Beer Potomania!

Guyssssss, who's coming to this awesome fun event with me?!??!?

Coming Summer 2013 to an open field outside of a city near you!  With music by all your favorite bands and food trucks from all your favorite restaurants!  Tickets priced only just outside of your comfort zone for how much you want to spend in one weekend!

Just kidding, it's a disease name (drinking all beer and eating no food means lots of free water intake but not enough solutes which causes hyponatremia).  But come on, doesn't it sound like a really fun outdoor beer-tasting festival?  And admit it, doesn't part of you sort of wish it was?

Oh you meant SURGERY?

Me: Have you ever had any surgeries?
Patient: Nope.
Me: Have you ever had any eye problems?
Patient: Yeah, I just had cataract surgery last week.
Me:

Scrubs

I was talking with some friends on internal medicine the other day and complaining (naturally, because what other type of conversation is there?) about the traffic that morning, and another friend on surgery was like, "Really? At 5 this morning, 280 was totally clear."  It got me thinking about the pros and cons about the different rotations. 

In terms of call schedule and hours, surgery is obviously the worst (helloooo 5 am).  But you got the best parking spots, it took you half the time to get to the hospital, and you got to wear scrubs every. single. day.  Ob/gyn was the second worst (helloooo night float), but you also got to wear scrubs every day - except for your week of outpatient clinic when your hours were 9-5 but you had to dress professionally.

Now for internal medicine, there are no overnights.  But you are on call every fourth day (weekends included) which more or less means you stay till 8pm and admit all the new patients for the day.  You are expected to dress professionally in the hospital, but on your call days you are allowed to wear scrubs. 


...Is anyone else sensing a pattern here?  Being allowed to wear scrubs is obviously a consolation prize for having a crappy day.  And it's totally effective!  "Sorry you have to be at the hospital for all of the daylight hours, but at least you get to wear pajamas!"  #Winning!

consolation prize

By the end of surgery, I was so excited to put on real clothes again - it was like a full two months of never wearing pants without a drawstring, and that can get depressing.  But now that I have to dress up almost every day, getting to wear scrubs and sneakers makes call days so so much more bearable.

More Technical Talk

A patient not too much older than me had been having erectile dysfunction, and his testosterone level was in the normal but low range, and he asked the doctor if he should be prescribed some testosterone. 

Doctor: Testosterone doesn't help with your erection but it does with the dirty talk, the dirty thoughts - if you know what I mean.
Patient: You mean sex drive?
Doctor: Sure, yeah, that.

The doctor was also trying to convince him to lose weight (more fat tissue --> more estrogen --> negative feedback on LH/FSH --> less testosterone) and told him if he lost 30 pounds he would become an unstoppable animal, and that girls would start calling him "The Animal."


...Meanwhile, I sat awkwardly in the corner typing the patient's vitals into the EMR.

Check!

Holy guacamole, I only have one clerkship left in third year.  Check to surgery, psychiatry, neurology, ob/gyn, pediatrics, and now check to family medicine.  And hellooooo to internal medicine.  Granted, it's the longest of the clerkships, clocking in at a solid 3 months.  But still!  The last one.  And then I'm a fourth year.  Which is basically vacation (I mean.... valuable time to learn all the things I feel like I missed out on the other years and brush up on before residency), and then I'm a doctor.

Textbook Classic

Sometimes a patient walks in and is the exact textbook version of whatever their diagnosis is.  In the middle of January, I saw a patient walking out of the clinic wearing a sundress, flip flops, and no jacket (and for those of you who forget I'm from NJ, reminder: I do not live in Florida).  And in my head, I was like, "Wow, crazy person."  But then later the other med student in the office was like, "We had such a stereotypical hyperthyroidism patient today."  And I was like, "I SAW HER!"  (because amongst other things, hyperthyroidism raises your body temp.)

a clear-cut case of hyperthyroidism

But sometimes things are really not so textbook.  For example, to remember who is most at risk for gallstones, everyone thinks of the Four F's: Female, Fat, Forty, and Fertile.  One day in college I get a call that my lanky 20-year old brother was in the emergency room with terrible abdominal pain.  It turned out to be gallstones, and a LOT of them.  My brother is not female, certainly not fat (especially three years ago), not forty, and not fertile (at least not in the estrogen-heavy-between-menarche-and-menopause sense of the word). 

However, he had very recently gotten over a really intense infection and was on like 7 billion different antibiotics (I took some creative liberties there and exaggerated just a touch), and the gallstones were most likely caused by one of those.  Once he stopped taking all the medications, the gallstones disappeared.

wise like Yoda I am

All I'm saying is .... sometimes things happen exactly as you expect them to, and sometimes they don't.  (Yes, I know, I'm very wise.)

Addendum to Theory of Relativity

Last night (Friday), I went out to dinner with some friends, and one of my friends is on his surgery rotation and was on call Saturday (today).  For those who have not gone through third year of medical school: when you are on call on the weekend, it means you show up in the morning for rounds and stay overnight through rounds the next morning. 

We were debating how much sake we wanted to order and my friend who was on call the next morning said, "I can drink as much as I want, I don't have to be in until SEVEN tomorrow!"  As if that was an awesome time to have to be somewhere on a Saturday morning.


And so I absolutely stand by my post that everything is relative, and seven can be awful or amazing depending on what time you woke up the mornings leading up to it.



....says the girl who wakes up at 8 am on Saturdays to update her blog.