A friend of mine introduced me to Intern, a recount of a cardiologist’s experience during medical internship. The author, Sandeep Jauhar, trained at New York Hospital–it is now known as NYP-Cornell. While internship is difficult regardless of where you train, his book details many of the experiences that still have gone unfettered by social reform, at least in NYC hospitals. Certainly, the unionized nursing staff in the city makes even basic morning labs and vitals a chore for the house staff, even to this day.

From what I saw as a student in the ivory towers, overnight cross coverage still remains harrowing, with an incessant onslaught of pages, difficult patients, and codes. What this experience amounts to is not only a learned resident, but a tome of unfathomable tales that you’d otherwise imagine only to be fabricated.

On one occasion in his book, Dr. Jauhar describes performing a paracentesis on an ascitic patient. He instructs the patient, with tubing in his peritoneum draining the fluid, to remain still while he checks on another patient outside. When Dr. Jauhar returns, bodily fluid covers the floor. When asked to explain why he moved, the patient stated that someone walked into his room and seized, knocking all of the ascitic fluid bottles over.  Frighteningly enough, that actually happened.

I had cared for an elderly gentleman (86-yr old) when I was a 3rd year medical student. He was bawdy and demented; on several occasions he would ambulate around pantless, and void in the hallways as if he were hoping that someone would slip on his urine.  His behavior was probably not entirely due to age; his brain was ravaged by neurosyphilis. One evening I saw him with a bruised forehead and ecchymotic eye. Had he fallen despite having a sitter? No, it turned out the sitter had punched my patient. I had a helluva time explaining that to my attending in the morning.

I’m relieved that I escaped from the city for internship. At times, however, I wonder whether this rite of passage would have made me a better doctor. It sure would have added to my list of stories I could reminisce over with friends at the bar.  Regardless, I’ll be back soon enough.

medicine medicine

I try to use generic-branded items as much as possible, for cost reasons. Most of the time the difference in quality is imperceptible; I certainly can’t identify a difference between Price Chopper and Morton salt. In some cases, the generic and the branded items come from the same manufacturing facility, like Jif and Great Value (Wal-Mart) peanut butter–they both came from the same facility in Georgia that was infested with Salmonella.

There is, however, a surprising difference in other products. I purchased a roll of “Ranch Wagon” clear plastic wrap on discount for $1. Saran wrap costs close to $4 for 100-ft, so I figured that it would be a huge savings. Wrong.  The trade-off comes in the form of pain and frustration every time I use it. You’d think all clear wrap were made to be equal, but this is not true. “Ranch Wagon” plastic wrap has amazing clingy properties only to itself–the moment it touches itself you will never be able to untangle the mess. It does not cling to anything else (bowls, silverware…etc), which makes it utterly useless for its intended purpose.

Saran wrap is constructed from low density polyethylene, usually laced with a lighter polymer to add some extra cling. I suppose the generic stuff doesn’t have the additional touch.  Lesson learned: never again will I buy generic plastic wrap.  I wonder if generic aluminum foil is comparable to Reynolds aluminum foil wrap…stay tuned.

misc food

In the spirit of The Office, I considered replicating Michael’s attempt to impress a personalized contribution to society by dunking my face in the newly minted black-top (It was still steaming) in the hospital parking lot.  The thought was short-lived, however; somehow I doubted that fresh black-top is as malleable as wet cement. Nonetheless, it would have been more enjoyable than performing medical research, with comparable results.

medicine humor

As part of my internship requirements, I work in the emergency room triaging patients. The shifts range from 10-12hrs apiece, and it’s surprisingly tolerable. Since I am not an EM categorical resident, I don’t have to triage the trauma patients. That leaves a medley of typical ED presentations along with some less common issues. These include COPD exacerbations, pneumonias, GI bleeders, HIVers, and obstipations. The best part about the ED is that all I have to do is determine whether a patient needs to be admitted or sent home. At the end of the shift, I sign out any pending labs and issues to the next resident, and I leave. No more worries. Since there are always patients waiting to be seen, the shift doesn’t drag along.

The attendings also seem content with their work–several of them noted that the best part of their job is that they rarely exceed 50, even 40 hrs a week! That leaves adequate time outside of the hospital to stay sane. Not bad.

medicine work

Recently I have been bombarded by automated voicemail messages from assorted vendors attempting to hawk their services. I’ve realized that they all revolve around selling an abstract service, such as car insurance, health insurance, or theft insurance. Surprisingly, I never received any of this spam prior to signing up for web hosting on GoDaddy. The chronological correlation was disturbingly clear; I started receiving random automated calls on my phone about 12 hours after I purchased a domain from them. I had explicitly indicated on my subscription application that I did not want to be contacted by vendors. I haven’t given out my telephone to any other service since then either.

It’s frustrating, because I have been unable to link GoDaddy with spam vendors, although I have read some forums with similar complaints. I guess they need to supplement their $1.19 yearly domain registration charges with other means.

computing tech