Thursday, September 24, 2009

The Saddest Day of Medical School

If you are hormonal or don't want to read about a baby dying....this probably isn't the post for you.

Sunday morning I went to the hospital to round in the nursery with Dr. G because she asked me to. Yes, I'm currently in my psych rotation, but did it anyways because I like her and was anxious to show her how much I have learned since the last time I rounded with her. Well, I walked into the labor and delivery floor and the nurses told me there was an emergency and I better get back in the room with Dr. G. I hurried back to the room where she came running out with a 26 week gestation baby. We all run to the nursery where they quickly put me to work. My job was to pull air out of the baby's stomach through an NG tube. Because of the ventilations being administered, the baby's stomach was getting full of air. I was thankful for a job, because I was able to keep my mind on doing the job right instead of sitting there watching all of this happen. There were 5 of us working on the baby, plus the people in the room grabbing equipment for Dr. G as she needed it. The baby's heart rate was only in the 20's when it should have been over 120. Finally, after an hour, Dr. G said she thought we needed to stop. Nothing was happening, the baby wasn't getting better, and if he did survive he would have been in pretty poor shape. So she asked each one of us if we were okay with stopping. Every single person in that room had tears in their eyes while we had the internal fight of stopping to save a baby's life. So as we pulled everything out, they cleaned the baby up, wrapped him up and took him to his mother so she could hold him. The mother was crying when she gave him the baby. Then she asked her "So what now?" And Dr. G told her "You're going to hold your baby and he's going to die." That was pretty hard to hear. I had to walk away because I started to cry. It was an awful feeling.

So you might be wondering why this baby died. The mother was a drug user throughout her pregnancy. She admitted to taking heroin, ibuprofen, Klonopin, and flexeril during her pregnancy. Oh yeah, and the baby's urine had 3 units of alcohol in it. And what was the mother doing an hour after the baby died? Oh she was outside smoking.

It's a good thing I had five healthy babies to examine after that. They made it much better.

So yeah, worst day of medical school. I know that event will stay with me the rest of my life. It was my first baby death and unfortunately probably not my last.

Tuesday, September 15, 2009

The Crazies Week 1 in Psych

Well, I'm in psych now. I'm back in Ohio and I'm stuck in this psych business for 4 weeks. Jake left this morning. Needless to say, I've been in better moods before. I spend my mornings at an inpatient geriatric psych ward and my afternoons in an outpatient setting with a different doctor. As of now, I really like the morning stuff. As of now, I hate the afternoon.

Inpatient: I have a schizophrenic patient who just makes my day. She's pretty old and looks really good for her age, but she has no clue what she is saying. I just laugh and laugh. Today she told me to go put some clothes on when I left. Yesterday, she told me that I look exactly like my preceptor so we must be siblings. (He's middle aged, Middle Eastern, and looks nothing like me.) Jesus also tells her every single day "To behave." She is constantly talking about inappropriate sexual things to the other patients and nurses, but she never speaks like that to me or Dr. S. She did hug and try to kiss him yesterday. It's very very humorous. And for everyone who is chastising me for laughing at a patient....too bad, it's funny. And she sits there and laughs right with us...she doesn't have a clue what she's laughing at, but it's ok. The doc I'm working with is fantastic. He sat down with me to make out a schedule for how we're going to go over all the material. I really am happy with him.

Outpatient: I hate it. I'm not too pleased with my experience thus far. I don't want to get into it too much on here, but I disagree with a lot that the doctor does. I dread going there and my afternoon drags on. Again, I hate it.

Tuesday, September 8, 2009

My Fave Thing to do in the Office

I really do think this is my favorite thing. I just love finding the baby's heartbeat for the first time in new parents. They are always so excited and happy. It just makes my day! It usually takes me a few minutes in early pregnancies so I always warn them that it will take me awhile and not to freak out or think something bad has happened. Those 12 week fetuses are like little fishies swimming around so sometimes it can be really hard. By the end of the three minutes it takes me to find it, my heart is usually pounding just in case something really is wrong, but alas, I find the heart rate.

Saturday, September 5, 2009

Fun Procedures and One Bad Story

I'll start with my good story. On Wednesday there was a guy coming in for skin tag removal. I asked Dr. M if I could help and she of course said yes. So he comes in, and there are 25 skin tags to remove in his armpit and side area. We walk out of the room to go draw up the anesthetic and she asks if I want to go get started while she sees another patient. My first reaction "You want me to poke a needle into this man a million times while you're in another room? Hell no." So I went in the room to start cleaning the site up..and then waited, and waited for Dr. M to come in. Well, she took too long, so I decided this couldn't be THAT hard. Besides I've anesthetized plenty of times 5 or 6 times. So I started numbing the guy up...and I did a good job. She came in the room and was like "oh you did get started?" So she took one skin tag off to show me how to do it. It's pretty easy. In fact, this is something you could do at home. You take a pick ups (medical version of tweezers)..pick up the skin tag, and take a scissors and cut it off at the base. The ones I numbed up didn't really hurt, but some of the smaller ones which couldn't be numbed he flinched at. I have to say that it's really hard to continue doing a procedure that I know is hurting the guy. So after they were all cut off, I applied silver nitrate to stop any bleeding..and he was ready to go on his way...25 skin tags less.

Delivering a placenta. Have you done this before? I delivered my first one by myself on Tuesday night. I've participated in a lot of deliveries but never have I delivered a placenta. So in case any of you want to know how to do it: you grasp the umbilical cord and gently use traction and pull. All of a sudden the placenta will plop out. Then you have to check the placenta to make sure it is all there and intact. It was awesome! I was a bloody mess.

Ok my bad story- we had a fetal demise at 37 weeks. It was awful. Especially because she was one of our patients who I had been seeing pretty regularly. The screaming and crying from the mother was enough to rip my heart out. I felt so bad for Dr. M as this had been her patient for those 37 weeks. I'd only known her for 3 weeks.

So this upcoming week is my last week in Colorado. I'm really sad about it. Oh well, what can I do?