How to be a doctor lesson #329

So, from the title you may be wondering why I chose #329 as the number when you have never seen any other lessons on how to be a doctor. Well, it is like personal checks. Who starts at number one, right? Anyway, I am working up at the Huntsman Cancer Hospital right now with cancer patients. Any patients who are going to be staying at the hospital for a few days are all supposed to be prescribed prophylactic anti-coagulation therapy (prescriptions to prevent clotting). When patients are at the hospital, they tend to be lying down a lot increasing their risk of clots. Also, patients with cancer have a hypercoagulable state increasing their risk further for a clot. The risk of this is that these clots can often go to the lungs (as well as other body parts) and kill a part of the tissue and sometimes, if big enough, can cause sudden death. Anyway, now that I have helped you understand the seriousness of it all, I will tell you what I learned. I had noticed that my patient had not been on this prophylaxis and I had written it in my notes for four days, but because rounds were always so rushed, I never mentioned it and just assumed I was wrong. Well, finally last night, I talked to the resident and asked her about it. She checked, and sure enough, this lady was not on anti-coagulation, and she was really concerned and told me that next time I noticed something like that, I needed to let her know immediately. Well, nothing happened to the lady, fortunately, but I learned that I need to trust my instinct, and that when something seems wrong, I need to voice my opinion. Or, a catchier way that Jon put it is, "When in doubt, shout it out!" :-) Anyway, I am glad that I got to learn this lesson without someone dying, and I am glad that I actually knew something. Hooray! Well, that is all for lesson #329. Good night.

Fickle Me

11:06 PM: Helped deliver baby boy. Decided that I want a baby, too!
4:30 AM: Doing rounds on postpartum. Babies crying in every room...maybe I can wait a few more years for kids.

Let's Play Doctor

I was tempted to discontinue this blog with the excuse that I am too busy and tired and have nothing interesting to talk about, but with the coaxing of a friend I have decided to at least keep the blog because I am pretty keen on the title. Plus, today was a great day...so I actually have something to write about! I will keep this entry short and mostly nondescriptive...I did 6 pap smears today! This may not be your idea of fun, but I thoroughly enjoyed it. Along with the pap smears, I did all of the interviewing of the patients. I played doctor all day, and I decided that I think I could get used to this. Yes, I may cry and say I don't know why I went to med school for about a week of the month, but the other 3 weeks I thoroughly enjoy it and the time passes so quickly. So, this may not be your idea of fun, and sometimes it is most certainly not mine, but one thing is for certain...today was a great day!

Breathe in, Breathe out

I am now 4 weeks into my 3rdyear and I think I saw the coolest thing ever on Friday. A woman on our service had a huge tumor in her lung that was taking up about 90% of her lung. So, the cardiothoracic surgeon was called in and she was sent off to surgery. I got a page from my resident asking if I would like to go watch...I practically sprinted through the hospital to meet her. I was so excited! When I got to the surgery, they had already opened up her rib cage on one side and her skin was stretched WAY out and the muscle had been cut between two of her ribs to spread them out. They were in the process of cutting off all of the blood supply to the lung. Then, they proceeded to remove the whole lung. It was amazing! After they removed the lung, I could see the heart beating. I don't think it was until I saw the heart that I realized that this was nothing like a cadaver; this was a real live person that they had just taken a whole lung out of! WOW! Then, they began to stitch her up. I think they had about five layers of stitches they had to do. They started by wiring the ribs back together. Then, they started stitching all of the subcutaneous layers and finally the skin. It was incredible. I think that one other thing that amazed me about this surgery is that someone without one half of their breathing capacity can live just fine. Our bodies are so incredibly resilient!

Well, that was my excitement for the week! I'm sorry I haven't been very good about keeping in touch...life has been a little crazy!