Reps

We had a patient crash in the OR while on the table. The junior resident did CPR for a good 10min straight during the whole ordeal. 

It was intense but we were able to get the patient back and stable. 

We were leaving when everyone realized the resident still was gowned and wearing lead vests (we were going to be working under X-ray) the whole time. 

His scrubs were SOAKED underneath the vest. 

The fellow takes a look as he peels off the vest and hangs it back on the rack. 

"At least you don’t need a work out today."

#MLIMS

But first...

Another night of emerg call. Poly trauma. Young male. Involved multiple motor vehicles. 

Patient rushed to trauma room, c-spine put into place, IVs running.

Primary survey, done. Secondary survey done. Determined stable enough for CT. 

Scan reveals several C-spine and L-spine fractures but nothing indicating a surgical laprotomy. 

He’s brought out of the radiology room back into the trauma bay. The residents leave to report back to their attendings. A few minutes later a nurse catches him almost falling out of his bed.

He had grabbed his phone and was trying to position himself to take a selfie. It involved loosening up his c-spine collars. 

I mean, it’s an unstable multiple cervical burst fractures but you know, priorities.

#MLIMS

O Captain my captain

image

If you’re like me and currently going through medical school, chances are you were a child of the 80s/90s. Which meant watching a lot of Robin Williams growing up. It’s not often I give pause regarding celebrity deaths, but his made me sad.

It’s sad to think that Robin Williams’ issues got the better of him. He was Genie, Keating, Peter Pan, Alan Parrish, Sean Maguire, and Patch Adams…to name a very few.

He made me laugh, he made me cry, he made me marvel at his shear amount of talent, such as his monologue of flatulence while depicting a colonoscopy on his Live on Broadway show.

And now he makes me think. Hard. On the issue of mental health. Again. Even behind the brightest of smiles and infectious of laughs can hide turmoil. Like the old joke ends…”But Doctor, I am Pagliacci!” 

Mental illness is something silent, something scary, and something hard to understand. I think it’s hard to convey as well. Rarely does it enter the discussion until a big death like this and rarely does focus stick. I don’t think we want to think about things we can’t understand easily, so we end up making the whole issue taboo and then things just fade from attention. People who are truly suffering often suffer silently and alone. I can’t say anything at all of Robin Williams’ mental state, but if he was suffering silently, then others can be too. 

Of course this blog is about medical school and mental well-being, depression, and burn out are all such real issues. We all know it. Yet again the unease and taboo creeps up and the walls come up.

I guess if there’s any lesson that can be gleaned from is the crushing nature of depression, substance abuse, and destitute nature of mental illness. I aim to remember this great icon in the characters that he breathed life into. 

Take care of yourselves and each other. 

#MLIMS

 

Not sure if they are joking about the last part there
One of the reasons it sucks having a med school/student lounge in the same building that conducts a lot of basic science.

Saw this posting today.

A Friendly Microwave Usage Advisory: before putting your food in, start it for 30s to 1 minute first. That way, the flies infested in the microwave should die before you put your food in… unless they’re anti-microwave mutant flies from the labs upstairs…

#MLIMS


Review of systems

We had a patient brought in from trauma the other day. 

She had a bad fall from a height and had a big broken ankle. 

We were making sure she didn’t suffer any other injuries that were overlooked due to the obvious (ie: open) ankle fracture.

"Is there anywhere else that hurts?"

Yes, down below *gestures with hand to rear*

I was thinking something like a sacral fracture or a vertical sheer fracture because of her mechanism. So I thought I would ask some more.

"Did that happen with the fall?" 

No. I’ve had it for a while. 

"How long have you had this pain?"

15 years of marriage. He’s the biggest pain the ASS I’ve ever had! 

Did I mention that the patient was hopped up on Ketamine at this point?

I couldn’t help but crack a smile.

#MLIMS

More than meets the eye

Rounding on some peds patients on one of the mornings this week. The kid was recovering well and playing with some toys his parents brought him.

Resident: “And which Transformer do we have here?”

Me: “That’s Ironhide”

Resident: “… I was talking to the patient. You know, the 6 year old boy”

In my defense, I have had weirder questions asked when being pimped.

#MLIMS

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