Tales From a Small Town ER, Part II

Did my second 12 hour shift in the ER on Tuesday.  Unfortunately this time there was no helicopter. And still no George Clooney.  There was, however, a thumb with a big, fat, gaping hole in it from a misdirected steak knife.  Oops.  Hopefully a certain someone learned a lesson and won't try stabbing at grapes with sharp objects anymore.  Hopefully.  But judging by the other scars on this patient's hands....well.....he'll be back. 

That was really the only exciting thing that we saw all day.  Then there were the people who, for whatever reason, think that the ER is their own personal pregnancy testing facility.  Really?  Have you heard of EPT?  They have them at Walmart.  I know you're familiar with that place. 

And you, ma'am?  You're here because you had a "funny feeling" in your wrist?  I'm sorry, you must have the EMERGENCY room confused with the I'M SMOKING CRACK room.  I haven't even started residency yet and I'm already jaded.  I don't know about you guys, but I wouldn't even entertain the thought of going to the emergency room unless I was convinced that I was dying.

Speaking of being convinced that you're dying....I think this is a common theme among medical students/residents/doctors.  Recently I noticed a big bruise on my arm, one on my leg and one on my tush.  I didn't know where the arm and the leg one came from.  The tush one came from an unfortunate fall down the stairs at my preceptor's house.  Glad nobody saw that one.  Not pretty....nor is the bruise.  Right now it's turquoise, purple and brown.  Kind of looks like a Monet.  Anyhow....the other bruises.  I had no idea how I'd gotten them, so of course I start to suspect that I have leukemia.  Random bruises, fatigue - I fit the description perfectly.  So I resolved to pay better attention to the things that I bump into.  By golly if I don't run into a bunch of stuff during the day.  Yesterday I ran into a door in the hospital, bumped my knee on the bedpost in my room and ended the day by attempting to run and jump into the gigantic bed I sleep in here in Iola.  Well, I misjudged my distance a bit and didn't quite make it onto the mattress, but instead hit the side of the bed and sort of slid down to the floor.  Glad nobody saw that one.  So, apparently I'm kind of clumsy.  Since I can now account for all of my bruises, I've ruled leukemia out of my differential.  But now the question lurks: Why am I so clumsy?  Surely there is something amiss in my brain!  I probably need an MRI. 

Well, I'm going to head to bed.  Tomorrow is my last day in Iola.  We have another section in the morning, then I'm headed home to the big city and my big chubby baby. 

*as usual, patient information has been altered to protect the innocent*

Last Week

Today I drove down to Iola for the last time. On the way I stopped at D'Bronx and got a J Bomb for my preceptor, then I was drawn by a supernatural, magnetic force to the corner of 119th and Roe where I found myself in the parking lot of Dean and Deluca.  Oh boy oh boy oh boy!  I was like a kid in a candy store, or an adult woman in a gourmet foodery surrounded by cases of desserts....same phenomenon.  I bought some brownie pops (chunks of brownie covered in chocolate - in an assortment of flavors - original, caramel, peanut butter, mint and raspberry), and then some chocolate kahlua something or others....all's I know is that they were balls of ooey gooey chocolatey deliciousness topped with more chocolate and then topped with white and dark chocolate shavings.  Does life get any better?  Me thinks not. 

When I got to the doctor's office, there was some sort of drama unfolding and hormonal typhoons were running rampant.  Luckily the chocolate that I brought seemed to squelch the adversity, restore peace and bring about contentment.  Birds chirped, woodland creatures scampered about and a lovely rainbow shown over the office.  You're welcome.

So this is my last week here.  Tomorrow we have a c-section scheduled in the morning and then a 12 hour ER shift.  Wednesday will be another day in the clinic and Thursday morning we have another c-section.  Then I'll head back to KC and pick up my peanut from her grandma and grandpa's house and smooch her like crazy.  I'll have the weekend off and then I start a Palliative Care rotation on Monday at KU.

In Weezy news, she had her 6 month check up last Thursday.  I can't remember her height and weight, but she is in the 70th and 97th percentiles respectively.  Oh, and her little noggin is in the 97th percentile as well.  She has a huge cranium...like sputnik!  Here's a picture from her 6 month photo shoot - complements of Oma....

I could gobble those little cheeks up!

While I'm in Iola I get frequent updates from Louisa's Oma and GG regarding Louisa's daily activities.  Today she ate lots of baby food, continued her frustrating quest to figure out how to crawl, took a nap on Oma's lap, then became indignant when Oma took a nap and in doing so, ignored her.  The nerve!  She also waved at Oma, GG and her daddy.  Speaking of her daddy....he's pretty cute.

See?  Told ya :)

In other news, Darius Rucker is trying to kill me.  Have you heard It Won't Be Like This For Long?  He is an evil, evil man.  Martina McBride tried to kill me a few weeks ago when I heard In my Daughter's Eyes while driving to Iola.  As of yet, Miley Cyrus has never tried to kill me, so It's a Party in the I-O-L-A!

Tales from a small town Emergency Room

Over the weekend I got to tag along with my preceptor during an ER shift.  Turns out, my assumption that the only time the fire truck and ambulance are called out in a small town is when a cat gets stuck in a tree, was wrong.  The shift started out quiet enough, a few random old people who weren't feeling so hot - filled them with IV fluids, marveled at their miraculous recovery and sent them on their way.  A quasi-trauma involving an old guy, a restaurant, a window and a motor vehicle.  Oh, and a backboard covered in potato chips.  That was about as exciting as it had been all day.  Later in the shift we found ourselves sitting around, a bit bored, when my preceptor declared me a "white cloud" in the ER.  (A white cloud is someone who seems to keep patients away, while a dark cloud is someone who seems to attract them and in doing so, conjure up lots of work - it's all very voodoo.)  Something else that is a bit voodoo is prematurely declaring someone a white cloud or uttering the words, "Gosh, it's slow."  As soon as those words come out, it's bound to hit the fan.  And sure enough, as soon as my preceptor labeled me as such, patients started coming out of the woodwork.  The first was an older guy who was working on his roof and slipped and fell.  He beat himself up pretty good and ended up being pretty critical.  The next patient was a younger guy who was playing footsie with his girlfriend in the ER bay while he was waiting for us to come see him.  As far as I'm concerned, if you're well enough to play footsie, you have no business in the ER. In addition to these patients, we had a smattering of coughing kids, twisted knees and facial lacerations.  Luckily I didn't get drafted to lay on anybody while they were getting their faces stitched up.  Instead, I helped the life flight crew load up our roof guy and get him flown to the big city for more specialized care.  And by "helped" I mean tagged along and tried to stay out of their way. 

Yeah, so the helicopter was pretty freaking cool.  They landed on a street behind the hospital, almost in somebody's back yard.  The person who lived there was out with his dog, who for a second looked like he was going to attack the helicopter....until he realized that it was much bigger than him and made of metal.  Smart dog....wise decision to run the other way.  Anyhow, after we they got the patient loaded up, the EMTs and myself walked about 40 yards away to watch the helicopter take off.  I had a pair of scrubs and a sweatshirt on and it was really cotton-pickin' cold.  If you've ever worn a pair of scrubs, you know that the only purpose they serve is to make you not naked.  They offer no warmth....none.  So as soon as those helicopter propellers (is that what they call them?) started spinning, I thought I was going to die a cold and painful death.  And as soon as the helicopter started lifting off, I had flashbacks of when the jerk doctor on ER got crushed by the falling helicopter.  And I again thought I might die a cold and painful death.  Then I hallucinated that George Clooney brought me a cup of coffee from the cafe across the street.  But alas, there was no George Clooney and the cafe across the street was just a Casey's General Store.  Then the helicopter got higher and higher and eventually flew over the hospital into the black night sky and all we could hear were its engines.  Then quiet. 

About that time, our shift was finishing up and another doctor was coming on (still not George Clooney).  Turns out that small towns have more than just cats stuck in trees.  Who knew?

*Ages, genders and/or diagnoses have been changed to keep me out of trouble with HIPAA*

Adventures in Iola Part II

A beautiful snowy day in Iola!  Actually not so beautiful, a little more on the stark and desolate side.  When does this thing called summer happen again?  Anyway...  We had a full day of clinic today.  My preceptor sees lots of peds patients, so I got to drool all over several babies.  I wish I was drooling on my own kid, or that she was drooling on me, but I'll get to see her soon enough.  I also got to remove another mole today as well as an ingrown toenail.  Pretty sweet.  And because it was so snowy, I wore my super-cute pink polka-dot boots to clinic instead of my super-ugly-yet-comfortable doctor shoes.  They were surprisingly comfortable.  I might have to wear them on a more regular basis.

Clinic finished up around 5:00 and I headed to Sonic for a burger.  I usually don't let myself eat greasy burgers with greasy bacon and mayonaise, but I'm 100 miles away from my sweet peanut and I decided that a little comfort food was in order.  So what does one do after dinner on a Monday night in Iola?  Why, go to Walmart of course!  I'm a little embarassed to say that it wasn't my first trip to the Iola branch.  Tonight I bought some Reese's Puffs cereal and some Ghirardelli dark chocolate.  60% Cacao - that's what it says.  Since when are we keeping track of the percentages?  And what do they mean, anyway?  There was one that was 90%, and I must admit, I was a little intimidated.  If anyone is a little more savvy as to what this phenomenon is all about, please enlighten me.  Thank you.

So now I'm back at the house.  I'm convinced that my preceptor is trying to turn me into a drinker.  She's always offering me hard cider or wine.... and I'm always accepting.  Now that I'm a little tipsy I'm going to take a nice little bath in the nice big tub.  I've got to be good and clean for our 12 hour ER shift tomorrow. 

More to come..... 

Adventures in Iola

Before we can graduate from medical school and be real doctors, we are required to spend a month in rural Kansas working with a small town doc.  My first year of medical school, I was paired with a third year family medicine resident as my preceptor.  She was just about the coolest girl ever and luckily, she's now a small town doc and I get to hang out with her during February to fulfil my rural requirement.  That's the good part, the bad part is that I have to leave my sweet little peanut and my super handsome husband at home for several days and nights.

Last week was my first week in Iola.  I drove the 100 miles down 169 in the dark on Monday night and pulled up to the 1890's Victorian that my preceptor and her family live in at 9:00.  Their home used to be a bed and breakfast so I kind of feel like I'm on vacation when I'm in my room.  Sometimes I say, "I'm going to retire to my quarters."  Because that just fits the feel of the house.  Actually I don't say that, but I think it to myself.  Then I giggle a little bit because I'm such a tool.

Anyhow, my room is large and has tall ceilings and lots of tall windows.  I sleep in a big 4 poster bed (requiring a stool or a running leap to get into it) with a heated blanket.  By the windows is a jacuzzi tub with lots of bath products for my sampling.  If you've ever lived with me (Rachel and Danny) you'll know that I rarely take showers, but usually opt for a nice hot bath.  Standing requires too much energy.  Why would you stand to do anything when you could lie down?  If I could lie down and drive I would do it.  Lie down and cook? That would be just dandy!  The only exercise I do is sit-ups....you guessed it, because you can lie down!  Anyways...Danny thinks that baths are inadequate for proper cleansing as you just "lie in your own filth."  But I disagree.  Unless you've been out rolling in the mud, a bath is a perfect way to bathe.

So, back to my room.  It's just all around wonderful.  The bed is ubber-comfortable.  There are lovely original antique touches here and there - the ornate old doorknobs, the embellished white radiator in the corner, the bowed stained glass windows in the bathroom.  OMG, I forgot my camera!  I must take pictures before this month is over!  Here's a picture of the house that I found on the internet:

 

Pretty sweet huh?

Last week was fun, as they let me jump right in and get my hands dirty, literally with a c-section on my first day and a mole removal my second day.  One of the doctors handed me a scalpel and let me go to town on the mole.  The patient was remarkably calm.  So was I until I looked away for a second to find my sutures, looked back and saw blood oozing down the patient's arm all over the sweater that was lying at his side.  Oops.  Luckily hydrogen peroxide takes blood out nicely.  

I'm having a good time down here, but man is it hard to leave my sweet Weezy girl at home!  I left early today to miss the snow storm that was forecasted.  The only thing worse than a two lane highway at night is a two lane highway at night in the snow.  So I'm here, safe and sound, but missing my little peanut.  

More to come....

Today I dropped the peanut off at her Grandma & Grandpa Bartlett's house and went out for a little retail therapy.  For me it's not so much about buying stuff, but just wandering through rack after rack of clothing.  It's mind numbing and wonderful.  I ended up buying a couple of outfits for Louisa because she WON'T STOP GROWING.  What is it with babies?


When I got home I thought, "by golly, I'm going to shovel!"  And not because I'm the perfect, dutiful wife, who wanted to save her husband a little work and save his little huge feet from getting cold on the walk in.  Nope, I shoveled because I had a pair of cute little pink polka-dot boots that needed a reason to be worn. 

Here we are before we got started shoveling....

Now, so you can experience the cuteness.....
 

And finally - we looked out over our handy work and said, "It is good!  And we are adorable!"

As cute as these are, with their precious little side buckles, I think they were designed for rain, not snow.  My feet are freezing!  But totally worth it...and Danny's going to be so pleased and think that I did all this for him.

My Three Stools - (not poop)

It seems like lately I've required the use of stools much more than any normal person should.  Sure I use one to get to the top shelf in the kitchen when Danny isn't around, but usually that's the only time I need one.  Sometimes I even use one when Danny is around just because he won't get up and help me.  He sees me standing in the kitchen jumping up and down with my arms flailing toward the open cupboard, laughs and says, "use your stool!"  And I say, "What?  Do you think I married you for your looks? Get your tall hiney in here and help me!"  Okay, enough about our kitchen stool drama.

So, here are the other stools that have come into my life recently:

Stool #1: I'm doing a rural rotation in Iola, KS and am staying with my preceptor.  She and her family live in a huge Victorian home that used to be a bed and breakfast, and I am staying in a guest room with a ginormous bed.  When they showed me the room, they pointed out that the bed was likely too tall for me to climb up in all by myself and pointed at the stool in the corner.  Actually, I can get into bed all by myself, but it requires me backing across the room and getting a running start.  Okay, so that's stool #1.

Stool #2: My first day in Iola, I got to help with a c-section.  The nurses saw me standing at the OR table, on my tip-toes trying to catch the action.  They were nice enough to bring me a stool so I could see what was going on...and break the amniotic sack....and hold retractors....and cut sutures...and irrigate.  Because that's what med students are good for dadgumit!

Stool #3:  Last month I did a rotation in the ICU. My last week, I was on nights (6pm - 6am).  My very last night, we were getting ready to intubate a patient when the patient coded unexpectedly.  We went through all of our options trying to bring the patient back....epi, cardioversion, and of course chest compressions.  Chest compressions can be pretty exhausting, so the people who are standing around jump in so one person doesn't have to do compressions for the entire code....which can be over an hour.  When I jumped in, one of the nurses told me to keep my arms straight.  Well, because of certain laws of physics and geometry and the fact that I'm a munchkin, I told him that I couldn't keep them straight.  Enter Stool #3.  Unfortunately our efforts were futile and the patient, who had been talking to us earlier in the evening, died right there in front of me.  And I had "Stayin' Alive" stuck in my head for the next few days. (If you do chest compressions to that beat, you'll stay at 100 compressions per minute - fun fact for the day)

So those are my 3 stools.  Stool #2 will be in my life for the next few weeks as I continue my rotation in Iola.  I'm sure I will see Stool #1 again as well.  Stool #3 can take a flying leap.  I'm tired of patients dying.