In The Fashion Mall, tucked back underneath the stairs leading up to the Food Court, is a little shop called "The Game Preserve," which is the last vestige of all manner of collector's game objects in Indiana. And Angel took me there. And there, in The Game Preserve, in The Fashion Mall, I found it. Mille Bornes. The card game I grew up playing, grew up adoring, in a collector's edition with the original 1962 artwork including the French and English words on the cards. Yay. We also picked up Munchkin and Settlers of Catan (thanks, indurate :P), as well as pondering very seriously buying the 2000 re-release of Cosmic Encounter (again, thanks to indurate and platypuslord). Did not buy Cosmic Encounter as I am frightened by the new graphics and big scary plastic thingies that have replaced the Warp Cone and the tokens. You can't flip the buggerin' things over; they're huge.
If you're curious, you may play Cosmic Encounter online here, and Settlers of Catan here. And I encourage you to play, as they are much fun.
And that's my weekend, much fun and games. Well, much fun and games after 10 AM. From 4-10, I was busily churning out numbers and managing patients. The morning's rounds were more or less a whirlwind of collecting data, scribbling out notes as we rounded, doing our physical exams in thirty seconds to keep up with the group, all for the sake of getting it all done between seven and ten. Nine, today.
Went back to the student lounge this morning, took over a computer and spent the morning typing up history and physicals, after doing a lot of the work last night after Angel left. I have to have six. I have three, once I gank the X-ray results from the computer again, and figure out what the de facto dosing is for a suspected UTI. I can get that from her chart, though.
Last updated Monday. Have had a light week for surgeries, mostly small things like hernia repairs, CVL placements, and the like. Thursday, I didn't bother to go into the OR at all, mostly because I took morning clinic and spent the two hours I had in the afternoon writing up my notes and doing physicals in my customary manner. Friday, I saw a hernia repair in the morning and then went to the ER to help consult on a possible acute abdomen. To be specific, I was sent there because everyone was busy, and could I get a history? R complimented me on my thoroughness once I wrote the H&P down. J, the other day, informed me that if I could turn an H&P in that satisfied Dr. E on the first try that I was destined for family medicine. Everyone else had to redo theirs.
The other one I have is on S, who's a 19-year-old born with a 46,XY genotype (normal male) but being raised as a girl. I don't quite know why - her medical record doesn't go back that far. But she did have cloacal exstrophy, and apparently they suggest that children with cloacal exostrophy are reconstructed as females, even if they're genetic males. Something about functionality, I think. Anyway, she's most interesting, looks about 10 or 12, has been in and out of the hospital so many times...she has Crohn's on top of the cloacal exstrophy, has a central line to get hyperalimentation and keeps getting central line infections, and so she's been in the hospital for a week or so 7 months out of 9. Bleah, disgusting. She's got a cool little Vaio, though, to keep her entertained.
Saw a little newborn boy with a cystic hygroma of the head. With all due respect, he looks like one of the babies Gary Larson draws, all giant puffy head and huge fat cheeks. Was kind of scary.
And then there's the $1400 skin biopsy. We have a little boy who might have Alagille Syndrome. Now, since there is a genetic disorder associated with Alagille, one has to test the chromosomes to see if the child has it. And for some reason, Genetics wants us to go to one particular lab. And this particular lab has particular requirements for their skin biopsies for chromosomes. Spend the whole day calling back and forth, getting everything straightened out. M, while showing the nurse how the punch biopsy tool works (still in the package) manages to biopsy her thumb. "I looked down," she says, "and I was hemorrhaging suddenly." She shows up to rounds with it all wrapped in band-aids.
We get the skin biopsy, and then Lab X tells us that there's this complicated billing issue that results in T's parents, who are on Medicare, having to pay the $1400 for the biopsy up front out of pocket. That's a load of spurious bullshit. It took forever, and several talks with the parents, and the tireless efforts of ME the nurse, before we figured out how to pay for it. Oooh, that dirty Lab X.
Dr. C's been acting strange lately. Maybe he's warming up to us. He makes jokes, and he talks, and he smiles more. I should hunt down my little one-liners jotted on the bottom of the census sheets. Things like "That's good Friday entertainment - laying the smack down on someone with 'tude." Andy's consistent inability to figure out what day of antibiotics his kids are on, and the jokes that brings even in morning rounds. And the little jibes he makes at me for my compulsiveness. The afternoon rounds are fun, playful almost at times. I like him more than I did, and I respect him more too.
Dr. C always holds his hand over the baby's eyes before he turns on the over-bed light. And he apologises when they squeal. That means something to me.
E-mailed Dr. E about the H&P's as Shubi thought we only had to do four. We only have to do four. I'm almost done. What a relief that is.
Thursday night I saw Josh, the pastor's son, one of the most genuinely nice people I've ever met. He was at the residency fair. Had a glass of nice white wine, a good dinner with Angel, and was officially elected 14th district Director. So I went to the Board of Directors meeting today and networked. Everyone thinks it's charming that I'm there.
I want to talk about these things more, but I've spent my evening roleplaying instead of writing livejournals. But I'm prepared for tomorrow's PBL session and I know what I'm going to do for patients. Now I just have to remember to print patient notecards in the morning.
It's a strange world, O Best Beloved. A very strange world.