28 -- eternal medicine

I start this hallowed rotation in the morning hour.

I did well here as a student, and I am looking forward to being on night call for three weeks straight.

I'm not really joking: this likely means no rounding with attendings and having a regular (not normal) schedule.

I have already gotten ~10 pages today, and I don't start 'till tomorrow.

I got paged while getting my pre-rotation haircut.

[Thick southern accents throughout]

Me: "This is Dr. S------, I'm returning a page."

Random Phonecall taker: "DR. SANLESIA -- anyone page DR.SANDLEGE?!!!

'just a minute'

Nurse: "Dr. S-------, are you taking care of Ms. Jonston?"

Me: "No."

Nurse: [speaking hurriedly] "Well she needs a consent . . . . . . ."

Me: [interrupting] "I am not on service as of yet."

Murse: ". . . Oh (pause)

--click--

Me: Continues generic conversation with barber.

just a dude 

27 -- last day of month #2

I am now 1/18 of the way through residency. I am having a blast.

mississippi river

26 -- preparing for takeoff

Time is ticking down . . .

Tomorrow is my pre-employment health screening (aka drug test).

Thursday and Friday I take the PALS (Pediatric Advanced Life Support) course.

Monday is the beginning of orientation.

And next Friday is my first shift. In the ER. Am I terrified? Well, I've been drinkin', so ask me tomorrow.

I requested nothing for my year's schedule, and got EM for the first rotation. Although this is my chosen field, and I feel most at home in the ER, I would rather have had internal medicine (or something, anesthesia maybe) first. It just takes time to get used to a new hospital, and I would rather have some time to get used to the forms, protocols, patient population, hospital layout, etc. I just don't want the people that I will be working with for the next 3 years (possibly longer) to think that I am an idiot.

Oh, and if you're thinking of going to the hospital, I would wait a few months . . .

25 -- my own personal hell

Scientologists
Circle I Limbo

Jennifer Wilbanks, and her fiance
Circle II Whirling in a Dark & Stormy Wind

Imus
Circle III Mud, Rain, Cold, Hail & Snow

People who talk on cell phones in the movie theatre
Circle IV Rolling Weights

Smokers
Circle V Stuck in Mud, Mangled

River Styx

Slow drivers in the fast lane
Circle VI Buried for Eternity

River Phlegyas

Lazy people
Circle VII Burning Sands

John Edwards
Circle IIX Immersed in Excrement

Osama bin Laden
Circle IX Frozen in Ice

Design your own hell

24 -- new home

We are currently moving into our new apartment. It is so much nicer than my old one, and the city and its people seem to be much more amiable as well. I start my residency on July 1, so stay tuned to find out how it goes. I am really excited . . .

23 -- i am tired

Just finished call in the ICU. I really have a great team this month. I am loving critical care; could there be a fellowship in my future?

Well, gotta sleep. We change attendings tomorrow - we are getting one of the smartest and most likeable docs in town. I'll talk at'cha later.

22 -- don't leave me now

Sorry for the paucity of posting. I am currently trying to buy a house, study for the Step II CS, apply for my residency training license, help organize my wedding, and enjoy my last days of freedom. People say 4th year is the easiest. Relax, enjoy yourself. Yeah . . .

I finished Rads last week. What a waste of a rotation. Oh well, I guess it is a good vacation from real work. I start my junior internship in critical care on April 5. I'll let you know how it goes.

21 -- emergency radiology site

Harris and Harris Emergency Radiology Primer - check it out.

20 -- link to a journal club site

Check out this JournalClub blog.

19 -- mini poll results

A 67 year-old white female is complaining of right-sided headache. She first noticed the pain while combing her hair. Review of systems is positive for general malaise. On exam, her scalp is tender to palpation.

Correct Answer: She needs prednisone, biopsy, and maybe opthalmology consult.

Explanation: This patient has features of Temporal (Giant Cell) Arteritis. This vasculitis has a female predominance and is rare before 50 years old. Non-specific, systemic symptoms are common. Headache and scalp tenderness are characteristic. Jaw claudication (pain with chewing) is also suggestive. If treatment is delayed, permanent vision loss on the affected side can result. The erythrocyte sedimentation rate is usually high. Treatment includes prednisone given as soon as this diagnosis is suspected. Obtain biopsy of the temporal artery within 2-3 days.

Look for the new clinical case mini poll in the near future.