Pardon me. I'm tired of learning these things. Once, I had hope that I could be the brilliant young doctor who comes from medical school and makes a life-saving diagnosis based on some incredibly rare syndrome that she heard about back in path. Now...now I'm hoping I'll be able to diagnose pneumonia if I hear it. If I hear it.
Spent two hours learning urology and looking at interesting X-rays. "Start your collection now," he says. "Ask for copies of interesting X-rays."
- The man who was "minding his own business" when he was shot in the rear end. Somehow ("because he's a scumbag," he says. "You or I would be dead, but he's a scumbag.") it missed his colon, perforated his bladder, and wound up lodged in the erectile tissue near the tip of his penis. "No, we didn't take it out. Bullets are sterile when they go in; they're so hot."
- The 17-year-old kid who didn't take the "trespassers will be shot" sign seriously and got a round of #6 shot in his tail.
- The bow-hunting 'accident' - Jim: "I know the guy who shot him. He still says he didn't do it on purpose, but at twenty-seven feet...come on."
- The picture illustrating why one should always wear a cup when chipping mortar off of bricks.
Afternoon was physical diagnosis. We saw Ms. B. who was the cutest little Asian 75-year-old lady on peritoneal dialysis. She had a bit of nodular goiter, which I might have felt - I'm not quite sure. Then we went to see a man with diabetes. His foot hygiene was awful, he had severe pitting oedema on his lower extremities, and he'd obviously soiled himself without knowing it. It was all over his legs. Somehow, all four of us kept from making faces either at the mess or the smell or the surliness of the patient. Next year, Rachel says, we get to be the ones cleaning him up.
Then I was dropped off to see L.A. She's 43, a cheerful woman with lupus. And she was the best history patient - she knew all about her disease, its diagnosis, all her allergiesm her meds...everything. Now if I could only remember to do everything on a physical exam. I get so flustered; I have no real rhythm to work from on history or physical yet. I need to work on that. Badly. I forgot to get social history, listen for bowel sounds, percuss her liver (I can't find a liver to save my life), or listen for bruits. There's so much to remember and do. And I have to write it up, too.
But we got out early. And I came home with all good intentions, laid down at 3:30 to take a little nap, and didn't wake up until 7:30 or so. That settles it, I'm still sick. I've gotten nothing done today - which means that tomorrow, I'll have to catch up a little more than anticipated.