Thursday, April 29, 2004

now for a whole new set of abbreviations

I just took my last cardiology call last night. Thank god. Two months straight of cardiology call is enough to make me realize that I probably don't want to be a cardiologist. I mean, I know it's different to be a cardiology attending as opposed to being a cardiology intern or fellow, but I just don't know if I could think about one body part for my entire life. (But don't tell Joe I said that.)

[As a quick aside, here are the top three questions that people ask Joe when they know he's going into Ophthalmology:

1.) Are you going to do Lasik?
2.) Ophthalmology? Like, prescribing glasses?
3.) So, really, could you do Lasik on me?

The Lasik question I don't think he minds that much, but I think probably most ophthalmologists get a little peeved when people confuse them with optometrists. In fact, I dare to venture that most of the general population does not know the difference between an ophthalmologist an an optometrist. So here, in brief, is the difference. One is an MD. One can do surgery. One can prescribe medications. The other can do none of these things. And now I'll leave it to you to sort out which one is which.]

Maybe it's not cool to admit this, but I almost had to strangle one of my patients last night. Granted, it was a 23 year-old woman, not some 3 month old baby (the you'd really be scared of me, right?), and the reason that she's on our service instead of on the adult side completely escapes me. You're a grown-ass woman! Get thee to Internal Medicine! Then again, the very first patient I took care of in my Pediatrics internship was 27 years old. Hell, he's probably 28 years old now, and still sitting on the children's ward. Aren't there age cutoffs for the hospital? You must be less than 21 to ride this ride? Or maybe we could divide up the floors by age, like at [Children's Hospital in the Bronx]. One of the parents on our service (his kid is 5 months old) complained that the teenaged roommate in the next bed was surfing for porn on the Internet. On the nursing computers, no less.

But anyway, my big girl last night. Maybe we started off on the wrong foot because she came to me at 3:00am as a last minute transfer out of the ICU. Maybe we didn't quite jive because literally the first words out of her mouth when I went in to examine her were, "Can I get some drugs?"

Drugs? What kind of drugs?

Pain drugs.

Where's your pain?

My tooth hurts.

Oh. OK. Well, for right now, I can offer you Tylenol or Motrin, and if you're really having extreme pain beyond that, we'll have to address it with the team in the morning.

I need oxycodone.

Well, let's try the Tylenol and Motrin first, OK?

Dumb bitch.

And maybe it's because she wouldn't cooperate with nursing overnight and refused to have her bloods drawn and refused her echocardiogram and pretended to be sleeping with her thumb in her mouth (her THUMB in her MOUTH--hello, you're OLD) and ignored everyone that came in the room to speak with her. This just proves to me that I couldn't have done adult medicine. I cut kids a lot of slack, because, whatever, they're 5 years old, but I have a very short fuse, at least internally, with people who should know better. Which, unfortunately, sometimes includes the parents. Oh, you don't want your child to get vanc for their line infection because you read that medications starting with the letter "V" can cause autism? Well, OK then!

I think the worst page I ever got overnight (and I mean worst as un "unecessary," not worst as in "some kid is trying very hard to die right now") was from a nurse who paged me out of sleep at 3am to ask me if I could help her print something from the computer. Apparently, she didn't have a log-in password. Um, hi, do not page M.D. for IT difficulties. Thanks ever so much. Of course there are always the standard non-emergent late night pages, ("Could you change that Tylenol dose from 79 to 80 milligrams?") or the "just-need-to-document-that-M.D.-aware-so-I-don't-get-sued" pages, but on the whole, I really don't mind getting paged on call, even if I'm sleeping. Maybe because I'm still at that stage where I'm not sure that I should be sleeping in on call at all, maybe I should be prowling the halls checking and re-checking my patients in an endless loop until morning comes. So if I get sleep at all, what reason do I have to be annoyed with anyone?

(That's a good discussion for the comments section, actually. What's the most annoying page you ever got on-call? Share.)

I start the NICU on Monday. Hello, freaky preemies. At least it'll be something different.

Currently reading: My outline for the next Scutmonkey strip, "Surgery." Coming soon!

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