This one is for Robyn

I had this patient today who sufferred some pretty bad injuries to her face this weekend. She had a rather angular face, but who am I to judge? Her face was bruised and swollen so I have no clue what she normally looks like. My attending kept accidentally referring to her as "he". I was embarrassed for him and he kept doing it, but to the patient's annoyance. So me, being the clueless person I am, am getting ready to intubate her. We have her on the table, I'm giving oxygen, my attending is putting meds in the IV. What to do you suppose tipped me off that this was really a dude I was dealing with? Was it his very large Adam's apple? Was it his stubbly face and square jaw? Or how about his deep voice? No! What tipped me off that this was really a guy, was that when I looked down his airway, I realized I would have to use a Mac 4 blade to get the tube down. I only use Mac 4's on dudes! That's what tipped me off! It is official. The only way I can tell apart men and women is by direct largyngoscopy to see what size blade would reach the eppiglottis.

It's official. I'm am now what you'd call in the truest sense, a Nerd.

Another example of people who dish it out but can't take it

Remember my last post about the mean bossy scrub tech who couldn't handle people giving some back to her? I've got another example. I was on call (for the 4th time in 9 days) last night when a gunshot wound guy came in. He was a skinhead who was getting drunk with his buddy when he accidently got shot right above his jewels. The bullet wound wasn't really all that serious. His friend missed all the important stuff, but he had to go to the OR for a "rectal exploration" to make sure he didn't damage any of his large intestine as well as irrigation of the wound itself. In the OR, the guy was really freaking out. Yes, this guy who spends his life scaring people and intimidating people with his "white power" BS was crying like a big baby right before we put him to sleep. Kinda makes you realize who the true cowards are in this world we live in.

Quiet Saturday

Don't ever say the "Q Word" when you are on call. It's a jinx. Q is for quiet. The minute you say it's quiet, it gets busy. Now, I'm not a superstitious person, but I'm not going to chance things, either. Plainly put, I had one of the best Saturdays on call ever. I only had 2 cases the whole 24 hours. One at 7am and one at 11pm.

My first case was kind of funny. It was a tracheostomy on a guy who has been intubated for awhile. I think I've mentioned before about fights breaking out between staff during the surgery. Well yesterday yielded a pretty good one. The scrub tech was being bossy to everyone. Yes, the scrub tech. The least educated person in the OR thought she was somehow the most powerful person in there. She was hateful to me, bossy to the nurse, and just generally being a pain in the ass. Finally, the surgeon had enough and told her that he really didn't need her in the case and could do her job for her just fine if she wanted to leave. She left, and we enjoyed the rest of the case. Of course, now the scrub tech is saying that we were all mean to her. Funny how there are people out there who can dish it out but can't take it when it's given back to them.

My other case was an extremely intoxicated fellow wrecked his motorcycle when he tried to drive it with the front wheels locked. He was nice to me, but being very mean to the recovery nurse, yelling at her a bunch. He sounded like a monster the way he was growling at her and carrying on. I finally had enough and told him he needs to be nice to the person who is giving him the pain medicine. He slept the rest of the night. Yes, I know it's mean to threaten to withhold pain meds in exchange for civil behavior, but in this case I felt it was appropriate.

They're Magically Delicious!

I have fallen in love with the new Chocolate Lucky Charms. I tried some generic ones at a friend's house last week and thought I had died and gone to Heaven. I don't think in my 36 years I have ever bought kid cereals, but yesterday I sought out and found Chocolate Lucky Charms. Imagine, those tasty marshmallows from childhood combined with the chocolately goodness of Count Chocula! It's sheer pleasure in a box! I figured while I'm at it, I might as well get some Fruit Loops, too. I always thought those cereals were awful breakfast food but you know what? They are less calories per serving than my Grown-Up Cereal. Plus, kids cereals are much tastier and may motivate me to get out of bed early enough to actually eat breakfast. Could it happen? Naw, but it's a nice thought.

Well so not many blog worthy things have been going on, really. After my wild vaca, everything else is just...boring. Today was my 12th day in a row to work. That's not really that much compared to some people, but I'm happy to have the weekend off to catch up on sleep (seeing as how I did not do that on my vaca).

So today in a big case, the scrub tech had an asthma attack. She was in her sterile gown and couldn't touch anything, so I got the inhaler that automatically comes with my drug tray and gave her some puffs of albuterol-all without touching anything but her mask and her mouth. Asthma attacks are nothing to mess around with. Many a asthmatic has died because they waited too long before they got help. I had a patient (who smokes) just last week go into bronchospasm in the middle of the case. I couldn't get her to oxygenate through her breathing tube and her lung pressures were way high. Scared me to death. Got through it, though. Long term smokers don't do too well with surgery.

So one of our interns has a 6 month old baby that was fine and dandy until a month ago when the baby suddenly collapsed and quit breathing. She and her husband (both doctors) resuscitated the baby at home and got her to the hospital. She survived but has a very bad congenital heart problem that no one knew about. Her only chance is a heart transplant. They have decided to forego surgery and bring her home on hospice. I was thinking today what a brave decision that was for them. I know it was really difficult and I hope they don't question their decision 10 years from now, wondering, "if only we had..." They saved their baby a lot of suffering in exchange for their own.

What happens in Dallas, stays in Dallas: My Vaca, part 2

I hadn't really intended on going to Dallas for the annual Red River Rivalry, but I have a group of friends that go every year, and at the last minute, talked me into going. "If you don't go, you're just going to stay home and feel sorry for yourself, wishing you had come with us," Julie told me. So I went.

Started of the day at Humperdink's for drinks and a big pep rally. Ran into a couple who the ex-boyfriend and I used to have dinner with regularly. As soon as we broke up, they dropped me. And as I would expect, I got an icy reception from the female. I have no idea why. I'll say one thing: you find out who your true friends are after a break-up.

Around 7pm, the party migrated to a strip bar next door to our hotel. A nice strip bar. Here's where things got strange. Two of the girls with us started making out with each other in front of their husbands. Then they started doing other things. Pretty soon, the crowd around our table was bigger than the crowd watching the real strippers. That's all I'm going to say about that. The girls ended up getting kicked out of the club after going to the ladies' room together. The rest of us went for pancakes. Julie and I managed to stay heterosexual throughout the evening. The funny thing is, as wild as our night was, we are all in our late 30's and were in bed by midnight. Of course, when you start partying at 2pm, midnight is a bit late.

I ended up having somewhat of an interesting weekend of my own, which I won't get into here. I just hope I don't live to regret some of the things I did. I did get to spend some unexpected time with a very special friend.

Oh yeah, and our team won. Seems sorta anti-climactic after all the things that went on. We all made it home alive and well. I was told this was the wildest Red River Rivalry Weekend they have ever had. I'm certainly glad I didn't miss out!

funny 1920's art deco train station in Baltimore. (I got to ride a train for the first time ever!)





One of my all time favorite paintings




Pink and Holiday

My Vaca, part 1

Did ya'll think I fell of the earth?

I had 10 days off. I took two trips. In 10 days, I was home 1 day. I started back to work this morning, exhausted and badly needing another vaca to catch up on sleep.

Trip #1: I surprise visited my friend, Pink, who lives in Washington, D.C. Being the shrewd, sneaky person that I am, I constructed a secret vaca to D.C. and crashed Pink's birthday party. Only her husband knew of the plan....and it worked, but barely. Pink is a shrewd, sneaky person herself, and suspected something was up, but fortunately, her parents showed up first, so she thought they were the surprise. When I showed up at her door during the party, she was speechless and teared up. Mission Completed.

We had a great time and I got to see a lot of stuff I missed back in June. ie..Spy Museum (I'm going to quit medicine and become a spy now), Holocaust Museum, and The Phillips Collection. I braved the metro by myself and managed to not get lost in D.C. while looking for these various sites. The Phillips Collection was neat because I saw some of the collection in 6th grade when it went on special tour throughout the U.S. and our class took a field trip to see it. That's when I saw a real Renoir for the first time. It was really neat getting to see my favorite painting again after 25 years.

Oh yeah, and I got to eat some great food, met a bunch of her friends, had long talks, and spent time with the sick doggie who has hemangiosarcoma.