Saturday, March 15, 2008


Ok, I just had to throw in that funny little story.
Now back to important things.
As part of our "friday clinic" experience, we are also assigned two in-patient experiences with PAs who work only in-hospital (YAY). Amongst the possibilities are otho, bone marrow transplant, other misc transplant, and ortho at Shriner's hospital (which if you aren't familiar with is a children's orthopedic specialty hospital, which is entirely funded by donations and so pts don't pay for treatment, and has mostly underserved kids and also bring kids in from Mexico to fix club feet, etc.)--I'll be there later in April so more on that to come.
But two fridays ago I got to go do neurosurgery at IMC with a PA who graduated from the U about 2 yrs ago, and incidently her brother is in my class now. She was SO awesome; totally chill and really wanted to teach us (I was paired with the Aussie girl from my group--which was fun and less pressure not being all alone). We got there about 7am, changed into scrubs, then rounded on the neuro ICU pts. Before each pt, she pulled up their brain CT on the computer to show/explain what was going on with them, then she'd go in and try to visit a little with them (if they were conscious) and do a little neuro exam, check their meds, what procedures they were having done, etc...basically just get the morning update on each one (she had about 8 in the ICU). There's quite a range of patients--brain mass, strokes, shunts that aren't working, brain abscess, and even a guy from Mexico who got some parasite that affected the brain. That was all really interesting (especially since we haven't had our neuro class yet!), but a couple of pretty sad circumstances. We also had to go to a few other floors like shock/trauma ICU and oncology to check on about 8 other pts of hers. Fortunately she had been sick all week, so most of the time we took the elevators all day :)
We met quite a few of the neurosurgeons and neurologists, as well as the other trauma PAs. One highlight was getting to go to department rounds while my classmate went with the PA to the OR. What this is is when the ICU nurses, PAs/NPs, dietician, other relevent people involved in the pt care all meet with the head of Neuro to update on the pts and make a plan for them, and this happens every morning. What's cool too is that the room has a projector where he can pull up the pt's CTs while going over each patient.
There is a term in the medical student world that is pretty common and dreaded; pimping. This refers to when a superior "pimps" the student about any various topic to either make sure they know what they're doing, keep 'em on their toes, make them feel stupid, etc. We had been warned about Dr. Head-of-neuro really liking to pimp students in advance (which we were pretty secure with...since we haven't had neuro yet), but I wasn't planning on being THE ONLY STUDENT THERE. True to his reputation, it didn't take long for him to turn to me and say, "Are you ready?" then ask me something I totally didn't know...but now I do! He was really nice about it, and fortunately one of the NPs and PAs were both REALLY new so he had lots to ask them as well. Later on when my classmate returned, I deferred to her (that was pretty mean) but then we both redeemed ourselves later on when there was something we knew. But, we did avoid eye contact and tried to walk the other way the rest of the day whenever we saw him.
We got to eat lunch in the Dr's lounge which is pretty nice and full of free food and drinks for the docs, and after seeing all the pts all day we got to go down to the ER for a 'trauma' that came in (which really wasn't too exciting or different from what I've done in the ER before), but it was cool to see how HUGE that ER is, and how many people show up for a trauma pt.
That's the shortened version of the day, but it kind of ruined me because it reminded me that I really do like working in the hospital in an acute setting, and that I'd rather wear scrubs than heels, and I'd rather have a 4-day on, 4-day off shift with no on-call and get to scrub in for surgeries than work in a clinic (even though clinic is very educational for this time...and seeing sore throats all day is super fun...)
To recap last friday back in el clinico: I got to see more pts on my own, felt a lot more secure about what was expected of me, saw a few depression/anxiety pts, and decided adolescent medicine is kind of fun.
Tune in next week!


gillian said...

We just read my brother's blog about his rehab rotation ( and now we have read about your neuro experience...pretty crazy. I hope I don't have a stroke anytime soon. About Joshua in the bathroom--Jonathan says that he knows from watching our nephew Henry Jon that the key to potty training is to have a book to read to the kid and a lot of time on your hands.

Marissa said...

Part of the clinics is figuring out what you like and what you don't like, right? So maybe it is a good thing you were reminded about liking hospitals.
Although, the fact that you have so many more clinics is probably a little discouraging. Just hang in there! It will all be worth it.
One day you will be rich and famous and working exactly the hours and days you want.