Target rich environment

So, after years of dating misfortune, and after giving up on romance for the time, all of a sudden, I'm presented with the strangest situation. There are women who are interested in me. It makes no sense whatsoever. I mean, WTF?

One girl actually mentioned the words "I'm single" "I wish I wasn't" "Are you single?" and "It'd be nice if we weren't single" all within the span of a 3 minute conversation. The other girls were a little more tactful.

And I know, I know, I can see the irate e-mails from friends coming already. Why aren't I doing anything about this? I wish I had an excuse. I really don't. I just have a lot of stuff on my plate right now, and I just couldn't bring myself to follow through. Y'know, they're not my type. Or some other excuse. Do you have a good excuse I can use?

Screw you

When you're a resident, you discover the myriad ways that one person can screw another. And you might imagine that having a bad intern would be the worst possible fate, or maybe as an intern having a bad senior resident would be tops. Now, having a bad intern can generate a lot of extra work, but there is no screwjob worse than what one senior resident can do to another.

This extends to both same service or consults or transfers of care, or best yet the ER. In all circumstances, the worst that can happen is always the same: one senior resident screws another one over.

I've been called to the ER to admit patients who don't even have charts yet, or labs, or even an x-ray. I've been called to admit a patient for observation for chest pain without an EKG having been done. I've had fellow medicine residents hang onto pending admissions until I took over the admission pager, leaving me with the new admission.

And worst of all, I've had residents lie to me about a patient's condition. That's by far the most common and most horrifying reality of the incompetence of some senior residents. For your benefit, some examples.

"Oh, her blood pressure was low, but it responded well to fluids. She's stable now." The patient was in florid neutropenic sepsis, and expired about 6 hours after this statement.

"His last cardiac cath, they didn't need to do any stenting, so he looks pretty okay." They didn't stent because he had triple vessel AND left main disease. He was a cardiac cripple.

"His last admission BP was low as well, so it looks like this is normal for him." So normal in fact that the last admission they addressed that blood pressure with dopamine and levophed.

But by far, the thing that gets me angry the most isn't this gross malpractice that I've described, but it's laziness. That's what bugs me. I've had people dump tons of work on me, couched in the noblest of excuses: "My son has to go to the doctor's today" "I have a meeting I have to go to"

Boo fucking hoo. More than once, I've had someone dump work on me so that they could leave the hospital for something, and as a result, I had to spend extra time in the hospital cleaning up their mess. And some people would flatly refuse. But I say bring it on, because if I meet someone who is so lazy that they are willing to dump their work on me, then I'd rather do it then let them ever take care of one of my patients ever again. I have literally carted people out of the ER and straight up to the ICU without a thorough evaluation because the care they had received was so atrocious that even blind, I could do a better job.

My feeling is that one person's laziness doesn't excuse me from providing poor care, so I will always pick up the slack. And it's a small price to pay to find out what doctors aren't worthy of my trust or my time.

No good can come of it

I wish I knew what it was like to deliver good news. I wish that I knew what it was like to tell someone, "It's a boy!" or something good. All my news is bad. Even my good news is really just neutral. It's stuff like, "You didn't have a heart attack!" It's never very pleasant.

I saw an orthopedic surgeon once, and he encapsulated our experience very well: "I'm a nice guy, but you don't ever want to meet me." That pretty much describes my day. I'm damn good at what I do, but if you're seeing me, no good can come of it, only getting back to neutral.

And it only takes one day of telling some lady her husband is dead, telling a family their loved one is terminal, telling a husband that his wife had a massive MI, and I realized today that if I was a patient, I wouldn't want to talk to me, because what good can come of it?

It's been a while

"Hello, my name is Dr. I Finding. I was part of the code team called to see your husband. When I arrived at his room, he had been found unresponsive without a pulse. We put a monitor on him and we saw that his heart was in a dangerous rhythm, so we shocked him several times to get him out of it, but instead, it got worse. We gave him high doses of emergency medications to try to jump start his heart, but he did not respond to any of these.

"We also put a breathing tube down his throat to help him breathe, and we did CPR to pump his heart for him, and briefly, his heart was beating on its own, but it quickly gave out and we had to go back to CPR.

"Finally, we tried all the medications that we could, and all the other measures at our disposal, but we could not get his heart beating again, and he expired. We did everything we could. I'm so sorry for your loss."

I tell you, there is no worse feeling than telling some poor woman that the love of her life is dead. And even worse when she thanks you for it.

Wal Mart

Wal Mart, uploaded by Wearn.

So, it's finally happened. I went to Wal Mart. I bought things. I felt dirty afterwards, like I'd pissed all over the flag. I needed to take a shower. It felt yucky.

I really do believe that Wal Mart represents everything bad about America. It is the dominance of corporations and the homogenizing of the country, and reducing pay scales to "greeter" or "stocker" or "cashier."

But where else can you find notebooks for 10 cents and Spam for $1.50? What a cruel world.


Recently, I stumbled upon Save the Internet, a grass roots campaign to push for net neutrality. Net neutrality is an effort to prevent telecom companies from creating a tiered system where their data is routed faster, while other people's data takes the scenic route. It'd be as if only 18 wheelers were allowed in the interstates, and everyone else has to take surface roads.

It's shit like this that made me forsake the Republican Party. Please make your opinion known to your senator and stop the telecom companies from taking over the internet.

Okay, no more political stuff for a long time, I promise.

Teach nothing

I really love teaching. It's such a joy to participate in the education of others. It's so precious that at the same time you teach, you can't help but learn as well.

But then, sometimes you make an ass of yourself, like when you can't remember the diagnostic test for Goodpasture's Disease, or you miss the Q waves in the EKG. Doh.

Don't stop believin'

I was in the hospital the other day, and I heard a song on the radio. Don't you hate when you hear something on the radio, and it sticks in your mind? Then you have some random song stuck in your head and it slowly eats your soul.

There are some songs that are SO BAD about getting stuck in your head, and then you find yourself humming it at the nurses station in the afternoon, and one of the nurses looks at you funny and asks, "Are you humming 'It's Raining Men'?" and realizing that yes, indeed you were.

So for your own interest, here are the songs that always get me.
Journey - Don't Stop Believin'
Geri Halliwell's version of 'It's Raining Men'
Culture Club - Karma Chameleon
Backstreet Boys - As Long as You Love Me
Cardigans - Lovefool
Rick Springfield - Jessie's Girl
Total Eclipse of the Heart
Soft Cell's version of Tainted Love
Moody Blues - Wildest Dreams
When in Rome - The Promise
Alphaville - Forever Young
Peter Cetera - Glory of Love
Lou Bega - Mambo #5
Kelly Clarkson - Since U Been Gone
Guns and Roses - Sweet Child of Mine
Rihanna - SOS
N Sync - Tearing up my heart