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Where did we go? - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
Where did we go?
Two days of no patients means that Nykki gets to take the kittens to the vet.  Kai has ringworm.  They have oral antifungals and we have solutions and topical for his ear where we can see it.  And they're being treated more heavily because of my profession, because I see children.
Scrub hands well.  Repeatedly.

One C-section, 19-year-old G3P1 (that's 3 pregnancies counting the current, one live birth not counting the current) from Mexico - one abortion, one baby dead at 4 days.  We delivered her of a 4-pound 4-ounce baby with Apgars of 6 and 8 at 1 and 5 minutes.  Baby was breech.  Dr. R extracted her quite neatly, with me watching in awe and S doing exactly as she was told.  A C-section is a fascinating thing, in the hands of an experienced surgeon.
Discussed C-sections done by family docs with the OB, in lieu of arguing politics and the stance that "any doctor who would vote for Kerry obviously doesn't care about making a living".  S needs to learn that an opportunity to open one's mouth is an opportunity to insert one's foot, and that it is vitally important to know something about the topics one protests vehemently about.  She is also a Democrat, in this state that has voted Republican for so very long.  So am I, but I try not to look foolish about it.  So I asked about the C-section topic.  Same potential for insulting remarks, but I put on the Bright-Eyed-Face and listened and made careful questions.
Dr. R likes me.  He failed to notice that my questions in the OR cleverly revealed that he could indeed provide me with no factual basis for the Bush-Cheney ticked, only anecdotal evidence against the Kerry-Edwards ticket; thus giving me no reason to open my mouth and interject into an argument based on that quasi-religious faith that.  This entire election is being fought on the basis of what the other guy isn't doing.  But he thinks that my plans to go out into nowhere and do C-sections are admirable, and gave me a mini-lecture on economics and the reality of needing to earn $100,00 in money paid to the practice in order to break even for a year.
And I came out of it refreshed and intrigued, rather than frustrated and grumpy, like S did.  Which was good.

Pogi in the next room.  A Pogi is a woman who is pregnant for the first time; it comes from P0G1, which is an inversion of G1P0, both of which mean Gravida (pregnamt)-once, para (what happened to the babies)-zero.  Young woman, early 20's, history of gonorrhea/chlamydia, history of another "vaginal infection" for which she had just started Flagyl.  Greenish-yellowish vaginal discharge, and copious amounts, too, smelled nasty.  And here we are, checking her cervix, discussing her temperature and the possibility of chorioamnionitis, and the whole room is taking on the odor of Something Wrong Down There.  My mood was dulled.  S's was just miserable.
Baby, on the other hand, was quite content in the uterus, and in no hurry to come out.  Perhaps he, too, was repulsed by the smell.  In any rate, we spent the rest of the morning watching fetal monitor strips (strangely flat, OB was still not worried) and then I went to didactics, got Hospital Swag and got out early.

I've been bumming around ever since.

now feeling:: flirty flirty

6 whispers echo . o O ( ... ) O o . whisper a word
From: sepuki Date: October 15th, 2004 06:04 am (UTC) (etched in stone)

I'm so glad that people can be doctors. If it fell to me, well...there'd likely be a lot of sick people lying about. ;_;.

I'm quite tempted to print this out and distribute it to my teen Night kids. Many of them are sexually active, and...it's just frustrating. My kids should not be having kids.
ayradyss From: ayradyss Date: October 15th, 2004 11:24 am (UTC) (etched in stone)
Maybe I'll write you something for your teens :)
mdrnprometheus From: mdrnprometheus Date: October 15th, 2004 11:25 am (UTC) (etched in stone)
FWIW, I think you should very seriously consider what the guy has to say about malpractice insurance rates. And, even though I have no love for Bush... the one redeeming factor is that his health proposals, particularly on liability, make more sense than Kerry's.

Old journal entry I wrote re: the liability issue, and another on Kerry/Edwards, should you have the time.
ayradyss From: ayradyss Date: October 15th, 2004 11:43 am (UTC) (etched in stone)
The second entry I've read, and to a certain degree agreed with.
As to the first...I know full well what we're looking at in insurance rates, and I don't like it. But my risk-benefit analysis for the overall picture comes down on the Dem ticket. Will just have to keep fighting. Like so many things, I'm afraid it's going to come beyond crisis to desolation and the reality overwhelm us completely before something is done. And I don't have a lot of faith that that something is going to hold up.
Won't keep me from fighting though.
And that's a ramble when I should be out the door. :P

Noticed that I didn't finish a sentence.
"...and interject into an argument based on that quasi-religious faith that. someone is going to do the right thing."
From: clypheous Date: October 15th, 2004 02:53 pm (UTC) (etched in stone)
You could make an argument that if doctors didn't ever screw up there wouldn't be a need for malpractice lawyers.

I also find it amusing that Bush/Cheney talk about Med-Mal in regards to Kerry/Edwards. Niether of them really did Med-Mal, Kerry was a prosecuter and Edwards mostly did products liability against big businesses, most of which deserved to be sued.

As a budding trial lawyer I may be slightly biased the other way, but Bush's proposals will basically make it even more economical for large corporations to cut corners. If you've ever seen "Fight Club" there's a scene on a plane where Edward Norton is talking to someone and he says that the car company he works for looks at a recall, sees how much money it would cost to recall the item, then estimates how much settling injuries and lawsuits would cost. If Recall>Lawsuits than they don't recall the product. This is alarmingly close to reality. If we allow businesses, insurance companies, etc a way out, the products and services they provide will be even more cut-corner and slipshod.

I agree that something might need to be done to reduce the number of cases that actually warrant a lawsuit, but I think that capping damages would be a disaster. I think eventually we will have to set up a totally independant review board for Med-Mal cases consisting of doctors with a record for honesty.
mdrnprometheus From: mdrnprometheus Date: October 16th, 2004 12:05 am (UTC) (etched in stone)
I do agree with you that the Bush proposals go too far by including corporations. I disagree that capping damages is a "disaster". It's worked really well in California and in other states that have done it.

That said, I do agree that it would be nice to have some kind of alternate resolution, like a no-fault system, and that this would be far more fair to injured patients.
6 whispers echo . o O ( ... ) O o . whisper a word