-Luc Picard.

Okay, Picard is just The Man, and that's all there is to it. Awesome Shakespearean accent, awesome Patrick Stewart acting. I'm going to show my nerdiness when I quote Tasha Yar (after her DEATH), "A man with the heart of an adventurer and the soul of a poet." And may I add: never, ever whiny.

2. The Token Hotshot

Star Wars: Han Solo.

Okay, there's no denying that Han Solo is the coolest character in Star Wars, at least from my perspective. And Harrison Ford is generally always an entertaining actor. But Han? He is totally a self-absorbed mercenary at the beginning. He does redeem himself, fortunately... but still.

Star Trek: William Riker.

Will starts off the series as kind of a friendly jerk, but then he gets older, puts on some weight, grows a beard, and mellows out. He's all friendly and good-natured (and also a total womanizer but apparently that's okay because it's The Future), but constantly demonstrates that he is a Hotshot with Mad Leadership and Tactical Skills. He gets offered positions as captain on various starships like three billion times but decides to stay on the Enterprise, which is admittedly a little contrived, but what are you gonna do?

3. The Token Female Character

Star Wars: Leia.

Leia, like her brother, is all about Total Character Shift midway through. She goes from being a white-robed, weird-hairdo-ed damsel in distress ("Help me, Obi-Wan Kenobi!") to being kind of kickass, riding around on speeders and zapping storm troopers. A little weird, don't you think? Also-- bizarrely incestuous romantic gestures, anyone?

Star Trek: Beverly Crusher.

Dr. Crusher runs around sick bay, shattering gender boundaries left and right. She always makes the diagnosis (thanks to the handy-dandy tricorder thingy), and when it's a brand-new never-before-seen illness, she just figures out a cure all by herself. Also, there's some romantic tension with Picard thrown in for good measure, but no incestuous moments. Fortunately.

4. The Token African-American Character (hey, blame the times, not me.)

Star Wars: Lando Calrissian.

Forgive me if I misunderstand the plot nuances, but isn't Lando kind of a slimeball who betrays his "friends" and hands them over to the bad guys? Despite his inevitable subsequent redemption? Man. The dude even just looks kind of sleazy, doesn't he?

Star Trek: Geordi LaForge

Geordi, on the other hand, is never a slimeball. (In fact, none of the Enterprise crew is ever anything but totally honorable, dutiful, and caring. If that's what the future will be like, then I'm all about it.) He knows a ridiculous amount of crazy things about quantum physics and stuff, but is charmingly inept when it comes to relationships.

5. The Token Know-it-all Robot Character

Star Wars: C3PO

C3PO is annoying, and everyone knows it. For one thing, he may speak a lot of languages, but he doesn't know nearly as much as he thinks he does. Also, he's a total wuss. And far too shiny.

Star Trek: Data

Data, on the other hand, knows exactly the amount of information he thinks he does. And he's always doing heroic things like offering to use his own body to shield other crew members from electricity, fire, and who knows what else. And trying endearingly to be more human.

6. The Token Whiz Kid Character

Star Wars: R2D2
Okay, R2D2 isn't exactly a whiz "kid," but he (she? it?) serves the same function. And he is oddly appealing, and saves the day frequently, but.... wtf? Why can't he talk? Wouldn't it be easier to just program a robot to talk than for everyone to apparently learn his "language" and translate his beeps and buzzes for the benefit of the audience?

Star Trek: Wesley Crusher

Wesley is almost unbearably geeky and naive for the first couple seasons, but he gets better as he gets older (and gets rid of that awful 80s rainbow-stripe sweater). And he has an IQ of like, 340.

7. The Token Scary Warrior-Type Character

Star Wars: Chewbacca

Again, what is up with the lack of dialogue? Obviously Chewie understands English, so why can't he speak it? I mean, seriously, how weird would it be if you had a friend from another country, and you both understood each other's languages, but you each insisted on carrying on your side of the conversation in your own native tongue?






Star Trek: Worf

Man, if you think the rest of the Enterprise crew is all about being honorable, they've got nothing on Worf. And when the other Klingons are mocking him for hanging out with humans? He just growls and takes it, because he's a freakin' Starfleet Officer, even though you know he would otherwise smash in their skulls. With his bare hands.

8. The Token Mystic Character

Star Wars: Yoda
I'm not dissing Yoda. But is there any particular reason he has to talk that way?

Star Trek: Deanna Troi

Fine, she's an empath, not really a mystic, but close enough. Admittedly, not as awesome as Yoda.... but definitely way hotter. I don't know exactly why she doesn't have to wear the Starfleet uniform like everyone else, but I suspect it has something to do with her rather impressive cleavage.

So there you have it. Not only evidence that Star Trek beats out Star Wars, but also evidence of the frightening magnitude of my geekiness. Be afraid, be very afraid.

Anatomy of a White Coat

Medical students are easy to spot in hospitals, for three main reasons:

1. They wear short (butt-length) white coats.
2. They are often seen following people with long white coats (the doctors), many times with a practiced, forced smile of pleasant expectation habitually on their faces.
3. Their pockets are loaded full of more stuff than the saddlebags on a pack mule.

see the smile? she will get a better grade than her bored classmate in the back.

The med student white coat, you see, is not to be confused with the attending physician white coat. Attendings are the head honchos of any medical team, so they are far too important to risk looking like pack mules. Their pockets are generally empty save for a shiny pen advertising Celexa or Zetia, the list of their patients, an iPhone or some equally fancy device, and-- if they're really on top of things-- perhaps a journal article they want their residents or students to read.

look how glamorous!

So here shall be revealed what the lowliest person on the medical team (the third-year medical student) is carrying around. Or at least, what I carry around, but I'd guess it's pretty typical.

Breast pocket:

1. Multiple pens, including one favored clicky or gel (or both!) pen, which I'll use until it runs out of ink... and at least one backup, a cheapy or found-on-the-floor pen. The backup is the one that, if a doctor asks, "Anyone have an extra pen?" I'll offer up. This way I appear helpful and avoid losing my favorite pen when the doctor then absentmindedly pockets it.

2. Penlight, for shining in patients' eyes and mouths.

3. Maxwell's Quick Medical Reference, much beloved by all medical personnel.



4. Smell-good lip balm... because I am, after all, a girl.

5. Alcohol pads for cleaning my stethoscope-- when I remember. Here's a comforting thought: your doctor's stethoscope may be the germiest thing in the whole hospital.

run away! run far far away!

6. Extra AAA batteries, because my cheap, school-distributed pager eats through them like you wouldn't believe.

7. Cell phone, for surreptitious text-messaging of the husband when I get bored on rounds.

note: my phone is not this cool

Left Outer Pocket:

1. My "cheat sheets"-- laminated cards outlining the basics of taking a history, listening for heart murmurs, reading EKGs, and deciding which antibiotics get used when.

2. Whatever snack or drink bottle I'm carrying around at the moment to quiet my grumbling stomach or keep myself from passing out from dehydration.

Left Inner Pocket:

1. Change purse (a cute one I got here) for storing my driver's license, debit card, and various cash & change... since neither the cafeteria nor the vending machines take plastic.

Right Outer Pocket:

1. Cheap, school-distributed pager mentioned above.

2. Handy-dandy little book of medications listing various info about the 1,000 most commonly used drugs-- brand & generic name, how it works, what it's used for, dosing, side effects, etc.



3. Highlighter(s), in constant rotation because they run low on ink so darn fast.

Right Inner Pocket:

1. Keys. (Self-explanatory.)

2. More laminated cheat sheets, these outlining differences in vital signs, lab values, etc. between adults & children. Most students probably don't still carry these around (they handed them out during our pediatrics rotation), but I do, because I want to go into peds and all that. Kids are my peeps, man. *insert fake gang sign, or something*

yeah, like this. you go, little dude.

3. Calendar/planner, which I mostly use, not so much for scheduling, as for (shh!) writing down the codes to all the keypad-locked doors in the hospital that I've learned so far. Don't go stealing my secret code book, now, or I will hunt you down!

Other:

1. Stethoscope slung around neck, unwisely without any kind of tag to identify it as mine if I misplace it (which has happened a couple times, but so far it's always been where I left it).

dr. miller has more foresight than I do

2. Some kind of study book, either carried around and used as a makeshift clipboard, or stuffed clumsily (if it's small enough) into a pocket.

3. Various other papers stuck wherever is handy-- patient lists, progress notes, hastily scribbled lab values, outlines of topics I've been told to read up on, etc.

4. ID badge clipped to lapel, identifying me as a MEDICAL STUDENT, complete with unflattering oily-faced photo. Oh, and the phrase "how may I help you?" in larger letters than my name... because if there's one thing med students learn during their third year? It's that really... we don't matter.

Just in case

Spotted this sign at the bottom of one of the hospital stairwells... a bit of a remnant of a bygone era. (It's a pretty old hospital.) It made me giggle, though I suppose it's good to know where it is.... you never know what might happen, right?

the good stuff

Disclaimer: I would like to clarify that the last entry was classified as "amusing" not because of the unfortunate patient receiving incorrect bad news... that part isn't amusing at all. It's amusing because it illustrates the absurdity of situations that can go on in medical education.

And on that note! More gallows humor!

Working on the floors in city hospitals, you do tend to see quite a few more examples of drug problems than you might otherwise. Now, I am definitely not downplaying the struggles these individuals have, and no, I don't think drug addiction is funny. But it can lead to some somewhat humorous and ridiculous situations... at least if you have a warped sense of humor like everyone in the hospital seems to have.

Some real life* examples:

1. Nurse: "The overnight nurse wanted me to let you know she found a syringe stashed in that guy's sock. His sock! And you know what he said to her? 'You're not going to tell on me, are you?'"

2. Doctor: "Oh, the arm abscess patient. Did you hear how he got it? He ground up some narcotic tablets, mixed them with water, and tried to inject them! Yeah, good thing he missed the vein, or he'd have lung fibrosis on top of the abscess... the talc in those pills is not meant to be injected."

3. Nurse: "The patient in that room is not the most pleasant person. She keeps yelling at us whenever we pass by, 'GIVE ME SOME F-ING DILAUDID!!!'"

4. Med student: "Patient denies alcohol use or smoking.... but then again, she denied cocaine use too, until they found it in her tox screen...."

5. Doctor: "Yeah, that guy admitted to using marijuana, but his eyes bugged out to here when we told him we found traces of barbiturates in his system. I bet when he gets out of here he's going to have some choice words with his dealer..."


*Real life, yes. But I'll always either change a few details or leave things vague enough to still protect patient privacy. You hear me, HIPAA police?

Mistaken Identity

An amusing story from the halls of the university hospital!

The other day, Jack was rounding in the hospital with the Internal Medicine team he's rotating with this month. Before they headed into one patient's room, the attending physician handed him an EKG and said, "Here, read this patient's EKG, and when you're ready, come in and tell us what it says." Then the attending, the residents, and the other students went into the room to see the patient.

A few minutes later, having duly studied the EKG tracing (it's more than just wiggly lines!), Jack followed them in to report.

JACK:
So, the tracing shows some Q-wave changes in the inferior leads... and some S-T elevation over here... [insert further medical jargon]

ATTENDING:
[takes EKG to look at it himself] Very good, it does show those changes! Hmm, we'll have to change our treatment plan based on this...

PATIENT:
What does that mean, doc?

ATTENDING:
Well, it basically means that we're pretty sure you had a heart attack.

PATIENT:
What?!?? Are you serious?? They told me my heart was completely clear!

ATTENDING:
Umm...

JACK:
[to another student, whispering] Are we sure this is the right EKG?

Well. As it turned out, he was right on both counts. The EKG did show changes suggesting a heart attack... but it was the EKG of a different patient. Whoops.


(Non sequitur PS: The allergy medicine I got is totally working! Callooh! Callay!)