This is what I feel like when I dictate.

Except I am not wearing shorts.

punk

hey andersen,

you got somethin' to say to me, say it to my face.

peanut lover jason

Bad times (sort of) at Baptist High

So things have been great at Baptist the last six weeks with the extended orientation and the river trips and bowling etc. I guess to offset the good times we recently found out that our program just signed an agreement with another surgeon to take interns during our two surgical months. Luckily I am not one of them. Any guesses who? Adam (your favorite buddy)? Rhymes with Ronny Derrano. We tried banding together to get it changed but they are going to leave it as is until they know of any definite problems. Nicole rotates with him next month so we'll see how it goes.

our future is looking bright

the vice chair of the anesthesia department is in our ward and invited us and the family of another lds guy who is a CA-1 for lunch today. the guy has a huge beautiful house. he and his wife give us the grand tour of their huge house. in one of the rooms he has this big terrarium that is hooked up by computers to some weather station in borneo and the terrarium mimics the exact weather conditions of borneo down to even the moon cycle. he had some other expensive hobbies but i was most impressed by his terrarium thingy. i figure if this guy has the money and time to have crap like that then the future must be pretty bright for us once we all finish residency. i can't wait to get my own terrarium. i'll have two, one that mimics the weather of utah and the other mimics the weather of arizona, so that oct-march i can look at my terrarium and be greatful i don't live in utah and june-aug be glad i don't live in arizona.

"Ricki Bobbi"

I thought I would tell you all an amusing story. There is a unit secretary with the first name of Ricki and I have now dubbed her Ricki Bobbi. Let me describe Ricki Bobbi she is a 55 y/o caucasion woman weighing 186 lbs and is 4'10" inches tall. She wears the exact same navy blue skirt everymorning has a lower lip that protrudes just like a chimpanzee. Her hair style borders very close to the female mullet but not as long as the classic mullet. Apparently she has worked here since the civil war and knows more about medicine than Osler.
This tale starts out with my search for a chart, a task I loathe in the morning. After several minutes I find my chart and it is opened up on a desk with a medicine team standing around it like they just finished with chart. So I go over and ask one of my fellow interns if they are done wiht the chart and he responds they are not using it. So I pick up the chart and take it to a quiet corner of the floor and begin my Pulmonary note for the day. About 3 minutes into the note I discover a large disturbance on the floor and I can make out that Ricki Bobbi is upset her lip is out quite further than normal, she is red in the face, and she is wobbling around as quick as possible looking for something. 30 seconds later I see Ricki Bobbi and she is coming straight at me, it takes her only 5 seconds to wobble over and stops 12 inches from me. I respond hello Ricki, where she yells "who's chart do you have?" Mr. So and So I respond, she then says you have stolen that from me what are you thinking. Apparently she had pulled an order sheet off and went to the fax machine to send it off. I told her I had aske the medicine team if they were done and thought they were using the chart. Apparently she did not listen to me because she asked if I thought it was OK to steal things. I said, Ricki if you were using the chart I'm sorry, let me just get my note out and you can have it. After getting my note out Ricki Bobbi snatched the chart and started away when all of sudden she turned around and asked my name, Dr. Glover I told her, I thought she was going to spit in my face. She turns around to leave for the second time without a word then five steps later she spins back around. There is a rule of no eating or drinking in Pt. care areas and one of the nurses had a big Pepsi they were drinking and it was next to me. She shouted IS THAT YOUR PEPSI. I responded Ricki Bobbi that is not my Pepsi, she was beside herself. OK I did not really call her Ricki Bobbi but I was thinking it. I wanted to ask her if she had a son with the name "Walker" or "Texas Ranger".
But Ricki Bobbi spent the next several hours relating this episode to several other of Ricki Bobbi's cohorts because they could visibly detect how unsettled she was, where she responded that she had a something stolen by a new intern.
So Rob the other intern on my team and I have started to give nicknames to some people after I told him of Tarmack, Fake Tarmack, Terminator, and Blackwidow to list a few. So we have Ricki Bobbi and Captian Obvious. Captain Obvious is another intern that is a DO doing radiology at the Cleveland Clinic or just the Clinic as he calls it. Captain Obvious is another story for another day. But come on guys lets hear those nicknames. See ya. My month for Night Float has started and I am on CVICU so I need to go give 15 milimoles of phos????

For the Phoenix Suns fans amongst us

Enjoy this article on how your team got screwed:

http://sports.espn.go.com/espn/page2/story?page=simmons/070722

It's too bad, I would have enjoyed the Jazz beating the Suns instead of getting obliterated by the Spurs.

My first operation

Took a lady with previously debrided labial abscess to the OR to debride the huge extension into her abdomen. The attending let me do the whole case. I got to cut out a piece of tissue 4 cm X 40 cm with the Bovie. Tied off 5 bleeders, and got covered in nasty stuff. I guess I'll never wear those shoes ever again.

Spent all night resuscitating a 92 yo guy with mesenteric ischemia, who spent all of the last month intubated being septic with C. diff. (Our hospital has a lot of C diff., I've seen more in three weeks than in 2 years of med student rotations). He has the worst past medical history I've ever seen, he has had EVERYTHING but a stroke on the ER's PMHx checklist. The family and him wanted everything done. I'm not sure if he went to the OR (there was some thought that he might actually have only had intermittent mesenteric ischemia, long story). I guess I'll find out in the morning.

Just finished a 94 hour week. I'm thru Day 7 of a 12 day stretch without a day off. I guess it's good to be busy, right Jason? Andersen and the boys at Club D wouldn't know what we're talking about. It's good though, I'm learning a lot and I'm involved with a lot of stuff. Way better than being a student standing in the back of the room while my attending blabs on and on.

the light at the end of the tunnel

this last week we had a new attending that actually figured out that i wasn't the only person who could be pimped on rounds, and low and behold, when other people were being pimped other than me i found out i wasn't as dumb as i thought i was. starting tomorrow i'm on call every other day for a week then post call on friday next week and then i get the whole weekend off then just mon and tue and i'm finished with SICU. maybe i'm a little premature but i'm seeing the light at the end of a very dark tunnel. i can't run too fast towards it though since i know the only thing waiting for me is CCU. your secrets out andersen, you wife leaked how easy you've got it on the ladies blog. we should all start calling you in the middle of the night with dumb question so you don't feel left out. hope all is going well with the rest of y'all.

going off the grid

i just wanted to say one last good bye to you all before i go off the grid. we are selling our house and going to buy a trailer and i'll pick up odd jobs here and there for money and we will live like vagabons traveling the u.s.a. this is what i feel like doing every morning after rounds. i cannot wait to get this rotation overwith. with three more months of icu medicine ahead of me plus 4 months of medicine still to do plus still two more weeks of this hell, i'm beginning to think the this year is going to suck bad. i too, damon, am enjoying my first day off today. well i guess today i'm post call so tomorrow is my first real day off. i can't wait to go to bed tonight knowing i don't have to wake up the next morning dreading morning rounds. the last two days are the first days of this rotation that i wasn't completly raked over the coals during rounds and i have to say those were the first times i actually enjoyed this rotation. i hear though that the anesthesia attendings are much kinder in the operating room than they are in the icu so that gives me hope. then i'll get to sit back and laugh at the surgery resident getting yelled at by his attending while he holds retractors for a 5 hour case. those days can't come soon enough. oh well i just had to vent a little. hope you all are as miserable as me. misery loves company!

Finally a day off

Sleeping in until 8am feels pretty good.

I got a really cool case the other night. A guy decided it would be a good idea to kick in a plate glass window. Of course, the window won, and took a big chunk of his calf with it. He completely severed the gastrocnemius, and about 50% of the soleus. Somehow, he managed to avoid any major tendon or arterial damage. I was on solo call the night (backed up by a senior resident who was at home). I got down to the ER, Dopplered his pulses, called my attending, scheduled the emergent case, and operated (assisted of course) on him postcall. I actually felt like a real doctor for once.

The OR staff don't like us much, they requested a meeting with our program director this week. They wanted him to give the nurses a list of which residents could do what in the OR, so the could "supervise the residents in the OR". No joke. We did get in trouble because some of us haven't been wearing our ID into the OR. Anyways, after the meeting a new Surgery PGY-2 they just hired told one of the circulators that they all had the reputation of being a bunch of female dogs. That was really helpful. I learned the hard way at Maryvale: don't pick fights with the nurses.

you know you've had a great night of call when...

you leave with 4 more days than you started with. for some reason the three interns on the SICU service only had 6 days of overnight call the whole month and we had three full weekends off during the month, which was nice because otherwise the post call day when you leave after rounds (leave between 10 am - 11 am) is the only time you have off. well the attending on call on saturday heard the senior resident complaining about it and so he added 4 more days of call to all the interns schedules so now i'm q 3 call this month. i have a stretch later in the month now where i am call every other day for a week with only my post call day in between call days. the one good thing about working hard is maggie mowed the law yesterday. it was looking horrible because i hadn't mowed it in two and a half weeks. i can only imagine what my neigbors thought to see my wife mowing my lawn. oh well, i never talk to them anyways. yesterday i was on call and i had no senior resident in house with me. i was up all night with an admission to the SICU and the other patients trying to tank their blood pressures. i'm doing all this crap for these patients blood pressure with only minimal response but there still doing reasonably well, but i'm sure i wasn't doing an optimal job, and of course when the senior resident comes in in the morning he gets mad at me for trying to kill his patiens (those where his words). i'm thinking what do you expect from an intern. during rounds with the attending he just makes fun of everything i did for the patients during the night. oh well, now i'm home and he's on call. funny story...one of the other interns this month was on call with a senior resident and he was sleeping when the resident get paged. she came and woke him up and says there's a lot of stuff going on on the floor if you want to come help. he must not of wanted to help because he just stayed a sleep for the rest of the night. i wish i had the balls to do something like that.

First Night of Call and First Code

Last night was my first call night since being a resident and I had to cover the medicine service and the peds service. We only had two kids on peds, and there was nothing to do for them, so I spent the night taking care of medicine patients.

We had a guy in CVCU who was bleeding out of his bumhole and was in diastolic HF; his Hgb had dropped a couple of points throughout the day, he'd been scoped, and all they could see were lots of clots and lots of blood. He was hemodynamically stable, but that didn't stop the phone calls. I was told by our attending to consult surgery early on in the evening so they could be involved - but the surgeon was a dink and didn't want to be involved, so whatever.

Anyway, after rounding on the bum bleeder, they called a code blue and I was the first non-nurse to get there. We had a 26 year old girl in respiratory arrest who had just had a seizure. I got to kind of tell people what to do at first and it was cool. I spent a good part of the night getting her transferred to the ICU and consulting the E-intensivist (they have cameras in our ICU for night coverage, where some intensivist in Arizona watches our patients and monitors their vitals).
Had to admit a crazy lady with a rash to the medicine floor and a bunch of other lame stuff for the rest of the night.

All in all I got 40 minutes of sleep all night, not in a row, and by morning I had a headache from no sleep, but it was pretty good. I feel like in my first week of residency I have already learned a lot, and I am really liking it. Hope all the good vibes continue.

- Adam

My first call is in the books

Just got home from my first overnight call. Ann and the kids are gone, and I'm still running on Diet Mt. Dew, so I thought I'd post a little.

All in all, it wasn't that bad. I had two sickies to watch out for last night. On one of them, the guy had DKA that made his belly seem acute, so our service was following him. The guy had a private attending, so the nurse decided that we could handle all his issues since we're in house. It took several pages and conversations to convince her that insulin pumps, regular Accuchecks, and bothering to call the Medicine attending are good ideas when your sugar is 440.

I sort of feel like a third year again. The computer system is pretty hard to navigate, the phones are weird, and it takes twice as long to do basic scutwork as it used to. I only got one hour of sleep last night, but I wasted probably 2-3 hours by being inefficient.

Got my first emergency surgery last night too. A guy going septic after a perfed ulcer got him peritonitis and an ex-lap. Free stay in the Step Down unit included.

All in all, a pretty busy week. I'm also on call Sunday thru Monday @ 6am, so I'll be close to 90 hours this week (and I was off July 4th too). I scrubbed around 12 cases, and have rounded on a lot of patients. It's a lot harder being responsible for 25 patients as an intern, than 3 as a student. But I'm getting a little better at it already. I like doing consults a lot, because they have been good learning experiences so far.

Jason, I get a whole month of Cardiothoracic surgery in December. I's going to be brutal.

my first kill

well not really, his family was withdrawing his care and he died the night i was on call, but my name is on his death certificate. i'm on SICU right now and the SICU is combined with the CTICU so we round with both the ICU attending (an anesthesiologist) and we round on the CT patients with the CT surgeons. I have one of the CT patients and every day that we round i get torn to shreds by the cardiothoracic guys. on the other patients whenever the attending wants to pimp us interns on something he says who should i ask and then always asks me the question. i think he does this because he thinks it's hilarious what the CT guys do and wants to carry it on during his rounds. needless to say i look forward every morning to rounds. the night i was on call i didn't call the attending once and only called the senior resident once to let him know the guy died and the next morning during rounds both the attending and the senior resident are both talking about how horrible call is because you don't get any sleep. i don't know what they were doing all night but it wasn't taking care of the icu patients. i'll have to wait till the end of the week before i know for sure but i'm on my way to 90+ hours this week. only 11 months 3 weeks and 3 days till intern year is over.
-jason

Independence Celebration

Hey,

Just thought I would post a few pictures we took while watching fireworks here in Columbus. We watched these fireworks at Beulah Park with one of the ortho residents' family. This is the home of thoroughbred horse racing in Ohio. It was a pretty cool park. In a couple of weeks there having CountryFest 2007 at this park. One of the performers is Andy Griggs. What?! Yeah, I think Andersen either couldn't take his 40 hours a week doing radiology or he's just prepping for Kentucky. Check it out, it looks just like him! http://www.beulahpark.com/

Anyway here's the pics:The girls couldn't take the noise.

I thought this was kind of cool. I accidentally moved the camera while I took the picture.

Shyler

Great View

We have a good intern class, 12 guys. I clipped about 80 hours last week this will probably be the same. I'm on Neuro surgery right now. Though I have to do cross cover call for general which is the killer. Tonight though I'm expecting a show, my call room over looks the Rockies stadium and they are suppose to have a fireworks show. I better not get any calls "Dr. can the patient use chapstick". Which is what I got the other night. I can see myself transforming into the bitter intern already and it is only my second week. Had to tell a family today that there Dad probably wasn't going to wake up from a subdural hematoma. That was kind of crazy.
Trent

Anesthesiologists mocked me today

They asked me what year I was.

"Intern."

"Only what... 1500 more days to go?... ."

The thing is, I remember being out 8 days on my mission, and it felt like I'd been out forever. So maybe it will be like my mission, where the days are long, but the years fly by.

Today actually was pretty good. I scrubbed 2 cases in the OR, and got to do 90% of a sharp excisional debridement of the nastiest sacral ulcer I've ever seen. WE have a good team, and the hospital is pretty nice. So I guess it could be worse: I could have 1500 more days in a hellhole. That's what I'll keep telling myself...

Can't get away from vaginas

My first day on the OB service was cake...got there at 7am (one hour late, med ed told me 7, but they start at 6) No problem though, they were cool. Finished surgeries at about three, hung out for a couple hours, and went home at five. I can't agree more about the importance of a good nipple exam. Just remember, when doing a breast exam, apply light, medium, and DARK pressure...just remember not to say that if your patient happens to be black like my first one was. Good 'ol AZCOM simulated patients...those poor people.
Rhett

First day on peds

My first day on peds wasn't too bad. I got to the hospital about 6:45, received night report from the on-call resident and it turned out I only had two patients to round on - a peritonsillar abscess and a pneumonia. Dictated one heck of a rough discharge summary on the peritonsillar kid, kept the pneumonia for one more day. Read for about 90 minutes, did chest x-ray rounds with the medicine team and went home about 2:30 PM. Not too bad. All that will change though when I have peds again in November and they're full to the gills. I'd better enjoy it while it lasts.

News from the Bone Guy in Buckeye-land

My day started at 6AM and ended about 6:30PM. So I started at the Children's Hospital in Columbus and I had to do some computer training to get up to speed. There are three different programs alone for this place!


I reduced my first both bone forearm fracture and molded the cast! The patient was a five year old that fell off the monkey bars. The attending gave his approval of my casting technique and the post reduction film didn't look half bad. I was pretty happy with that. Here's the fracture:

Okay, that was Fido's both bone fore-leg fracture...you know the HIPPA thing...but, the one I did looked pretty similar. You can call me OVS V (osteopathic vetrinary student, year 5!) now.

That was only the beginning. We saw a septic hip, supracondylar fracture and more.

I've learned a few things: Don't let kids play on monkey bars, trampolines, ride bikes...or bulls!



Bone guy is out!

Day 1 down, only 1700+ left to go

So my first day is in the books. Pretty standard, arrived at 6 AM and rounded for 2 hours. Hit the OR for a couple of lap chole's. Had to go to breast clinic for 4 hours in the afternoon. (Shyler and Jason will be pleased to know that I got plenty of nipple exams in.)

Tomorrow looks like more of the same.

Ethical Question

Let me know what you think. I rented some books on CD from the library that I wanted to listen too, but my only mobile device to listen to said book is on my ipod. So can I put the book on my ipod listen to the book then erase the book when finished?? Just one of those questions that I wonder about. Shane sorry to hear about the 97 hours thing. I am on Pulmonary this month and the other intern on the service with me is going to U of Pitt for radiology and we have not worked 40 hours yet!

97 hours!!

So I did the math on my first week on wards and it = 97 hours. Took my first call 3 nights ago and worked 36 hours- did not even see the inside of my call room and sat down once for a 5 minute dinner at 3 in the morning. The only thing that keeps me going is knowing that I have only 355 days left before I can start passing gas while surfing the internet. Instead of the never ending pages of cross cover, I will only have to deal with surgeons interrupting my reading on ESPN.com to change from trendelenberg to reverse trendelenberg!

I wish I were like many of you and out of Arizona where it is expected to be 120 this wed and thur. Atleast I don't have to worry about poison ivy in our back yard. Shyler- glad to hear your in buckeye country. Get us some tickets for a game in the shoe this year and I will be on the first plane out of Phoenix. Hope all is good with everyone!!

Not too bad after all

Just a quick report on the first day--started at about 5:30 this morning, and by noon I was wondering, "is this it?" I'm working in the observation unit (the ER substitute for a month of internal medicine). I saw my 5 patients, handed out Percocet and Oxycontin like they were candy (abusing my new power!!), ate a few of the patients' salads and sandwiches before they had a chance to see them (then told the patients they were NPO--I love this doctor stuff!!), then came home around 2. Maybe the rest of the month will go as smoothly (though they promise me that 5 patients in the Observation unit is the lowest they've ever had and that I should expect more like 35, which is capacity). Here's hoping it stays less than 15, at least.

Ken