first thoracentesis today! half a liter of milky, orangy fluid, looks like sobe. so fun.  must do again.

just a few things about block 2: the hospital that smells like pee.

- well, it does. smell like pee.  in the lobby.

- it’s old, like the patients.  and creaky.

- my new senior is super cute.

- my new patient is super sick.

- food sucks.

- one of the super-chinese nurses snapped at me today for changing my name.  “hmmph! that must be your HUS-bands name.  tsk tsk tsk….”

- i think i’ll like the computer system as soon as i figure out where everything is.

- scrubs for a month! woo hoo!

- 2 lectures a day… where people struggle to stay awake or just hang limply in their chairs.

- q4 call… while also covering the micu.  scary.

i’ve just finished my third week of intern year!  woo hoo!  call has been less painful than expected, but i’m on night float this week, so we’ll see how long i last.  the entire hospital is buzzing about the last harry potter book… so i caved and read the first in the series yesterday.  i bought the next two today.  hopefully i’ll be caught up by the end of the week enough so that my eyes no longer glaze over when the conversations start.

woke up to scary alien millipede monster bug near my closet. freaked out, made ryan get up and kill it for me while i freaked out in the bathroom. then my mouse stopped working and somehow ended up in my work bag.  then… i shoved a kashi bar in my mouth and a can of coffee in my pocket and ran off to work.

today my team was admitting all the peds patients, so i watched them roll in– 6 in all. mine:

- teen with chest pain, troponins bouncing up and down, diffuse ST changes –> pericarditis

- practically-an-adult-should-know-better teen who drank some jimson weed tea and proceeded to wig out and become “mad as a hatter, dry as a bone, red as a beet”. CPKs are up, so we’re running sodium bicarb to counteract the acidosis from the ensuing rhabdo.

- huge-ass hordeolum on this poor kid. optho to consult tomorrow. it’ll probably be drained in the AM.

otherwise, i discharged my old kids and finished my dictations and now… it’s BBQ time.

the non-stop party that was my family medicine rotation has ended, and i’m off doing internal medicine again… which is fun in it’s own right, but lacks sushi lunches and procedure training. i didn’t leave without a souvenir, though! i now have an ugly case of strep throat, evidenced by the nasty exudate coming off of my left tonsil. grossness fantastico. ryan’s trying to keep me at home (drinking tea, preferably), as he has forbade me to go out to the gym and grocery store, and is trying to get me to take a couple days off of work. really, i don’t need time off, i need antibiotics. big, ugly, stinky ones.

it was a busy evening– little time to sit and chat… which is a good thing. less chance for me to fall asleep in the nurses station.

patients of note:

2 year old with viral gastritis: vomiting, fever, more vomiting, motrin, vomiting, tylenol suppository, screaming.

21 year old with clay shoveler’s fracture (spinous process fx) of C3 plus alveolar bone fracture (with a near loss of teeth) from her husband beating her, dragging her outside, beating more, dragging her inside, and beating her again.

75 year old with serious epistaxis, not on bloodthinners. i got to insert a “rapid rhino” (tampon-like apparatus with a syringe at the end to inject air) into her nose to stop the bleeding. (FYI: #1 cause of epistaxis is nose picking in kids and adults.)

MVA: rear ending that caused a car to roll over several times… three passengers walked away shaken, but thankfully undead.

MVA: drunken, belligerent driver with depression successfully pisses of entire nursing staff. broken clavicle… demanding pain medications and death.

woman freaked out while watching a scary movie at the nearby motel, jumped off bed, landed on outstretched palm. no scaphoid fracture seen, but she sprained her thumb… and took a shot of whiskey to try and dull the pain.

MRSA abscesses: 16 year old with one smack on the middle of the forhead (kept trying to pop it) and one on a 29 year old’s butt. puss-tastic.

40 something year old man with a nasty case of otitis externa.

thankfully, we didn’t have any arrests all night– my arms are still sore from lifting weights at the gym, and full extension at the elbow is difficult and quite painful. argh.

updates from the ER:

- reduced a patellar dislocation yesterday on a young girl with MR and rheumatoid arthritis. afterwards, she tried to give the doc a hug, and then me… but we both ran away. far, far away.

- scrubbed in on a laparotomy with a super fun surgeon at 5am to repair a perforated ulcer.

- saw an LP done for the first time… and the next one i’m doing!

we get a call into the ER that a patient is coming in from our friendly neighborhood psych facility… because she has inserted 2 keys and a keychain up her butt. while we wait for the patient, the nurses speculate to whether we can just grab and pull the keys out without causing massive bleeding– someone suggests inserting a speculum (ouch), someone else suggests inserting a lock.

the patient arrives, and x-ray of the abdomen and pelvis show only one key, and it’s in the vagina. whew. the doc and i go into the room together to see if we can retrieve it.

doc: so, you’ve stuck a key in your vagina.

pt: [smiling] ooooooooh! BUSTED!

doc: ???

pt: if i take it out, can i go home?

doc: [in a strangely patronizing tone] yes, if you take it out, you can go home.

pt: ok! [proceeds to fish around under her blankets] i’m on my menstrual period.

the patient then pulls out a horribly bloody key, and tries to hand it to the doc, who steps away quickly. the patient’s caregiver quickly produces an emesis basin where the patient promptly drops the key.

the end.