Hotpocket Heroes

Quick update

2011-04-24T16:26:00.000-07:00

T-minus 14 months and counting.

I signed a contract to return to our hometown in Farmington, NM. I'll be doing general surgery/trauma.

We now have 4 kids (Zeke 7, Hallie 5, Rock 2, Bo 4 months). Time sure flies.

If anyone is going to the AOA this year, let me know and we'll hook up. Also, I'm planning a road trip to watch BYU play Ole Miss in football on Sept 3rd.

Hope everyone is doing well. I wish that I did a better job of staying in touch.

where you all going for jobs

2010-11-07T06:31:00.001-08:00

i know at least all you doing anesthesia are in the process of finding a job. where are you interviewing or where have you accepted jobs. no offers yet here. curious about what the rest of you are up to.

Yearbooks

2010-05-15T14:11:00.000-07:00

So did anyone else just get a yearbook from AZCOM? Seems a little late, but I just got mine yesterday. It was fun looking at all the people I have forgotten already. I couldn't remember real names, just "Black Widow," "Tarmac," "Pseudotarmac" etc. Now I know their names. I am a little jealous of those of you who are nearing completion of residency, I still have at least two years if I don't do fellowship. That stinks. Anyone going to end up back in AZ? We are thinking about it.

Going to Idaho

2010-04-26T18:39:00.000-07:00

Hey guys. I know I have never posted on here, but we're wrapping up residency here in Omaha and I have my next Air Force base assignment to Mountain Home air force base about 40 minutes south of Boise. I thought about a few of you who went to residency in Idaho and wondered if you are going to be practicing in Idaho after you are done. Anybody else have any future news.

Austin

Prayers for Kevin and Leslie

2009-05-30T16:19:00.000-07:00

Kevin and Leslie have two beautiful boys Isaac and Austin. Recently Austin suffered a seizure and the exact cause is still pending some testing that is being done. I spoke with Kevin today and asked him if it would be OK if I posted this on the blog. He and Leslie said that would be great.

I also told him that all those Mormon guys he hung out with know how important family is and that we would be more than happy to remember him and his family in our prayers. And if needed rent an RV and drive out to help.

Acutally Kevin and Leslie were able to come to our home on memorial day weekend for what you ask, a Bar-b-que. We grilled steaks and played with Austin, looks and acts just like Kevin. But I blabber on. So Kevin and Leslie please know that you will be in all of our prayers and we will be ready to help if and when needed. Thanks to all.

Housekeeping

2009-02-25T12:44:00.000-08:00

A few quick thoughts:

1. Priceless 360 degree post by Dr. Glover.

2. Looks like I'm going to pursue Vascular Surgery. Love them diabetic feet.

3. I have a lead on a urology spot for any interested individuals. Especially those serving our country in the dangerous battlegrounds of North Dakota.

4. Detroit is a rotting carcass of a city, but pretty fun to train in.

5. Hope Jeremy's hernia is OK. Must be tough falling apart, old man.

6. Ann and I were talking about heading to Hawaii some time next winter (got to moonlight and make some $$$ first). Anyone interested?

7. Also still thinking about going to New Orleans for the BYU/Tulane game this fall.

"360 Evaluations"

2009-02-10T10:14:00.001-08:00

Don't know if anybody is still reading but I noticed last week not much traffic. Anyway you all here would appreciate this story the most.

Just finished our 6 month evalutions. Called 360, meaning you get evaluated from all sides. You know the nursing staff, PACU nurses, Cafeteria workers, cleaning staff, and your attendings. So I am reading through my reviews which I must say were all pretty good. My program director and I are laughing about a few things but no problems. I notice she is holding one last evaluation, she said she wanted to save the best for last. It is from a PACU nurse. Apparently I wronged her a few months ago, when I did not comments on her new pattern for her scub top, or forgot to tell her that her new "crocks" were the bomb. I have a sneaking suspicion that the comments relate to the fact that I do not just give her dilaudid at her request and occasionaly ask such silly things as what the urine output is, what the last hemoglobin was, what is the BP, how much dilaudid has the patient recieved?? You know silly, stupid things like that.

Anyway in her evaluation of me it stated that Dr. Glover is "arrogant" and "belitteling". Her spelling. My program director was laughing and asked if I had a response. I told her to tell the nurse she has'nt seen anything yet. And come June 30, 2011 she would be wise to not be in the PACU because I will proceed to open a can of arrogant, the likes of which she has not seen before.

So you Family Practice guys get to open that can a year earlier. Would you please yell at some old overinflated ego of nurse for me. You know kind of like a shout out to all of us still in the treches. If any others have had the sublime opportunity of 360 evaluations please share. Especially Dr. Caywood and Koth.

Case Presentation

2008-12-03T18:01:00.000-08:00

The setting: MS-2 year, Sahuaro Hall.
Present: MS-2 class, Dr. Finch in a sweet blue Hawaiian button-up shirt and his wavy blonde hair that needed to be cut about six months ago.
Dr. Finch: Ok guys, it's time to do another ICM case. This was submitted to me from a Dr. Jensen in Wray, Colorado. I'll start out by giving you guys some pertinent information, and I want you guys to come up with a differential diagnosis.
CC: "I can't poop"
HPI: 32 year old Mexican male with no past medical history is brought into the ED by his wife and family in moderate distress. He states that he awoke this morning around 2 AM with abdominal pain in his LLQ. It comes and goes, he is unable to describe the character of the pain. It's worse with standing upright, relieved by lying down. He notes that the pain has moved from his LLQ to his RLQ over time. He admits to some rectal bleeding this morning when attempting a bowel movement. He also admits to some nausea, but no vomiting.
PMH: None
PSH: None
Meds: None
Allergies: None
Social: No tobacco, had some drinks at a friend's home last evening.
ROS: No fever, chills, otherwise as above.

Dr. Finch: Okay guys, what is your differential?
Number 2: GI Bleed
Finch: Ok, good
Damon: (says to Jeremy, "That number 2 is a real prude. It's clearly appendicitis.") Appendicitis
Finch: Good Damon, what else can we come up with?
Caywood: How about a butt tumor?
Finch: You mean like an adenocarcinoma?
Caywood: Sure.
Kevin: Tapeworm
Finch: How do you figure a tapeworm into your differential?
Kevin: When I was a cop up in the Northwest I saw a guy with this same presentation who we did a drug bust on and we ended up hauling him in to the ED and he had a tapeworm.
Finch: Okay, if you say so.
(Kevin shakes his head in disgust)
Slice and Dice: What about a diverticulosis or diverticulitis? See, I spent nine years in the OR and I saw this kind of thing all the time. We cut guys open all the time for abdominal pain; maybe he needs surgery.
Jeremy: How about an abnormal skin lesion?
Brizzee: Psoriasis?
Finch: All right, you guys are getting way out in left field here, let's redirect. LLQ pain moving to the RLQ, nausea, comes and goes, what else do you guys want to know?
Trent: It could be a kidney stone or even a testicular torsion.
Finch: True.
Fake Tarmac: How about a Suave deodorant bottle stuck in this guy's rectum?
Finch: How in the crap did you guess that?
Fake Tarmac: Just a feeling I've got.
Finch: Yup, that's right. And here's the x-ray to prove it.

So what's the rest of the story? I went through a 15 minute HPI with this freaking guy on the interpreter phone and finally at the end of it he said, "Last night I went over to a gay friend's house and we had some drinks. I passed out and I think he put something up there."
Ok, so if only he had come into the ED and said, "I think I have a deodorant bottle shoved up my butt" it would have made things a lot easier. Needless to say, the rectal exam revealed a round plastic object high up in the rectum. I tried like the dickens to get the sucker removed, but ended up needing to transfer him so that GI could do the dirty deed.

If anyone really wants to see the x-ray, just email me, not sure if I should post it on the web.

Have you ever met a proctologist? Well, they usually have a very good sense of humor. You meet a proctologist at a party, don't walk away. Plant yourself there, because you will hear the funniest stories you've ever heard. See, no one wants to admit to them that they stuck something up there. Never! It's always an accident. Every proctologist story ends in the same way: "It was a million to one shot, Doc. Million to one."

passes step 3...barely

2008-11-08T20:02:00.000-08:00

i was going to take step 3 a while ago but then i wasn't able to schedule it until recently. i got my score today and could tell by looking at the score that i must have barely passed but didn't realize by how narrow a margin until i read the score report that the minimum passing 2 digit score is a 75 and i got a 78. i would say how glad i am that i can finally forget all my omm but apparently i all ready forgot it. congrats to all of you who seem to be multiplying like crazy. hope residency is going well for you all especially my fellow gas passers. everyday in the OR i am so greatful to not be on the other side of the drapes. are you still out there shane? i think you and i are the only ones left that can go to a restaurant and fit our whole family in one booth.

It's Another Boy

2008-10-20T14:28:00.000-07:00

Rock Thomas Kalcich

Born 10/15/08
20.5 inches
8 lb 8 oz

Delivered via C-section (no OMM required)

Mom and baby at home and doing well.

It's a Boy

2008-10-06T11:15:00.000-07:00

Finally, we will be having a boy to end our family. The only question left is can he swing a golf club?? Early March we are expecting.

Hope everybody is having a tremendous learning experience, and keeping up on the OMM skills. There will be an exam at the end of residency. I will not be using CV4 from now on.

Anyone up for fantasy football?

2008-08-28T14:45:00.001-07:00

Can we get enough people (8-10)?

ED Thoracotomy #2 this week

2008-08-24T17:13:00.000-07:00

So I'm driving in to round on Sunday morning, and I'm about two minutes from the hospital hen my pager lights up: "Code 1 GSW abdomen"

I get to the hospital, cruise down to the trauma bay, and the on call resident is opening the chest. I throw a gown on and help out. We get a weak, thready pulse back. Off to to OR.

On the way, we pass the family in the hallway. They are (understandably) going nuts. We get to the OR, can't identify any bleeding in the thoracic cavity, and decide to open the belly. Blood gushes out (despite our clamped aorta). We lose our pulse. Quickly mobilize the left colon/kidney/spleen, and find a huge aortic injury.

We try and resuscitate/repair, but to no avail. Patient expires.

When my attending tells the mom, she runs out of the hospital and has a seizure. Luckily, she is caught by another family member, or she would have been a trauma consult too, and thus on our service. I feel a little guilty that instead of feeling bad for her, I was happy that she was caught so that I wouldn't have to admit and round on her.

Sometimes, cleaning up the list seems to matter a little too much to me. I'm not sure what that means, but there it is. Anyways, we're 1 for 2 in lifesaving thoracotomies this week.

Things I only saw on bad TV shows

2008-08-19T16:40:00.000-07:00

I used to watch the TV show "ER", and "Trauma: Life in the ER". Nowadays, I really wonder why I wanted to watch a show about work.

Anyways, I got to participate in an ED thoracotomy today (The 3rd one in 6 weeks here). A guy took a sawed off chotgun blast to the leg and back. He had an obviously catastrophic leg injury, but he coded twice during the resuscitation. We had yet to even roll him over to look at his back because we had airway issues and needed a Cordis. Right when we flipped him and noticed holes in his back/neck, he lost vitals, so we cracked his chest.

It was awesome. Did internal compression until his heart started beating again. He had a pulmonary laceration that was bleeding pretty good, so we whip stitched it and ran to the OR. Gave him a wedge resection, tons of blood, and cut off his leg. (And you thought you had a bad day.). First pH in the OR was 6.6.

Good news is, he awake and alert in the SICU. He'll probably get ARDS, but he's alive for now. Pretty freaking awesome day. Then I had to go to stinking clinic, and be the king of Vicodinland for the afternoon. All in all, a good day.

A new title for the blog.

2008-08-13T14:01:00.000-07:00

Because The BackRight was a lame name that came to me when nothing else would, this blog was so titled.

But no longer.

Let it be dedicated to the veterans (and brothers in spirit) of the Conshohocken Convoy, many of whom suffered (and still suffer) from Hotpocket Fever. Symptoms include an irresistible desire to drive over rumblestrips and a craving for red beans and sausage.

It is rumored that brother Jason Caywood still has loose stool from said disease, and brother Shane Taufer might be dead.

Paging "the guy called" Dr. Lohman

2008-08-01T16:55:00.000-07:00

Rhett, I don't know what kind of internet "scheme" you have going, but my wife just got this post on her blog a few days ago:

"Hi Anne, you don't know me, my name is David, I live In Spain where the guy called Rhett Lohman was serving a mission. I have tried to find him for more than 10 years! He was serving in the Santa Cruz branch. I don't know if he remembers me but please, give him my email if you can, I would be eternally grateful.
bubuni08@gmail.com "

Can you please ask "BUBUNIO" to stop emailing my wife!

Thoughts from the ICU, and why Detroit is a scary place

2008-07-27T14:19:00.000-07:00

I've been meaning to type up some stuff about the transition to 2nd year, being at a new program, etc. I'll get to all that stuff in a few days. But today I'm post call, and I had to tell you guys about the amazing volume of trauma I get to see.

Now a lot of people talk about trauma, but they're talking mainly about blunt trauma. Blunt trauma is boring. For a resident, it means chasing labs all night, cajoling radiologists for stat reads on imaging, and waiting for a drunk guy's EtOH to get back to double digits so I can send him home. If blunt trauma goes to the OR it'll be the Ortho or Neurosurgery guys taking them. (You're welcome for the babysitting.) So when people talk about trauma, they usually aren't describing anything cool, but rather just a bunch of tedious (albeit nessecary) work. Nothing for a surgery resident to get excited about.

Penetrating trauma is different, although at most places much more rare. Nothing quite like the rush of going to the OR with an unstable GSW. Don't get me wrong, I'm still a junior resident and don't do much to actually fix the guys. I'm just a small cog in the machine. As an intern, I did the H+P thing, acted as the scribe, did all the erannds and followed up everything. If I did go to the OR, it was as a third set of hands. A few times I did get to break scrub and eyeball a new trauma code while the attending and chief operated. It was a whirlwind of activity, and I was in the middle of it all, even if I was as important as trash blowing in the breeze.

Fastforward to 2nd year. Now I'm in the SICU. I'm barely out of second year, and I'm expected to manage critically ill patients by myself. I usually want to pull a Caywood's dad in my own shorts. But the cool thing is, I'm finding I can handle most stuff. I do have to call the intensivist with big stuff, but 90% of the time I'm running the show. Mananging vents, starting drips, doing procedures, the whole thing.

My first call I had a textbook case of severe hemorrhagic shock, and I was all alone. 18 yo male with GSW to right eye, belly x2, scrotum, and both lower extremities. Systolic out of the OR was in the 70s, refractory to fluids. I admit the patient, start some basic orders and call the attending with the admit, and give him exactly what I've typed here. He says "Sounds good. Get him a subclavian and a CVP at 8 or higher. Good luck."

I was almost constantly at his bedside for 18 hours. He was in shock, sedated, ventilated, the whole deal. But the guy lived. I can honestly say that my post op management saved that guy's life. Not that I'm anything special, any resident could have done it. But I did it. Even though he'll look like a pirate, that kid is alive because I helped him. (Two day later, we were able to extubate him, and amazingly he did really well. He even remembered me from that long night. So I guess he wasn't that sedated. Rarer still, he thanked me!)

This guy was the first of 5 GSWs that I would admit and manage that day. The crazy thing is that this number was not unusual. Being in Detroit provides us with an amazing volume of penetrating trauma (we still get plenty of blunt). The gangs here taunt each other on the streeet by touching their throat and belly simultaneously, as if to say "You're going to need a trach and PEG after we get to you." (We have medically savvy gangs here in Detroit.) We get a lot of patients purposely shot in the neck, and these are celebrated as "wheelchair shots".

I used to think Maryvale was a tough hospital (one time James Matthews and I watched his car get stolen from the 7th floor). But here last night there was a double homicide directly across the street from the hospital. Last week someone attempted to abduct a hospital employee standing outside in broad daylight. Three months ago a guy walked right through security into the ED with a loaded semiautomatic shotgun. He was upset that his grandma died in the ED earlier that week. He raised the gun to fire and it jammed. People started diving out of the way, and security caught up to him and shot him in the ED. A vascular surgeon got carjacked while driving up to the hospital for a case late one night. Crazy, crazy stuff. And it doesn't shock people here at all.

It's definately scary. But I love it. Despite the violence, a lot of the patients are good people. I really like my co-residents. (It's interesting how green we all are, under the same pressures, working together constantly. Sometimes it feels like it's us against the world. You bond with these people in a way that reminds me a lot of being on the mission.)

I am amazed and inspired by the two surgical intensivists I'm working under. Some days I even feel like a doctor, instead of usually feeling like I'm just a poser. I'm absolutely drinking from the firehose and learning tons every day. And then I come home every day to a big party with happy kids and a great wife. Who, despite being pregnant in the humid summertime, still has a pretty great attitude.

(And I'm dang glad I'm not an intern anymore.)

email addresses

2008-07-10T16:17:00.000-07:00

Everyone survive intern year? Glad that is over. I'm sure mine and Jon's wasn't as bad as some of yours. Just glad to be moving on. Hoping everyone can post their current e-mail address. Or if you are afraid of spammers just e-mail at jeremykbingham@gmail.com. I'll put them all together and send them out.

Enjoyed the nursing horror stories. The "look it up yourself" comment was classic Damon. Would have paid to be there.

Be planning ahead for the Backright reunion in Hawaii 2014 (or recreating a 6 day roadtrip to Conshohocken, we'll jury rule it). There will be plenty of advanced notice so everyone can make it.

Jeremy

Small world

2008-06-10T09:41:00.000-07:00

Damon,
I worked with this nurse all year and I just found out that she is from Farmington NM. I asked her if she knew any Kalcich's and she said she knew of them. And then I asked if she knew any Fishburns. She says, I know Ann Fishburn she use to babysit me. Her name is Gentry, I don't know her maiden name. I thought that was pretty cool.

Moving Day is Over

2008-06-06T04:54:00.000-07:00

Just moved us into a home. (We rented for a year while we tried to figure out the Detroit real estate scene).

I am so sore this morning. That's what eleven months of lifting nothing heavier than a Bovie will do for you. But we're in, gotten most of the big stuff put away. The first 48 hours stink, but it's pretty nice now that we're a little more settled. Watching the Lakers/Celtics game was pretty cool.

I am still amazed that half of our stuff is children's toys and clothes. Even my unborn son has more stuff than I do.

Tornado

2008-05-23T13:09:00.000-07:00

We're all okay. One of the tornadoes touched down just two miles from our house, killing a guy who was in his RV. Rachel didn't even know there was a tornado watch/warning in effect when that one came. The big one that destroyed part of Windsor was just 10 miles from us. Pretty crazy. Rach and the boys spent most of the afternoon down in our basement (that's where you're supposed to go when there's a tornado, I didn't learn that until yesterday). I was in clinic when all of this happened and we had to go down to the basement of the clinic with out patients for about 20 minutes or so. But did we cancel clinic? Stop working? Nope. We didn't lose power at our house or anything, so we got off pretty good. Just makes you think about how truly unprepared we really are; we have 72 hr kits, but that's about it -- no supplies of batteries, extra flashlights, supply of water... makes good sense to get some more food storage, I think I'll do that.
So I'm on call today at the hospital and we have another tornado watch, but don't be afraid. We have trained tornado spotters that go up on the roof and watch if we move to full tornado warning status. Sheesh.
Check out some photos from it here: http://www.greeleytribune.com/article/20080523/SPECIAL_MEDIA/4697714 On photo 16, I'm glad the goat was okay.

- Adam

Heads up Adam

2008-05-22T12:32:00.000-07:00

Check out the freak weather in Colorado. Hope you guys are fine.

Life Flashes

2008-05-18T02:38:00.000-07:00

So, Steve and I have had a few shifts together in the ER this month--tonight was another. We were sitting there talking about my hyponatremic seizure pt when all of a sudden we hear, "GSW at the door--NOW!" There was a massive rush to the main entrance of the ER, where a car was waiting with a guy in the back seat. He had a bullet entrance wound in his anterior neck. As we all approached the car to help the guy out, out of nowhere, a second car whips around the corner and screeches to a halt right behind the first car. Out jump 5 very scary-looking guys. Steve backed up to where I was already standing (just inside the entrance to the ER), and we waited for the guns to be pulled and the shots to start out. Visions of the TV series "ER" came to mind as my life flashed before my eyes--no way this was going to turn out well. Luckily, they ended up being our guy's "brothers," there for moral support.
I ended up climbing into the back seat of the car to help carry the pt out and to help get him on a stretcher. Unfortunately, the pt was offering no help (all limbs completely lax) and complained of difficulty breathing (yes, he complained of paralysis and difficulty breathing before we started helping him out). C4 and C5 Fxs. Pretty sad life left for our guy.
Unfortunately, less than 2 minutes later we had another GSW arrive by ambulance and then about 5 minutes after that another GSW arrived by car. We had already had one. My shift was over, so I left right after number 4 got there. Who knows what else came in afterwards--maybe Steve got to see some more?

One of Steve's comments caught my attention

2008-05-04T07:13:00.000-07:00

Steve (or is it katiemama?) mentioned how a couple of interns at his hospital get written up frequently by nurses. It made me wonder what the working conditions there are like. I can't imagine that it's a positive working environment if you are going to get "written up" all the time.

And what's with getting written up anyways? Is that supposed to scare me? It's not like the useless nurse managers have any authority over me anyways. (A note about nurse managers: they are not actual working nurses. They wear business clothes, wear a long white coat, eat in the doctor's lounge, park in the doctor's lot, and do nothing in terms of patient care as far as anyone can tell.)

The vast majority of the time, the nurses treat us okay, and we treat them okay. We all have to work together. It would be tough to do that if we were writing each other up all the time. So I was wondering, do you guys have this issue in your hospitals?

Passed Step 3

2008-04-25T07:57:00.000-07:00

Took 3 days of study of NMS practice questions (about 400 questions), read OMM Review 1 hour the night before, passed w/ a 92. Look out Ohio, I'm getting my license (and moonlighting pays 2 1/2 times what I'm getting now--nice!).

Suns

2008-04-24T19:55:00.000-07:00

Anybody else watching the Suns crash and burn? I was ready to hang myself after game one when Duncan hit that three. To make matters worse the Jazz are doing so well.

Off the hizzle

2008-04-09T13:58:00.000-07:00

Great news, just in time for Conference.

http://www.benderboyz.com/2008/SHOWBIZ/Music/04/01/

My OB/GYN Vacation

2008-04-02T12:25:00.000-07:00

So today is Day #2 of my time on OB. Guess what I did today? Wrote an order for a transvaginal ultrasound. That's it, no notes, no rounding, no sitting in triage. Definitely no deliveries. They occasionally let the off service surgery interns scrub some cases.

It sounds like OB is pretty boring, but I wouldn't have it any other way.

Anyways, internship is 75% over. I have OB, ER, and floor Medicine left. Easy-cheesey. This must be what radiology residents feel like every day.

Is this story about you Dave?

2008-03-17T17:29:00.000-07:00

http://www.foxnews.com/story/0,2933,338295,00.html

Headline reads: Naked man creates havoc in vandalism spree in Pennsylvania

Finally home in the ER

2008-03-09T15:39:00.000-07:00

After 8 long months of trauma, OB, Pediatrics ICU, and other off-service rotations, I finally made it to my new home--the ER. My first month was a full month of nights--20 shifts in 28 days--not too bad. Some of the highlights included 12 intubations (the ER residents are the responders to all calls for intubation help on the floors), 5 central lines, 2 LPs, multiple laceration repairs (I was pretty proud of some of the stuff I got back together), 4 STEMI alerts that went straight to the cath lab, a bunch of CHF exacerbations and SVT arrhythmias, and a few full arrests and trauma arrests (like the gunshot wound to the left chest). Of course, I had a few colds/flus, stubbed toes, and hang nails in there as well. All in all, it was a great month, and I can finally say I'm glad I'm going into emergency medicine. Of course being a resident in the ED is way different than being a medical student in the ED--I'm glad I still like it. Now I've got 4 months in a row in the ED before I have to go back to the floors (with trauma, neurology/neurosurgery, ICU, etc).

cold spoon

2008-03-07T08:18:00.000-08:00

i'm sitting on my couch a few days ago and i for some reason start thinking of the myth of the cold spoon and i realize that since we are all officially doctors and unless one of you has had a different experience than i, i believe the myth of the cold spoon can officially be laid to rest. Man Law?

Update on Step 3?

2008-03-04T16:44:00.000-08:00

I have come out of the woodworks. Life is good but busy as you all know.
I looked back at a few comments about step 3 that some of you wrote. Has anyone taken it yet? when do you plan on doing it? I signed up for the end of April...I'm on "Radi-holiday" that month so I should have some time to study. I plan on using Boards and Wards and maybe Crush Step 3 but I would be willing to go in on USMLE World with somebody if they are doing that. Let me know.

By the way remember never to mix heroin, alcohol, and sawed off shotguns. They don't mix very well. The unfortunate kid that did somehow managed to shoot himself in the buttock, shatter his proximal femur, and nearly miss his man parts as it exited his front anterior thigh. Fortunately for him, he did miss those parts. Unfortunately for the rest of the world, he can still pass on his smart genes to the next generation. Good times doing ortho!

Two items of business

2008-03-02T14:13:00.001-08:00

Two items of business on the agenda. First, the big news: I am not sterile. Initial testing is positive (see the picture), with confirmation expected in October.

Second, I will be changing residency programs. As many of you know, I matched at a place that shut down shortly after the match. I was placed at a new hospital, but it just isn't what I'm looking for. I have accepted an offer to be a PGY-2 at a new osteopathic general surgery program here in Detroit. It's at a large, inner city hospital that has trauma and all that good stuff. The most penetrating trauma in Detroit, which is saying something.

drew daniels

2008-02-11T13:25:00.000-08:00

to shane and andersen and anybody else buying a house in the near future, you guys asked if i had drew's number for the compass bank loan and i just found it. so if you are still interested in using him his number is 512 419 3435

"The Packet"

2008-01-31T06:03:00.000-08:00

Who else got the packet asking for money from midwestern? More importantly who put a copy of their loans in and returned it to Dr. Geoppinger's office? I think this is a task for Jason, you have such tact when it comes to these delicate matters.

Remember this guy from OMM Class?

2008-01-22T17:43:00.000-08:00

And who said surgeons don't have sweet hats?

2008-01-17T19:28:00.000-08:00

Oreopath featured on Monk

2008-01-15T17:35:00.000-08:00

on the new episode of Monk they had this cult leader and his doctor was an "osteopathic surgeon" and was treating this guys back pain. he was treating it with steroid injections though instead of OMM. i guess he was really an oreopath.

"THE TRIP"

2008-01-07T13:55:00.000-08:00

It only gets better with time. There are some guys in the ward that want to go play Bethpage Black, the golf course where the 2002 US Open was held and the site of the 2009 US Open and I volunteered to put the trip together. As I was researching the logistics for the trip, I informed the others we would have to drive about 7 hours after work on a Friday and then sleep out in the car at the course, because the line to get a tee time starts the night before so we can play on Saturday. They did not know if they could sleep in a car for a night. I informed them that I drove from Arizona to Philly and back in 6 days with 12 grown men in an RV. One night in a car is nothing. They were amazed. That trip will not be beaten any time soon, it is something I speak of proudly to others. Well done men.

On a side note I will be running in a half marathon in South Bend, IN on May 31st if anyone else would like to go. The finish line is the Notre Dame football stadium with you running through the "RUDY" tunnel to deafining music. Some guys ran it last year and said it was pretty amazing. Jason please do not ask why I am not running the full marathon, lets just say I hope to finish the half.

Intern is over half over.

Glover

here's funny poem for you all

2008-01-01T08:28:00.001-08:00

i was bored and got onto student doctor and was looking on the osteopathic portion of the site and found this poem. thought you all might get a good laugh from it.

'TWAS THE NIGHT BEFORE CHRISTMAS (The Osteopathic Medical Student Version)Written by SawBones, MS-IV
Twas the night before Christmas, and all through the house.Bones were a'crackin' while I manipulated my spouse.
It appears she was shopping, and this was her plight,Her bags were too heavy, her spine now sidebent left... rotated right.
She entered our house, all stooped and in pain.Screaming, "Thank Goodness you're an osteopath, please fix me again.
"Excited to treat so my skills I could hone,So I led her to our table, that was paid for with loans."
One moment," I said, as I looked at the pile,Of folded laundry that's been atop my table for awhile.
Once clear, I bid her lay atop the black rigid table,For I would now manipulate, (tho' I'm just barely able).
So I moved my hands up and down and back along her spine,"Releasing tension" said I, though I was just buying time...
While trying to recall the proper setup and force,To place her spine back in place where it was once before.
Now was it high velocity or low, low amplitude or high?Oh why, oh why did I sleep through OMM lab, oh why, Oh, why?
Then it occurred to me, the solution I sought.It was a technique so unique that only my school has taught.
I believe the professor, his name may have been Seuss.A funny old lad, with a tall hat and large caboose.
And the technique that he taught and for which he was proud,Was the "Spine-Wackem'-Now-Go-Backem'-WallaBoom-Osteo-POW!"
So I took my poor wife, and wrapped limb over limb.Over limb then once more, and for good measure, once again.
By now she was a pretzel and I more confused,This is the price I have paid, for my skills I have not used.
I put pressure on the sacrum and made a fulcrum somewhere else."Take a deep breath now," said I as I prepared to pounce.
Then I leaped on top of her with a thudding kaboom,I swore I would move SOMETHING and finish this soon!
And to my relief (and surprise), I did heard something crack!But it didn't sound right... oh no, what WAS that?
I imagined my wife's eyes rolling back in her head,Spewing blood from her mouth as her body went dead.
But to my suprise, she was fine and shouted "That's it!"By George, I actually fixed her... Damn, I'm the s**t!!"
It was nothing" I said, full of confidence and pride.Not letting on just how nervous I had been feeling inside.
She arose from the table, and walked across the floor."I feel so great," she said. "I think I'll go shopping some more."
And as she did leave, I did sit in my chair.Pondering what I would do next time, when she asks for my care.
If I don't use my skills, and I become rusty at best,I could kill my own wife, cracking the bones in her chest.
So alas, should I study and then practice and drill?Hell no, I'm a fourth year. Screw that... she can take Advil.

Can you believe we are now officially half way through intern year. hope the second half goes by faster than the first.

Pop goes the weasle

2007-12-13T19:40:00.000-08:00

Karie had a baby. Tell your wives. 12/12/07. We made it to the hospital at 3:00 am the baby was out at 3:30 am. No time for the epidural. It was a girl. Amelia. She was in the NICU for the first few hours for an irregular heart beat. But now all is well. Have a Merry Christmas. I get a week off for Christmas, and then go q2 the next week. It is so worth it though. I plan on a lot of skiing.

Our Christmas Card

2007-12-11T18:16:00.000-08:00

Hello,

Merry Christmas from Pennsylvania. Pittsburgh, PA to be exact. Dave was forced to get a job so here we are. We have been here since June and are having a great time. The girls were excited to start a new adventure. Actually, adventure is a good word to describe our year, and we will just leave it at that.
Elisha is getting the house put together and doing a fantastic job. She is busy being the Mom to our three girls and a cheerleader for me. She is also busy with her calling at church.
Josie started two new things this year. 4th grade and the saxophone. We get concerts all the time, we are so lucky. She is growing up even though we tell her stop. Great at being a big sister and working on her Faith in God award.
Savannah started 1st grade. Also great at being a big sister and loves school. After her first day she came home and said, “It was the best day of her life”. She gets to ride the bus. You cannot ask for anything more.
Kate is now two almost three and still controls our lives. She helps out in Nursery, so the other kids will stop crying, she says it really hurts her ears. If they do not stop crying she will stare at them for a minute and then ask them, “what’s your problem?” We anticipate a degree in Psychology.
We love and miss you all. If you are east of the Mississippi please stop by. We hope you have a Merry Christmas and Happy New Year.

Love,

Dave, Elisha, Josie, Savannah, & Kate
That’s right; I am surrounded by beautiful women.

Intubation vacation, as I like to call it

2007-12-08T21:14:00.001-08:00

After 2 gruelling months of trauma, it's nice to have a change of pace. I call it my intubation vacation, b/c all I have to do is show up in the OR just after the bolus of Diprivan has been given, insert a Mac 3 blade, then watch myself pass the ETT past the vocal cords. At that point, I thank the anesthesiologist and nurse anesthetist, grab a sticker, and walk to the next room. It's a pretty nice rotation--no charting, no assigned call, no rounding, just looking for 80 intubations. I'll echo your comment to me, Caywood, I can see why all you anesthesiologists have chosen your specialty. That being said, I think I would miss the variety offered in the ED, so I'm still glad to be where I am.

Trauma for me was being alone in the hospital with 48 patients on the floor and 13 admissions overnight. My highest admission night was 17. Of course, by sheer numbers, if you have 48 patients on the floor and 13 new ones coming in, you're bound to get a few (okay, a LOT of) floor calls.

Oh, yeah, and since my schedule's a little lighter this month, I signed up for 7 paid/"moonlighting" call shifts--just in time for Christmas. Nothing like working a 26-hour shift and making as much as you did in the past 2 weeks.

my 2 cents about ER

2007-12-04T19:28:00.000-08:00

after completing my ER month i can see how you could want to do emergency medicine ken. so far it was the best month of my intern year. i worked 18 12-hour shifts and was actually home enough for maggie to get sick of me. once i had three days off then worked two night shifts but it was really slow and got sent home before 02:00 both nights and then had 3 more days off, so i actually had 8 days off in a row. now i know how you feel every week andersen. it wasn't nearly as great as anesthesia will be, but i have to say you picked a pretty good specialty ken. this was much better than my month at maricopa. what probably made it so great was nobody really cared how hard i worked so i would carry about 1-3 patients at a time and would go the whole 12 hour shift only seeing about 6 patients total and tried to avoid as much as possible the rectal bleeding or a woman with abdominal pain. off the topic, but have any of you surgery guys realized yet that surgery is not a lifestyle specialty and decided to switch to anesthesia.

Cardinals...no wonder everyone moved from Phoenix

2007-11-25T17:51:00.001-08:00

I'm ticked, just tivoed my may through another disaster after a long 24 hour call. Jason your 49ers had the benefit of a massive implosion by the huddy Cardinals. How do you miss a 32 yard field goal in overtime and then a minute later fumble in your own end zone to lose the game. Because you are the Cardinals.

Weber is back :)

2007-11-19T18:54:00.001-08:00

Hey guys,

It has been very fulfilling to hear of all your horror stories and fun adventures. I heard about some of your plots to get my pager number from Ken Bassett and then page me continously. Nice try. Anyhow, I'm currently doing ER, fixing the drunks of Toledo, and it has been fun passing patient's off to Ken who is on Trauma.

Dave, I just took step 3 Comlex today!! Not a terrible test. And yes Anderson, I did pull out my old path/pharm/micro notes- hey they were helpful in medical school...helpful in residency:)
For the most part, step 3 was just like step 2. 8 hours, 8 blocks, 50 questions each. I took a week off and studied for a total of 2 weeks using Crush and USMLEWORLD. That was plenty of time. Good to have it overwith. Happy Holidays

Somewhere in Detroit, a lady is missing a leg.

2007-11-17T17:59:00.000-08:00

And I'm the one who has it.

Well, I took it anyway. Doing an AKA is fun, keeping the specimen as a trophy is sort of creepy. Forgive me, but I just capped 26 days straight of work with a 37 hour shift.

We started residency interviews this week. Lots of eager, bright eyed 4th years. They can't get here fast enough for me. Almost 39% done with internship.

big career move

2007-11-13T05:51:00.000-08:00

i just got a call from the 49ers head of personel scott mccloughin and he has offered me the starting quarterback spot. he figured, and i agreed, that i could probably throw passes about as off target as alex smith but for a whole lot less money. look me up in a few years when you all need your loans repaid, i've got money to burn now!

2007-11-11T20:03:00.000-08:00

Hey guys,

just thought I'd let everybody know I'm still alive. I have had a similar intern year that everyone has. I was on call my first night of residency, and I finished the 30 hours with the boasting that I neither wet my pants or cried. Although by the end of my first week I was only able to keep my pants dry bragging rights. I am now doing a 2nd year cardiology rotation, and I love being able to spend 3 half days at my family medicine clinic. I have been keeping busy with other things too: I tiled my entryway, I spend all my free time with my wife and kids of course, I am counselor in the EQ, and I faithfully follow the cougars march to repeat MWC champions. Go Cougs!

Austin

p.s. I was shown this funny youtube thing I don't know if I can put the link in but if the link doesn't work then you can look up Regan ER on youtube, and watch Brian Regan Emergency Room parts 1 and 2 and the doctor clip, and any others. I thought they were really funny, my wife and I watched all the clips for one of our date nights.
http://www.youtube.com/watch?v=k9m2FLHlEwA

Glad I'm out of the AZ housing market...

2007-11-08T16:34:00.000-08:00

I checked zillow.com to see what my old house might be worth in AZ nowadays. It's dropped almost $20,000 in 6 months.

Buy low sell high, I guess.

2007-11-08T10:42:00.000-08:00

Dr. Rumblestrip

I talked to John the other day he told me of your brilliant plan to drop out of residency, don't do it its to risky. Although skys-the limit on the upside.

Good Luck

Step 3??

2007-11-06T11:55:00.000-08:00

Anyone taken step 3 yet? If not what do yall hear on difficulty or study time required for normal people or slightly below normal? This is serious, $600.00 serious so lets go to work on getting some good info.

winter wonder land

2007-11-04T15:48:00.000-08:00

While the subject of weather has come up. This was a couple of weeks ago. It has been in the 70's the last few days though, perfect. I'm still in shorts and t-shirts. Ski resorts are starting to open and I can't wait. The moon boots are Karie's I don't own any of my own.

On Call Halloween Night

2007-11-01T12:14:00.000-07:00

I had probably the single busiest call night of my short internship last night. I went to the OR 3 times after 5 pm, managed a huge degloving leg laceration
in the ER, and had it out with a PACU nurse. The call pager went off more than 40 times between 5pm and 11pm (this does not count the Rapid Response pager and my personal pager).

And the beauty of it all is that I'm all call Friday and Sunday too. Q2 rocks.

Supposed to get cold tonight in Detroit

2007-10-28T18:53:00.000-07:00

It will get into the mid 20s tonight, with frost. And I don't yet own a windshield scraper.

Is it hot in Phoenix? Man, I'm going to miss those Arizona winters.

Dave's Great Adventure!

2007-10-24T16:44:00.000-07:00

http://www.myabcadventure.com/index.htm?movieid=C391D732-E1A0-483C-B2BB-FBFC55E28CBA

What can I say I am on medicine this month and have lots of free time!

Sacagawea

2007-10-23T17:34:00.000-07:00

''72 Miami Dolphins or Lewis and Clark?

2007-10-19T17:47:00.000-07:00

Most of you know that I have a brother in law who is a third year at Midwestern. He called last night because several of his classmates have heard that a group of students rv'd to Conshohocken and they are trying to get a group together. He was calling to let me know and figure out the logistics. I gave him Master Messner's website (as straight a shooter as you'll ever find). I am torn a little bit though. What do you think, should we be like the '72 Dolphins and their perfect record and hope that nobody emulates, or like Lewis and Clark, the trailblazers for others to follow?
Either way, The Legend Grows.

This one is for Jeremy!

2007-10-15T17:24:00.000-07:00

GO ROCKIES!!!!!!

What my life in the hospital revolves around...

2007-10-13T05:42:00.000-07:00

Two things:

1. The List
2. Unit clerks

The First and Great Commandment of Internship: keep the list updated. Common things told to any intern at my hospital:

"Take this person off the list."
"Have you printed me a new list?"
"Add this patient to the list."
"Why did you put this on the list?"
"Ummm... I lost my list." (medical student)
"It's time to run the list."

As for unit clerks, never underestimate the power they hold over your daily routine. They control all facets of your life. They control what (if any) orders get carried out.They control when you get to the OR. It's up to them to call you about new consults, which happens usually at shift change. (I can count on my pager blowing up at 5pm and midnight, every night).

Because of this power, they dictate when (or if) I'll get to eat, if I get any sleep on call, if I'll even get out of the hospital on time. Think you're safe when you're at home? Ummm, no. They'll call or page you whenever they need something, because when they need something, it's always urgent. And if you don't jump when they snap their fingers, you will get "written up". Beware the wrath of the unit clerk.

Dave/Shane/Jason "This ones for you"

2007-10-11T19:28:00.000-07:00

http://www.youtube.com/watch?v=xuZl9tRqjoQ

Check out this link

Kevin

The saddest thing I have ever seen.

2007-10-09T14:36:00.000-07:00

Today, I saw the sadest event I have witnessed in my medical career. I am on surgery and was carring one of the trauma pagers. I get a page that comes across saying 16 year old male, hanging. So I go down and as we are getting ready I find out it is one of our ER attendings sons I just finished my ER month and know him well.

So the ER attending was home today and he goes into the garage for some reason and finds his 16 year old son hanging, he grabs something and cuts him down, the paramedics arrive and he opens his sons chest in the field and is doing cardiac massage. The son comes by lifeflight and the attending roles in with the son, flew with him and he has his scrubs on covered in blood. His hands up to his elbows. He gives a quick story of what happened then turns and looks right at me does'nt say a word but I have never seen someones face hurt so bad. To tell you the truth my stomach still hurts. Not because of what the son looked like buy how bad his Dad was hurting.

All of the seniors are throwing lines in getting him ready to go to the OR. He was bleeding everywhere but supposedly still had a pulse. Rushed him to the OR don't think he is going to make it. Thing is the Attending seems like a good guy, by all acounts that could have been anyone of us. I kept thinking what if that was me. I am sure he had no idea. Hang onto those kids guys, its a crazy world.

Just committed my first patient to the nuthouse

2007-10-01T12:47:00.001-07:00

I had clinic this morning and had a well child check no-show, so they put in a lady that thought she was pregnant. Ok, I thought, this will be a real no-brainer. Instead, I got a psychotic, delusional, manic lady who was off her meds. She was absolutely convinced she was 3 weeks pregnant, despite any evidence to the contrary. When I first came into the room she said in a strong English accent, "My, aren't you a tall drink of water." Didn't know what to say to that. She then proceeded to speak a mile a minute and tell me about how the oil fields in the Middle East release toxins into the air and that they have been getting into her brain. That ain't the only thing wrong with her brain. Oh, she also broke into Yiddish and Hebrew complete with the throat-clearing and all. Needless to say, two hours later I had her on a 72 hour hold and unhappily on her way to the ED to get admitted to the psych ward.

2007-10-01T10:35:00.000-07:00

"BackRight"

Just Finished 108 hr week

2007-10-01T07:35:00.000-07:00

From monday Sept 24 to monday Oct. 1 have been in the hospital for 108 hours. I am on General Surgery if have not already firgured that one out. Mon. through Thur. 12 hour days then Friday to Saturday I have a 30 hr call. Come home Saturday sleep and back on Sunday to Monday for the last 30 hrs.

So lets hear it boys who tops that one. Make sure and include the documentation. Oh and this morning as we are rounding with a new attending and I am trying to keep my eyes open I get my @$$ reamed for some other interns poor H&P. This was quite possibly the worst H&P and as I am presenting the patient because that guy got off service today and started something new there is no information. All I knew was that he did not crap for 4 days had abdominal pain and I ordered everything but the kitchen sink up his rectum. But did he go you ask and the answer is YES.

7 months left!

25% Done with Internship

2007-09-29T11:06:00.000-07:00

Absolutely flew by. I did General Surgery, IM, and ICU.

The next leg looks pretty sweet: General Surgery, ER, and Family Practice.

At this point, I can't believe how clueless I was just three months ago. I know I have a ton to learn, but I finally feel like I'm getting into the groove a little bit. It helps that I'm going to a service that I already know (General Surgery). It's hard to maximize the rotation when you spend the 1st week just getting oriented and learning how to get things done.

As for my hospital situation, it's about the same. On the bright side, things are moving along on other fronts. I'll have official news in a few months.

Congrats and best wishes to everyone having babies. Ever thought of trying to mix a girl in there Andersen? If you and the Healey's keep going, you could have 7 Brides for 7 Brothers.

(Did I just reference a crappy musical? I'll turn in my man card on the way out the door.)

For Dinner Tonight

2007-09-23T14:56:00.000-07:00

We're having Zatarains red beans and rice with sausage. Hat tip to Rhett, emeritus president of the Tremendous Twelve.

Had an interesting roomate last night.

2007-09-22T13:25:00.000-07:00

Our call rooms are being renovated right now, so we've been sleeping in patient rooms on a patient floor. Good times had by all.

So last night I was on call, and I went into the room to get a few winks at 2am. I open the door, and there's some guy snoring in the bed next to mine in the Surgery room. He smells like vomit, and snores like a bear (but he was too short to be Jason Caywood). Turns out it was a medicine intern that went to Octoberfest, got really wasted, puked all over himself in somebody's car. His friends dropped him off at the hospital, but he didn't think it was a good idea to drive home. So he bunked with me last night.

When I went to get my stuff at 7am after call signout, he was still in there, now awake, and still drunk. It was pretty funny.

Just a little moaning

2007-09-10T19:26:00.000-07:00

Well, no more moonlighting for me for awhile. I'm about to start a couple months of trauma--a couple months of real work like the rest of you have been doing. Last night's trauma resident had 16 new patients besides the several floor calls. His pager wasn't working, and I swear every 5 minutes I heard him paged overhead. I don't mind the consults/new patients, but I'm kind of stuck in the whole ER mindset and would rather not deal with patients after fixing the initial problem--not a huge fan of rounding, dealing with floor crises, etc. Nothing like being in the middle of one intubation in the ER and hearing your name called stat to the floor for "code blue" for a crashing floor patient. Or there's the middle-of-the-night calls for crazy nakeds needing Haldol or suddenly-unresponsives needing intubated and transferred to ICU (the problem with that one was that we transferred to the neurosurgery ICU, and the neurosurgery intensivist was, well, me--no seniors, attending a million miles away and not answering his phone. I wonder if that's why most places don't let first years moonlight? Luckily, the patient ended up doing all right after a 9-day intubated stay in the ICU.).

Quickly, in other news, last Tuesday I placed an IO at the tibial plateau, did a DPL, performed a pericardiocentesis, did a needle decompression thoracotomy, placed a chest tube, did an open thoracotomy with heart massage, inserted a foley catheter into a hole in the heart and inflated the foley balloon and applied pressure to stop the blood flow from the hole in the heart, did a cricothyroidotomy, and did a lateral canthotomy. Unfortunately, after all of that, the anesthetized pig did not survive. I think it was the high-dose potassium chloride injection that threw the heart into v-fib that finally did the old gal in. We have pig labs every 2 weeks to practice these procedures (only a couple residents at a time). We have to do like 9 during our 3 years here. It was actually very helpful.

When it's good to do family practice

2007-09-09T20:29:00.000-07:00

Sounds like everyone one is doing well. We moved into Caywoods old ward after several houses fell through. Jason, seems pretty good but there are a few crazies, every ward has them I guess. I am doing OB at Joes right now. Wish I spoke Spanish. I have been keeping my eyes open for Shane but that dude is never at work, the IM program seems pretty easy over there. I have been going to elders quorum for the first time in three years and realized why I liked young mens a lot better. Lesson today was on sabbath day. The usual arguments over paying for gas at the pump and using vending machines etc. Some guy went on and on about how if doctors work on Sunday they should pay everything they earned that day to tithing. It is a good thing we only make 8 bucks an hour, in the end though it is going to be costly for some of you. Glad I'm FP, no Sunday work for me.

Guess who I saw

2007-09-08T14:42:00.000-07:00

So today I was at work and I saw Cameron Kessler, Most of you may know him. He is a year a head of us. Played basketball, hung out with the cheating flagfootball team. Anyway, I didn't get a chance to talk to him much. But, he was in San Diego doing IM with the Navy and I guess there were "family things" and that program sucked, so he asked to be transferred here to Colorado. And they let him. That is about all I know right now. I hope those of you in San Diego are doing OK.
Trent

Baby Austin is here!!!!

2007-09-02T20:47:00.000-07:00

Hey All,

I just found the link to the blog and thought I would write a little. Leslie had Austin on the 17th of Aug and all went well. He has been doing good but eats all the time. I have not been getting home very early so I don't get to see him much. I just got off G surgery with an attending with very similar characteristics to that of Dr. Goldberg in my 3rd year. I am very glad to be done with him and his staff. Anyway, now I am on a vascular surgery rotation that is awsome. I have been able to do so much in the CV Lab. I am no longer worried about getting vascular access.

I will put pictures of Austin here when I get them down loaded to this computer.

By for now,

Kevin

Went to Kirtland

2007-09-01T18:35:00.000-07:00

Hey, we went to Kirtland, OH today. It was a pretty cool. The visitor's center was nice but I was disappointed to see how The Community of Christ Church does not care for the temple very well. Either way it was a good time with the family after not seeing them too much last month.

Time to pull a Trent

2007-08-27T19:22:00.001-07:00

Our list had 8 people on it Friday night, and we've gotten it down to one by this afternoon. Our attendings are not on ER call tonight, so we won't get an admit unless one of their clinic patients shows up in the ER. Our last patient on the list is in the inpatient rehab, and is going home in the morning.

I maybe, just might, be able to pull a trent Shelton tomorrow and have a clean slate list. Wish me luck.

In other news, we went fishing tonight for FHE. It was fun, but we didn't catch anything. The 8 year old girl next to us on the pier caught one though. Nothing beats getting shown up by a small child.

You want some of this?

2007-08-27T13:14:00.000-07:00

This is Maggie. Someone wanted a copy of this when it was taken. I don't remember who it was. If you want me to email it to you, let me know. If you changed your mind then, oh well.

Maggie

So much animosity!!

2007-08-24T17:30:00.001-07:00

Ah, yes, the infamous 450 lb Mr. Rectal Bleed himself coming to the ED. He's a cousin of Harry Bunn, isn't he, Caywood? We in the ED know him well and can smell him a mile away. Yes, Dave, it's something that takes some fine tuning to get, but once you've got it, you quickly learn how to pass him off to some poor unsuspecting intern. Suddenly Sue Damonas in the next room needs her arm wound re-examined. Of course, Ralph Salot and Ben Dover are other favorites to pass off.

Sorry no one's having an absolute blast in the ED. I guess I can't say for sure how awesome the ED is here in Toledo (I don't actually get a month there until next February), but lots of interns are considering applying to the program after their month in the ED. We've got a PM&R guy thinking about changing over, and I believe there's an anesthesiologist--gasp--also thinking of switching. Me? I'm looking forward to a month of delivering babies. Gotta catch 12. That's it. 12 an' I'm out. Residency requirements. Sounds like we haven't been very busy lately, so I hope I can get them all early.

DO Scam!!

2007-08-23T19:37:00.000-07:00

So my wife has talking to her old boss this afternoon and catching him up on the latest news of our family including where I will be doing residency. When she told him I was going to mayo he repeatedly asked if I had taken "the test all DO's have to take to get into a MD residency." My wife, knowing there was no such test, nicely tried to explain to this man that he was an idiot and to stop with his ignorance. This guy then went on for about a half hour or so about how he is 100% positive I have to take a test that will "prove to them that I am up to par with MD's" and that"I really know what it takes to be a doctor". He then went on to explain to her that until I take that test, eventhough I am already matched, I will not be able to start residency there. He pleaded with my wife that I look into this and "find out how it really works", so I don't mess up my residency spot there. If any of you have any ideas where I can go and take this test to prove I really am a real doctor please let me know ASAP!!!! I also am leaving this post to help all of you other fake doctors that have matched into a MD program know how it really works. I am so glad my wife ran into him today!!!! I knew I couldn't trust ERAS.

Rectal Bleeding

2007-08-22T15:23:00.001-07:00

I hate rectal bleeding!!!!!!!!!!!!!!!!! I am currently doing my ER month and when the pt. list with presenting problem comes up on the computer and it says RECTAL BLEEDING it is a race to be as busy as possible so you do not have to see that patient. The other senior ER residents are scary good at this. By the time I see it on the screen, it is like a ghost town and I am the lone rectal bleeding checker. Of course the patient is a 450 lb black man with an amputed left leg, due to his uncontrolled diabetes.
When you go into to question the guy and ask if he has hemorroids he does not know what that means and wants to know what kind of surgery it requires to fix. At this point I want to tell him we will remove his rectum so he can never return with the symptom of rectal bleeding and that he will have a colostomy bag which will catch all of his crap for the rest of his life and he will be required to change it himself. How do you like that because how you are feeling right now is about the same way I am with the knowledge that I have to check your RECTUM.
Anesthesia HERE I COME!!!!!!!

Glover is out got to go check a few RECTUMS.

at war with the VA nurses

2007-08-22T09:11:00.000-07:00

i don't know how many of you have VA hospitals at your program or what your va nurses are like but here they suck. the nurses on my floor will be so glad when this month is over because every day i have to get after them for not following my orders and for why none of the lab work i ordered is drawn yet or why the EKG's i ordered at 5 in the morning are not done yet. since everything is on computers including orders i always send the nurses condescending text orders with the order sets that i fill out to let them know i have ordered something and that they will have to stop checking their email and actually follow my orders and get it done by the time i have indicated it to be done by. only two more months during this year then i will be done with the va forever. i'm looking forward to the next 9 months when i will be at the university hospital where the nurses are pretty good. at the conclusion of this rant against va nurses i want to include for your pleasure that i had a patient named harry bunn. what parent in their right mind names a child that.

whoops

2007-08-20T17:18:00.001-07:00

um, this was supposed to go to the girls blog. Sorry, don't know how that happened...at least there wasn't anything to "girly."

2007-08-20T17:15:00.000-07:00

not much

2007-08-20T17:06:00.001-07:00

Well, I am not one with great wisdom or words to comfort, but all I can say is that I feel for both you two, Rachel and Ann Marie. I have actually had a pretty good week but felt a little guilty as I keep looking at the clock and counting down the minutes til I can put the kids to bed. Terrible I know. Trent is on-call tomorrow night but if that doesn't stink already, the on-call guy tonight called and said he is out of town and trent has to cover him. Whatever!!!! Well, I'm ready for winter to hit, not just for the heat but I could deliver right now. Ann marie, what are you having anyway? Also, can everyone post their addresses/contact info? :) Karie

Ups and Downs

2007-08-15T04:29:00.000-07:00

So, after bragging what a great life I have, I got slammed in the face. Friday I went to work at my usual 7:00 a.m.--watched a couple autopsies performed, starting chatting with a dude on toxicology, got paged. I was on "jeapordy call," a privilege 1st years have of picking up shifts when someone calls in sick. I ended up going in to the ED and working until 12:00. Then I had to get up at 3:30 to round on all of the 5 pages of neurosurgery patients before the attending got there at 6:00, then spent the day discharging patients from the neurosurgery list (the doctor didn't round on more than a couple of HIS pts, left the decision up to me if the rest were ready to go home. Me, a first year, no experience in neurosurgery, deciding when people whose brain/spinal cord were just operated on could go home. Scary). The rest of the day and night was filled with more consults like depressed skull fractures in kids, newly found spinal tumors, head bleeds, etc. I got to sleep at about 2:30 a.m. only to get awakened 15 minutes later for another consult--T7-T11 Fx with fragments in the canal. Didn't get any more sleep that night. Unlike others, I had every excuse to NOT go to church, except that I had to teach the lesson in Elder's Quorum. So, that was basically a 52 hour shift with a 4 hour break (11:30 p.m. to 3:30 a.m.) and 20 minutes of sleep. The problem is that most people who hear this story don't have any sympathy for me when they hear I was getting about $1400 for Saturday's woes and long hours.

In other news, the weekend passed, I went to work for about an hour Monday morning, then I went to the zoo with the kids for a couple hours, then back in to work. Yesterday, grand rounds day, we had "EMS day," where we spent the time using "jaws of life" to rip the doors and roofs off a couple cars. Then we used the fire hoses to put out a couple mini-fires, then transferred patients from an ambulance to a helicopter with its rotors spinning (preparation for Life Flight next year), and a couple such things. Then the Toledo SWAT team came out and showed off their stuff and let us shoot a few of their guns--the rubber bullets, gas balls, foam bullets, etc.

Don't worry, it's not always this glorious. I have OB next, then trauma for 2 months. Trauma is one of those you-won't-get-any-sleep-at-all and definitely pushing 80+ hours a week kind of rotations. The dude on trauma the other night had at least 15 pts come in over night, often 3 or 4 at a time.

96.5 hours

2007-08-12T13:22:00.000-07:00

so now I am pissed. I can't believe you are making 8k, Ken! I am definitely jealous, but at the same time happy for you. I just got off a 28 hour shift to cap off a 96.5hour week. I could feel the rage building inside me the last few calls from nurses asking for tylenol for a "fever" of 100.1! My typical day starts at 4:30-5:00 am and ends at around 6:00pm, but I had a couple late nights and just finished weekend call. But I have to admit, I really enjoy cuttin' and sewin'. (not as much cutting yet, only with the bovie, but lots of sewing.) At least next week won't be as bad hours wise. Not many people speak a foreign language around here either, Jason...one of my senior attendings goes to mexico alot and wants me to teach him spanish. our first lesson was the other day in the doctor's lounge...I asked how he was doing and he said "estoy muy caliente" translated as "I'm really horny" (he was trying to say he was really hot) remember kids...the word for "I'm hot" is "Tengo calor." (unless you just got off a 96.5h week...gotta go)
Rhett

Ortho Boys Reunited in Columbus

2007-08-12T08:10:00.000-07:00

Kevin and I had a conference in Columbus this week. It was cool to get together and talk. Every month we have a conference for all of the ortho residents in Ohio so we'll be hanging out a bit. Kevin looked a bit tired after finishing Gen Surg cases at 2 AM the night before. But with the presentation about personality typing even I was snoring. Hopefully it will be better next time.

Kevin wanted to see our house so we went by and checked it out after the conference. They have most of the plumbing in and they are starting on the electrical. It's moving along. Pretty soon we'll have sheet rock gonig in. Then no more of this two bedroom apartment!

Signing out.

Shyler

Greatest call night ever

2007-08-12T04:21:00.000-07:00

I did not discharge all the patients on my service(Gooooo Trent!), but I still had a night for the ages.

My last page was at 9:30 pm, someone need colchicine because "the gout is comin' on". After that page: nothing. I went to bed at 11:00pm, woke up at 3:00am to make sure the pager was working (paged myself). Went back to sleep, woke up fresh as a daisy at 7:00am.

The only downside: since I slept so much, I don't have an excuse to skip church.

ForePay

2007-08-08T17:43:00.000-07:00

By the time you finish reading this, some of you may wish you had done emergency here with me instead of your chosen specialties. We have Grand Rounds 1 time a week (Tuesday, for 6 hours). Last week was a particularly gruelling day of . . . golf. Anytime there's a 5th Tuesday in a month, the residency program pays for a fun activity such as golf, paint ball, etc, and that's the lecture series for the week. We got 18 holes, golf clubs, carts, etc, all covered. I hate to admit, it was my first time ever golfing, so you can guess how well I did, but by the end of the day, I actually hit a ball further than 20 yards.

Right now I'm on call for neurosurgery and neurology. Let me show you a picture of how things are going (taken with my new laptop that my program purchased for me):

Granted, last week was a little busier by this time--3 headbleeds (Subarachnoid, subdural, hemorrhagic midbrain), one T8-transsecting gunshot wound, and 2 stroke pts, but I still can't complain too much, especially after hearing some of your stories. So far, knock on wood, nothing today, though I am expecting a Cauda Equina in a few. Oh, yeah, did I mention that this is MOONLIGHTING for me? I'll make somewhere around $600 tonight--my second night of call ever--and hopefully I'll get to sleep for most of it. This Saturday is Shelly's birthday, but she gave me the go-ahead to pick up an extra moonlighting shift and then use some of that money for an even better gift. The Saturday shift, 24 hours, will bring in somehwere around $1400. Not too bad, eh? All told, I should bring in around $8000 this month. Oh, yeah, and my regular schedule is ultrasound for the month. I go in for a couple hours, do a few ultrasounds, then go home for lunch with the kids. After that, sometimes I go back in, sometimes I take the rest of the day off.

Well, that's about it. And "ForePay" (NOT ForePLay--I know you had to read it twice!), fore is for golf, pay is for moonlighting, but I'm sure you've all figured that out by now.

DID IT!

2007-08-07T19:39:00.000-07:00

0 pt's for 8 hours. booya grandma.
Trent

banking with drew

2007-08-06T17:19:00.000-07:00

is everybody else that used drew for their mortgage getting their statements on a postcard instead of the more traditional paper statement with an envelope to return their payment in? and as an aside i just realized today that i have never had a pt while here in georgia nor seen any other resident with a pt that did not speak english. i love georgia.

It was the best of times, it was the worst of times...

2007-08-04T11:10:00.001-07:00

July flew by, and I ended up having a good time on General Surgery. Now I'm on Internal Medicine. The attendings are really nice, but rounding for 5 hours... I could do without that. We have some crazy medical students too. One of them takes notes on whatever the interns say. Here I am, a glorified student, and some 3rd year transcribes my every word. Very amusing.

In other news, my program director resigned (or was actually fired, depending on who you talk to). We'll have more news that we can share in the coming months.

Records

2007-08-04T10:32:00.000-07:00

So I'm going for a new record, it has never been done before by an intern. I'm on call this weekend and I am trying to get all my pt's discharged from my service. I'm down to two left and I'm trying to pawn them off to medicine. If I can do this I will be put in the intern hall of fame. GOOOOOOOOO Trent

2007-08-02T18:45:00.000-07:00

This is what I feel like when I dictate.

2007-07-31T19:50:00.000-07:00

Except I am not wearing shorts.

punk

2007-07-31T15:19:00.000-07:00

hey andersen,

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

peanut lover jason

Bad times (sort of) at Baptist High

2007-07-29T15:06:00.000-07:00

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

2007-07-28T20:19:00.000-07:00

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"

2007-07-23T14:13:00.000-07:00

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

2007-07-22T14:30:00.000-07:00

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

2007-07-22T13:57:00.000-07:00

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

2007-07-19T13:37:00.000-07:00

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.