Differential Diagnosis Part 2

During my Hematology rotation, I became convinced that I had leukemia, or some other horrible cancer that had metastasized to my bones. My symptoms were: weight loss, night sweats and leg pain.  I had several conversations with my senior resident trying to convince him that I needed a bone marrow biopsy.  He thought I was crazy. 

After analyzing the situation further, it was determined that my symptoms were residency induced.  The leg pain was secondary to being on my feet all day, and being dumb enough to wear heels.  The night sweats were caused by my crazy stress and anxiety.  They got better when Danny started turning the fan on at night.  And the weight loss....well, I guess that's expected when you have no time to eat.

So....I feel better now. And I have all day tomorrow to try to re-gain the weight I've lost.  And my senior resident was right.  

Day Off!

Happy Saturday to you!  This is my fourth day off for the month and I'm enjoying the heck out of it!  I went to bed last night at 9:30 and woke up this morning at 9.  During that time I dreamed that I had another baby....who I delivered all by myself.  And then somehow I ended up in a canoe.  And then a strip club.  Freud would love me.  Last week I had a dream that I could palpate my own pancreas.

Enough about my freaky-weird dreams.  Things at the hospital have been good.  I kinda-sorta feel like I'm getting the hang of things.  For one, I've learned that when I go to the bathroom, I should leave my pager elsewhere.  I've also learned not to pimp the med students.  They seem to know more than me.  But my coat is longer, so neener neener neener. 

Oh, and my journalism degree is finally benefiting me.  I've received several complements from my fellow and my attending on how nicely written my consult notes are.  This really says nothing about how knowledgeable I am about Factor IX deficiency or thrombophilia, but how well I can feverishly scribble down what my attending rattles off and translate that into a note.  It's been suggested that I write better than I speak.  I'm not sure what to make of that.  Maybe I'll stop speaking. 

And of utmost importance.....I finally got PAID!  They don't pay the residents very much.  One of these days I'll calculate the hourly rate.  I anticipate it will be in the neighborhood of $3.00ish/hour.  But regardless of how measly my salary is, and how utterly and hopelessly and hilariously in debt I am, when your family income doubles all of a sudden, you can't help but feel like you're RICH!  I've warned Danny that I might go a little "willy nilly" and take myself on a shopping spree (don't tell Dave Ramsey!).  I told Louisa that we can start shopping at Gap Kids and Janie and Jack.  She didn't seem to care.  At the time of this conversation, she was wearing a yellow and white polka-dot halter top and pink and white stripped terry-cloth shorts....happy as a clam.  Okay, so I won't go too willy nilly with my newly found riches, but at least I can buy myself some new underwear so I won't have to do laundry so often.

Alright, I'm going to get back to my day off.  Have a lovely weekend!

-Dr. B 

Hellooooooooooo

Is anybody out there?  Anybody? 

Just wanted to let you all know that I'm still here.....still alive.....haven't been eaten by the boogie man.

Residency is going pretty well so far.  Everyone has pretty low expectations of the interns which is fantastic.  I'm on the Hematology service, so I see lots of patients with leukemia and lymphoma.  Cancer sucks.  That's what I've learned so far. 

My attending is an old salty fellow who is quite legendary at the hospital.  He commands the attention of everyone in the room and he makes my blood pressure, as well as my anxiety level skyrocket when he shoots me his infamous, squinty-eyed glare.  My co-intern and I, as well as the two med students on the service, have taken several a tongue-lashings from him.  But as much as he tears us down, he tries to build us back up as well.  His tirades usually go something like this:

One breath:  Why didn't you check Mrs. So-and-so's fibrinogen?  That is completely irresponsible!  Is this your patient?  Are YOU managing this patient?  Why don't YOU know the side effects of all of the medications she is on?

The next breath:  I remember what it was like to be an intern.  It's hard.  You don't know whether you're coming or going.  You guys are doing just fine.

The third breath:  Did the patient have pulsus paridoxus?  What?  You don't know?  You didn't check?  This patient might have tamponade and you didn't CHECK FOR PULSUS PARIDOXUS!?!?!?

Next breath:  You guys are doing a fine job.  I think we have a really strong team of residents and students. 

I must say, although I might be developing an ulcer, I really like this attending.  When he's not making us want to pee our pants, he's so darned funny that I forget how scared I am. 

So that's what's been going on with me.  I've been averaging just under 80 hours a week, but when I'm at the hospital, the time seems to fly.  I hardly have time to eat and go to the bathroom.  This might be the best diet plan ever.  And when I finally had time to eat today, I really had no appetite.  Hard to snarf down a quick meal when you can't get the sight and smell of your patient's diarrhea out of your head.  (Thank you, Mr. Patient, for saving that just for me.)