While my GME contract has clear delineations of my job responsibilities as a resident, it is amazing how much additional work we do to survive in the workplace. Back when I was working for the government, nobody breached their job descriptions–there was even a person designated to brew the morning coffee.

In keeping with a concise entry, the following is a list of some tasks I accomplished today. You can decide which ones are reasonable or outright ludicrous:

• Emptied my garbage can into the dumpster: a patient threw a banana peel and apple core in it at 9am–I did not want my exam room to smell like banana the entire day
• Checked my patient’s vision, dilated, them, and filled out a driver’s license renewal form.
• Refused to fill out a disability application for a free Metrocard on an otherwise healthy 33 year-old guy who supposedly had a back injury before he moved to this country. He also had 20/15 acuity.
• Called a primary care physician’s office for records.
• Faxed physical exam requisitions to physician’s office.
• Cleaned the computer keyboard with alcohol swabs.
• Faxed forms to schedule my surgical cases.
• Asked surgical scheduler why he did not fax my surgical cases.
• Spent 2 hrs entering clinic notes on our broken EHR.
• Glared at technician who bypassed my exam lane 3 times while attempting to “find” me to place a patient chart. I was the only physician examining patients in the entire hallway of lanes.
• Called patient to remind her for surgery for tomorrow.
• Performed forced ductions on a STAT 9pm consult in the operating room for someone s/p orbital floor fracture repair. ENT had already closed up the incisions.

medicine work

Some of my holiday obligations to family always include fixing computers, rewiring home outlets, repairing broken fixtures, and plumbing.

Yes, plumbing. Sort of like cath-lab work and stenting vessels, right? Nothing like cataract surgery.

One of the plumbing jobs I encountered this year involved this:

Read more…

misc work

I have always been fascinated by playing card manipulation, partly because there is an analytical component to card games. For the masses,  Hollywood has  been responsible for publicizing card gaming, through Rounders and 21.

However, the appeal of gambling as a profession is attributed to Jon Chang, who spearheaded the MIT card club into a lucrative business. “Lucrative” is certainly not exactly an accurate description of the profession anymore, but much can be gleaned from gaming history nonetheless.

The game of choice at the time was Blackjack, which was simple enough at the time produce a probabilistic advantage to the player. The fundamental premise behind winning in Blackjack is to keep count of which cards have been cycled out, and increase your bet when there is a higher chance of obtaining face cards (table is hot).  Casinos have since implemented strategies to discourage card counting. One frequent finding in casinos is simply shoe recycling. Dealers and pit bosses have much lower thresholds to reshuffling the shoe even after about 50 cards in a 6-deck shoe. In Vegas, the tables with more lenient shuffling policies tend to have a higher minimum bet. Overall, winning in Blackjack consistently is more of a chore. Read more…

misc work

I used to toss sensitive documents in the hospital shredder bin. The bin is usually a locked cabinet that is emptied occasionally by a professional shredding company.

Several weeks ago, I noticed that a few of the hospital maintenance workers were digging around the “locked” bin. Since then, I’ve acquired a cheap-o-shredder for shredding purposes.

What I’ve discovered is that the standard 6-8 page vertical shredders are junk. You can’t aggressively shred anything thicker than 5 pages without jamming the grinder. In addition, the papers shreds could actually be reconstructed without too much difficulty if all the pieces were available.

I guess I have two alternatives:

1. Buy a nicer, cross cutting shredder with larger blade.
2. Burn my documents.

Or shred AND burn them. That would be entertaining and most effective.

misc humor, work

Every year, the Academy of Ophthalmology holds an annual meeting that most ophthalmologists attend. Those that are usually left behind are junior surgeons who end up covering the on-call pager.

I was unfortunate to be covering the primary pager for the hospital this weekend, which is Academy weekend. Generally speaking, this is the worst weekend to have an eye problem, because your primary ophthalmologist is probably out of town in a meeting (or getting drunk). My pager rang early yesterday morning with a long distance callback number. Bad news. When the emergency room or floor resident pages me, I usually receive the hospital extension. A long distance number always means that you’re getting shit that you don’t want to (and should not have to) deal with.

The call turned out to be from one of my attending’s wife. She woke up with an itchy eye and foreign body sensation. Her husband was at the AAO meeting in San Francisco, and she did not wish to bother him with a call. Her son-in-law, daughter, nephews, and nieces were all ophthalmologists at the meeting as well. Her primary ophthalmologist was in town, but she did not wish to bother him either because it was Saturday (Jewish sabbath).

WTF?

I suppose that leaves me, the on-call resident. I offered advice to the best of my abilities over the phone and offered to see her in the emergency room (the one where patients wait 4 hours to be triaged). She politely declined.

Lesson to be learned: if everyone in your family is an ophthalmologist except you, you should go with them to the Academy meeting.

medicine ophthalmology, rant, work