Doctor Psychobabble

It’s official. My one month of inpatient internal medicine has come to an end.

I am a changed person.

Even my attending told me during my evaluation session today that it has been one hell of a month.

I will definitely never be the same.

Tomorrow, I start a new month of inpatient neurology.

Lots of asking my patients to “puff out their cheeks.” (Test of cranial nerve function.)

I am unbearably tired.

I did not eat today.

I did learn a hell of a lot during this past month of insanity.

But strangely, it was not really all about medicine, per se.

Mostly I just learned how to be a doctor.

How to answer pages. How to interact with nurses, techs, and social workers. How to talk to patients’ families.

Speaking of, I have so much to say about that.

Why are doctors so scared of telling patients and families about their diagnosis until it is “confirmed?”

A patient’s wife thanked me today for being upfront and telling her that her husband may have metastatic cancer. No, it wasn’t definite. But it was highly probable. And she needed to know. She really did.

So much to say on this topic. I mean, so much. But too tired right now.

It’s bed time for me.

Rinse.

Repeat.

Photo: Taken outside the hospital this morning.

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my thoughts about thinking. I think you will enjoy.

Click Here to View the Original Post on Medscape

“My mind’s such a sweet thing
I wanna do everything
What a beautiful feeling
Crimson and clover
Over and over”
- Tommy James and the Shondells, “Crimson and Clover”

It’s Saturday evening. As always, I am post working at the hospital and tired beyond comprehension.

I didn’t eat today.

I know, I know. Stuff bars into my pockets. Cram food into my mouth when no one is looking.

It all sounds so simple in theory.

But the reality is that my pockets are already overflowing with test tubes and alcohol swabs and lots of other random things.

No room for food.

And people are always looking.

More Random thoughts:

I do like my job. Being a doctor is actually pretty cool. But it is more discombobulating and strange than I can explain at the moment.

The “chute” system in my hospital was down for a day. This meant running all over the hospital delivering labs on foot. I didn’t even know there was a “P” building.

The microbiology lab is pretty cool.

Showing up to the lab with my furry hat on and a vial full of blood saying, “I need you to run this for parvo antibodies” is strange.

Only slept for 3 hours last night.

It’s snowing outside.

Again.

I really need to do laundry.

And dishes.

I have a good “psych-dar.”

Okay, thoughts are defragmenting.

Big time.

Going to eat now. And then sleep. And then do it again tomorrow.

Crimson and clover.

Now I don’t hardly know her.

But I think I could love her.

Over and over.

Photo: The contents of my white coat pockets. This is the slimmed down version.

“It’s a conniption, fit from the microphones flit
I take it higher like a bird on a wire, retire the fire
I never cause I’m just moving on up
Choosin’ to touch, the unseen, craving the clutch
The most inevitable, legible pyro-mania
Slaying the devil, and sendin em back to Transylvania
Strangely enough, I evolved that side of the ghetto
but my heavy metal, will settle the puppets like Gepetto
Damm, if mirrors were created by sand
then I’m looking in the water for reflections of man
Understand the minds above time when it’s empty
Emcee, Tragically Hip – Ahead by a Century
No time to get down cause I’m moving up
No time to get down cause I’m moving up
No time to get down cause I’m moving up
Ahh, haa… check out the crabs in the bucket”

- K-OS “Crabbuckit”

I’m so tired right now, it’s really not even funny. Lyrics above are from my new favorite walk to the hospital song.

So many thoughts rumbling around my brain right now.

I was on call today and worked for about 16 hours.

I’m starting to get the hang of this whole inpatient medicine thang. But now I only have 3 more days left.

Will sleep for a few hours tonight.

I drew a lot of blood today. I called a lot of consults. I performed a rectal examination. I discharged. I sedated a psychotic patient so that I could draw his blood and infuse him with IV antibiotics. I sent blood cultures. I put a patient on respiratory precautions. I counseled an HIV+ woman. I talked to cardiology.

I felt like a doctor.

I wish.

I mean really wish.

That I had the energy and time to share all of my stories from the day.

I have so many.

But.

No.

More.

Energy.

Promise.

More.

To come.

Photo: Taken on my walk to the hospital.

“Sleigh bells ring, are you listening,
In the lane, snow is glistening
A beautiful sight,
We’re happy tonight.
Walking in a winter wonderland.”

I awoke this morning to over a foot of new snow (there was already so much of it) covering the borough of Brooklyn. There was something strangely mystical and wonderful about trekking through the freshly laid snow this morning before the sun rose.

It was awesome.

I’m too tired to write about my day.

But let it be known that I am happy that I only have 4 more days of inpatient medicine left.

Rather than attempting to use my fatigued brain to express my thoughts at the moment via words, I will leave you with a photographical story.

Click Here to View the Pics

• Epilepsy Blamed For Chopin's Dark Hallucinations : Shots – Health News Blog : NPR
  (tags: interesting)
• José Carreras Leukaemia Foundation
• Mezzomedical
  (tags: blog medical student)

“I want to hold the hand inside you
I want to take a breath that’s true
I look to you and I see nothing
I look to you to see the truth
You live your life
You go in shadows
You’ll come apart and you’ll go black
Some kind of night into your darkness
Colors your eyes with what’s not there.”
- Mazzy Star, “Fade Into You”

It’s Wednesday. Today was my day off from the hospital. When I awoke this morning, there was a mini-blizzard occurring outside my window. The snowflakes were coming down like dogs and dogs.

For just a moment, I thought to myself, “only a crazy person would go running right now through the snow.” And then I remembered, I am a crazy person.

I slipped into my shorts and running gear and made my way out into the blizzard.

It was awesome.

I did my standard “two bridge” run into Manhattan and back. The snow never stopped coming down. By the time I got home, two hours later, my clothes were sheets of white ice and my skin was a lovely shade of red.

My favorite part of the run was coming back over the Manhattan Bridge and looking over at the Brooklyn Bridge (which I had just run over less than 20 minutes prior). Normally, you can see the Brooklyn Bridge very clearly. But today, it was almost completely whited out by the snow.

Awesome.

When I got home, I took a bath, cleaned my apartment, got a manny peddy, did laundry, and caught up on my emails.

When I sat down to blog just now, the song “Fade Into You” by Mazzy Star came on my iTunes radio. I remember listening to this song many, many moons ago as a teenager during a winter storm.

Funny how things change, but never change.

It’s calling for even MORE snow tonight. Should make for an interesting walk to the hospital tomorrow.

Fade into white.

Photo: Taken by my awesome medical student. He knows that I have a “photo a day” project, and he emailed this to me today from the hospital.

“tonight i’ll dream while i’m in bed
when sill thoughts go through my head
about the bugs and alphabet
and when i wake tomorrow i’ll bet
that you and i will walk together again
cause i can tell that we
are going to be friends”
- The White Stripes

Today was not so bad. I’m actually starting to get the hang of this whole medical medical doctor thing. I’m sleep deprived right now. Hungry. And I’ve had a glass of wine, which went straight to my neurons.

So stream of consciousness is what you get.

Today, as I walked to the hospital, I heard the song, “We’re Going to Be Friends” by The White Stripes on my iPhone. It made me very happy. I realized at that moment that if I could figure out a way to listen to music while doing some of my work at the hospital, I might be a bit happier. Plan in progress.

Random events from the day:

1. Explaining to a family that their loved one might have a very aggressive type of brain cancer.

2. Talking to a patient’s family, wearing a full protective gown and face mask because the patient was on respiratory and contact precautions, and having the family member say to me at the end of the conversation, “You have beautiful eyes.”

3. Ruling out malaria.

4. Having a food service worker say to me, “I love your grapefruit” (commenting on my grapefruit tattoo peeking out) and me saying “Thanks, I’m so glad that you said grapefruit and not orange” and him saying “well, I do work in food service!”

5. Comforting a psychotic patient and preventing him from requiring restraints.

6. Hearing the words, “thank you doctor, you have done everything you could, and that means so much.”

These are all examples of why I put up with all the other crap, which my job entails.

The rare good moments make the predominant bad moments actually feel not all that bad.

Medicine, I can tell that we are going to be friends.

Photos: 1) My patient’s flowers 2) “Kill your TV.” A destroyed television found on my walk to the hospital today.

Part of My “Trash Talkin” Photo Series

Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read about my robotic love.

Click Here to View the Original Post on Medscape

Today was my very special, sacred day off for the week. I did what I always do on my day off. I ran all of my weekly errands, and I just ran.

I was planning on going for a super, duper 16+ mile run today over three bridges. However, I had a little incident, which prevented this plan from coming to fruition.

Do let me explain.

As I was running through Chinatown, some lady decided that she was so scared of my very-not-scary-dogs that she had to scream very loudly and abruptly at me. My dog Molly was so scared by this that she lunged away from the lady and right into my running path. I took a huge tumble and hit my head, hip, knee, ankle and elbow.

Of course, I did what I always do and jumped right back up and started running again.

I’m sure I looked quite the sight…running through Manhattan with two dirty dogs in shorts and a sports bra in 22 degree weather, with snow and slush splashing all over my body, bleeding from several different locations, the blood running down my body and quickly turning into blood slush.

I thought I was going to make it, but then my injured knee started to give out and I came to terms with the limits of my own body. I cut my run “short.” A pitiful 12 miles and 2 bridges.

I just wanted to put this public service announcement out there:

1) My dogs are not going to attack or scream at you. Please do not attack or scream at them.

2) Even if you are very scared of dogs, screaming is not a very appropriate response.

3) There is no need to ask me “aren’t you cold?!!” If I were cold, I would not be running around half naked and covered with slush, dirt, and blood.

This has been a public service announcement from Doctor Psychobabble. Thanks for listening.

Photos: 1) My shoes pre-running. You can tell by the filth that they are well used. They were soaking and even more mud-covered post run. 2) My knee. Ouchy!