Tales from the land of Er, the final chapter

Hello, all you out there in cyber-land. A few things.

1) When you see something funky in the ER, chances are it's an uncommon presentation of an common disease rather than a common presentation of an uncommon disease. Like the weird eye thing I saw this morning. But you know how much I don't like eyeballs, so I prefer not to relive the ordeal. But I did learn to use the pokey-eye-pressure-measuring-stick thingie, and that was fun.

2) If the nurse has to get a three-step running start to push your wheelchair down the hall, it's time to make some lifestyle changes.

3) I have developed a new irrational fear after these couple weeks in the ER. The fear of being in a car wreck. I know, it sounds like a reasonable fear on the surface. But it's not the threat of broken limbs... it's the knowledge that rule #1 for any MVA victim is expose, expose, expose. Meaning, they cut off your clothes. This renders them irreparable and unwearable. And I don't own clothes I don't like, so the thought of my favorite silk ruffly blouse and tweed pencil skirt shredded and thrown aside makes me very sad. Maybe I should start changing into scrubs every time I get in the car, just in case.
That is all. Only one more shift, then... time to catch a plane to H-town!

Tales from the land of Er, chapter 3

Last night was not a good night to be a trauma surgeon in Middle Tennessee. I lost count of the car, tractor, and freak gardening incidents (careful with your pitchfork) sometime shortly after dinner. I wasn't in charge of anything, just another blue-gowned and gloved alien, singing back-up in the chorus. Reminded me of med school actually, in a very PTSD from general surgery kinda way.
Then EMS rolled in with a young guy, gunshot wound. The trauma team flies like a NASCAR pit crew - expose the wounds, mark the entry site, IV in, roll him over nothing back here, oh wait that's arterial (lots of cursing), push the paralytics intubate now, xray! beep!, ok let's roll... And he's gone. Upstairs, where in all likelihood after a few hours of yet more intense labor and toil, the surgeons will repair his severed femoral artery. And he'll live. Not because he deserves it more than the guy before or after him, but because the surgeons are good at what they do. Well, that and the fact that God said so.
Watching the spectacle, I couldn't help but appreciate how the scalpel jockies wield that sort of life-saving (or at least altering) power every day. Way too stressful for me. But today, on this Easter morning, I'm reminded that God has that sort of power from eternity past and doesn't ever get stressed out about it. Thank you, Lord, that I don't have to try and save myself because I never could.
Alleluiah, Messiah is risen!

Tales from the land of Er, chapter 2

I saw a lady today who presented with neurologic complaints. Being the superstar resident I am, I did a complete neurologic exam on her. Trust me that this includes testing for temperature sensation, usually done with something cold, like the handle of a reflex hammer. I don't have a reflex hammer. So I tried to find an appropriate substitute. My stethescope? No, that doesn't feel cold. A clipboard or metal bedpan? No, none in sight. Ha! I know.
Me: Does this feel cold on you ankle?
Patient: Aah! Your hands are freezing!

Tales from the land of Er, chapter 1

Today was my first ER shift for my two week rotation, otherwise affectionately known as the Er. Things got a little crazy when I picked up not one but TWO septic (disseminated infection) patients who both earned non-stop tickets to the MICU. This led me to break out into impromptu song while sitting beside a medicine intern also condemned assigned to the ER this week.

Me: (chanting) I got the sepsis, I got the sepsis, I got the sepsis. (now to the tune of "I Shot the Sheriff") I got the sepsissss... Intern! I can't think of any more words!
Intern: (humming, humming) Oh, ok! How about... I got the sepsissss, but I do not have an S-T-D. No, no, no, I got the sepsisss, but I do not have an S-T-D.

The remainder of our lyrics involved references to various body fluids implicated as the source of his sepsis, but I can't exactly remember them right now. Sorry. Good-night, all.

His, mine, and ours

Nick and I have never been good at compromising. Oftentimes, we both want what we want how we want it or nothing at all. So instead of meeting in the middle where neither one is satisfied, we just take turns. Movies, dinner, etc - we alternate whose vote wins. But occasionally the stars align, and we want the same thing. And vacations are no different.

His: The USS Midway
A decommissioned aircraft carrier converted into a museum. This was actually Nick's first time on an aircraft carrier, since he was an airman and not a seaman. Pitiful excuse for a sailor if you ask me.

Hers: The Flower Fields
Several acres of ranunculus blooms, kinda a historical remnant from the life's work of a California botanist. Oh, if only they let you walk out into the fields for pictures. Alas, this is the best we could do.

Ours: The World Famous San Diego Zoo
Yes, that is its actual name. And this was mostly a "hers," but Nick liked it enough that I'm categorizing it as "ours" for posterity. We got some fun pictures, and Nick even walked away with a modified farmer tan - ie, a redneck.

And there, in a high-resolution JPG nutshell, you have our San Diego vacation.

Love in my tummy

So I was going to tell you all about the zoo as the second installment of my San Diego series, but I couldn't think of a sufficiently catchy title. So instead, I'm going to talk about my favorite thing.

Food.

Oh, cyber-friends, I can't even tell you. Nashville is famous for a lot of things, but food isn't one of them. Then you go so long eating at mediocre restaurants that you start to think they're good. Then, a wonderful place like San Diego happens to you. Happy sigh.
Our favorite meal of the trip was dinner at the Indigo Grill. Yelp labelled it "New American." I have no idea what exactly that means, but it was delicioso nonetheless. We started with the brie plate, which was so far beyond the usual cheese and cracker plate that it requires a picture to do it justice.
Panko and sesame crusted brie, honey-roasted garlic, jalapeno jelly, cotija cheese, and mole sauce with creme fraiche swirls. Not to mention the super cool branded tortilla. Thankfully, our waitress warned us that the red pepper in the center of the plate is for garnish and way too hot for actual eating unless you're a fire swallower.



 Dinner was good, too, but check out dessert, a baked Alaska-style concoction with mint ice cream, chocolate cake, and swirled merengue. Not to mention the flaming ramekin of rum to complement the dragon chocolate mini-sculpture. Sorry, the flames don't show up well in photographs.

The same management company also owns a groovy little place called Corvette Diner, which was way fun, 50's diner style. Nick enjoyed his "Elvis" burger; apparently the king really liked peanut butter on his burgers. And my sandwich included a patriotic toothpick flag, which as you can tell by this picture really tickled me.



My last culinary recommendation should you ever find yourself in sunny San Diego is the Oceanaire Room. Hands down, the best seafood I've had. Ever. And the food is fancy with debonair waiters in their little white jackets, but the atmosphere is overall still casual, which befits the vacation mentality quite well.

War stories

My moonlighting shift last night was overall... disappointing. Almost no admissions, and LOTS of cross-cover. It was so painful. So, so painful. But it got me reminiscing about the good ol' days as an intern, when cross-cover was my seemingly permanent lot in life. I have a few doozies - here's one of them. This one is the truth, the whole truth, and nothing but the truth. I kinda feel like I've told it before but can't find it in the archives, so humor me.

It's just after midnight, and I'm typing away at my latest H&P. I've been getting hammered all night about this one guy in particular - definitely an HMP. So I decide to get on the offense rather than play defense all night. I'm gonna pre-emptively write an order for a prn (as needed) sleeping pill to go along with the constipation, pain, and anxiety meds he's already asked for. I open WizOrder. Am-bi-en. Click. 5mg. Click. Qhs prn. Click. Accept. And done. I sit there with a smug little grin on my face, so proud that I'm saving myself a page. Approximately 1 minute later...

Beep, beep, beep.
Me: Morgan [general medicine].
Nurse: Oh, hi. Did you just put that order in for Ambien on Mr. Smith?
Me: Yes.
Nurse: It's so weird. I was just in his room, and he asked me for something for sleep. And then I walked out of his room, and your order was on the printer! How did you know?! I was only in there for a minute!
Long, tension-filled pause.
Nurse: I mean, it was just such perfect timing.
Me: Well, he's needed everything else under the sun tonight.
Another long pause.
Me: Do you need anything else?
Nurse: No, I just wanted to ask you how you knew.
Me: OK. Bye.
Click.

You can't make this stuff up.