Finished rounding to discover that our patient in Detention is going to have to be transferred to the ICU so we can keep him hydrated and do something about his 104º-106º fever. Whoops. Fortunately, he's also going to wind up on the Medicine service sooner or later, which is all good by me. Grabbed breakfast (I have got to find a cheaper way to eat) and then ran off to a meeting with Dr. S, who is a crazy black man by all accounts. He's fun. He was also 40 minutes late, so we met with Dr. G and practised tying knots. I think I understand what I was missing, finally, although I'm still not very good at it. I need some rope to practise on.
Talked about trauma and about reading CT scans, which I did reasonably well paying attention to, even though Radiology makes me unbearably sleepy. I could never be a radiologist. Then went back and wrote notes, grabbed a sandwich, wrote more notes, and handed the Detention patient off to Medicine for a consult. Their assessment? "Assessment: D*head, Plan: Go f* yourself." The man's a medical nightmare. Apparently he's in jail for setting himself on fire and crashing into a hospital or some such; the stab wound that put him in this time is self-inflicted, he's from some middle-eastern country we don't know where or what, and although he speaks English, he refuses to talk. Go figure.
Next on the list was the 50-year-old man who drinks 1/2 pint of Jim Beam and 12 beers a day, smokes pot, lives alone, and last used crack cocaine on the day before he entered the hospital. He didn't want to talk to me either, as I wasn't bringing him food. He has horrible pneumonia and a chest tube in; he's NPO so he doesn't aspirate and bring his saturations down even more. He warmed up a bit and told me about how all the Hindus don't pay any taxes and run the country, and how I could look at any Wal-Mart and see proof. Riiiight
Then in the afternoon was clinic, in which I think I conclusively proved to JB that I suck. I was late (I went to get my pager set up to receive Code 77 alerts, so I know when trauma comes in), I only saw one patient, and it took me all afternoon to figure him out. And then we got a Code 77 page and ran down to the ED.
Turned out it was a drunk hispanic guy who'd been nailed a good one - somehow - in the back of the head. He said his wife scratched him, then he said she tried to shoot him, then he said he'd tried to shoot himself, and a lot of other things. But he was stable, CT looked good, he just had a big bruise and a scalp laceration, which explained why he was bleeding everywhere.
Finished clinic, came back down to the ED. Next door was wailing and sobbing. From what I overheard, the unconscious young child of indeterminate gender being intubated and cathed had gotten hold of a bottle of medicine and drank it. Please, when you have children, be careful...
And now it's time to go find the mandatory financial aid meeting so that I can eat pizza. Until later, O Best Beloved...