Sunday, August 23, 2009

Long, long week

My long week was topped off with a Sat to Sun 24-hour call. I accumulated 84.5 hours this week - it's amazing they make us pay tuition to work this much!

While I was on call I was able to work with a resident who was covering surgery from multiple services. This means I got to see surgical issues outside of bariatric surgery. A lot of elective surgeries are done on weekdays, so I wasn't in the operating room as much as normal. I only saw one surgery. It was a neck lymph node excisional biopsy of an AIDS patient who probably developed lymphoma. AIDS is a devastating disease and wrecks havoc on the body. I'm not sure what it is about infectious disease that fascinates me, but I was enthralled with this man's case. I read through his chart (which was basically a novel), and was able to review several infectious agents and the diseases they cause (Cytomegalovirus, Mycobacterium avium, Cryptococcus neoformans, and many more). AIDS completely destroys the immune system leaving its victims vulnerable to all sorts of crazy infections. It is an infectious disease doctor's dream... or nightmare... patient.

I spent most of my 24 hours in the ER working with Traumas and potential surgery candidates. As a student I basically collect the patient's history and perform a physical exam. I am able to formulate a diagnosis and a plan of action, and then present that to the resident. The resident then assesses the patient and changes or confirms my diagnosis and plan. This has been far more exciting for me than standing in surgery for hours at a time holding a retractor or camera. I love talking to patients, seeing the clinical manifestations of disease, and figuring out a solution to solve the problem. Actually fixing the problem (at least surgically) has been less exciting for me. I guess I'm not intended to be a surgeon...

We only had one trauma last night that was very minor. I guy was loading a scooter into a truck and it fell on him. As the trauma team assessed his condition I was able to help by cutting his clothes off, putting in a foley catheter, and cleaning up his wounds. I really enjoyed my night in the ER and I'm excited to spend the next month there. I'm really just excited to see new cases that don't involve surgically altering people's stomachs!


  1. WOW!! That is amazing! I am so glad that you love what you are doing right now! keep up the good work!

    85 hours in a week. I think I would DIE! In fact I know I would DIE! I can bearly work my 40 hours. Lucky for me I am full time at 36 hours.

  2. Kent it is so exciting to here about the things that you are doing right now. I'm very proud of you. You will make a great Doc. Showing that you care about the patient is very important. That's what it is all about careing and helping them solve their medical problems. Can't wait to see you and your family this Friday.
    Love, Dad

  3. That is one HECK of a long week. Bless your heart!