GI bugs

...they suck. They really suck. They really suck hard. They suck hard every day.

They suck balls. They suck big hairy balls.

Hairy balls not bad enough...

Think of the worst thing to suck ever - that's what GI bugs suck habitually.

urgh.

Regression

I don't know what the hell is going on, but today, I wanted to kick my patients out of their beds and crawl in myself. What do you people know about GI distress!! In fact, I sort of did that: I actively searched and found the call rooms at the hospital where I rotate currently, cracked the secret code to get in (it's written on the door) and passed out for about 2 hours while not busy. And when I say "passed out," I mean, I don't even remember how I ended up sockless and sweaterless in the bed, or how long I spent there, exactly.

It's been awful all day!

As a reasonable physician, I'm a lumper, and hate to give two unrelated diagnoses, so I was trying to lump my whiplash and recent car accident and this horrendous GI distress I'm having into one entity, but I'm starting to have trouble doing that.

My intestines are rather delicate, plus I ate all that seafood yesterday - oh, btw, I was supposed to finish it for lunch, but Blueberry saved me from a sure death by seafood firing squad, because able to sniff out yumminess even through a non-biodegradable Styrofoam container, he knocked that shit over off the kitchen counter onto the floor, and then crouched over the seafood explosion on the floor, and feasted, like Nosferatu - this is probably IBS exacerbated by shrimp, scallops and dubious shellfish. Or it could be food poisoning exacerbated by IBS.

I was walking around diaphoretic, intermittently double over with cramps, dizzy and myalgic all day, and at one point, I thought, as I wrapped my wool sweater, white coat and extra blanket from the warmer around me, if I don't lie down somewhere right now, I will fall over. (that was when I went in search of the callroom)

I finally gulped down some Advil (I have stock in the company, I use it for everything, bleeding ulcers be damned.). The chills and myalgias went away, but now they came back with a vengeance. The Advil must have worn off.

As soon I got home, I cried that I wanted my mommy, and called her, asking what I should do for this abdominal pain and these runs.

Go ahead. Ponder the rich irony of what I just said. I'll wait.

Don't get it?

I'll explain.

I'm a gastroenterologist.

Now do you get it?

MVC, bedpan manner, HCG

An Jewish man and his wife are gonna have a baby. Sadly, she dies in labor. As is customary, he marries her sister. A year later, she passes away as well. As is customary, he marries the youngest sister, Rosa. A year later, she goes into the hospital to have a baby. The doctor comes out and says, "Don't laugh, but Rosa also died..."

This is how I felt when I had to call work and tell them I'd be absent again because I had another car accident. "You're not gonna believe this, but...."

Well, this time, the awesomely obvious FUCK YOU, and exquisitely appropriate end to a perfectly FUCK YOU type of year, occurred in the same geographical area and at the same time of the day, but I wasn't alone and the husband was driving. The husband is an excellent driver: he has never had as much as a fender bender in the last 23 years. It's part of the superhuman charm that attracted me to him in the first place. But the road was perfectly slick and smooth with pavement that was laid down, like, yesterday, so when the cars in front braked suddenly, and he braked too, the car refused to stop and glided happily forward. He said, "Shit!" And turned the wheel to avoid a head on collision, but it was too late and we slammed into the BMW SUV in front of us.

I really hate those 0.05 seconds just before the accident when you totally know it's about to happen.

So there I was, one moment, taking my gaze away from my reflection in the passenger-side visor mirror and onto the rapidly approaching rear end of the other car, and the next moment trying to figure out why my eyes are watering profusely.

The airbags deployed, the windshield cracked, and the car filled with smoke.

"Are you ok, are you ok, are you ok?" I asked like 10 times not registering the answer at all: "I'm perfect, I'm perfect, I'm perfect." Then, "Get out of the car! Get out of this car!"

We got out of the car, coughing and gasping for air (well I was, anyway). Holding on to my chest, which was really sore because of the seatbelt, the airbag, and probably my knees, which I tend to draw up to my chest instinctively whenever the driver brakes too fast. We always used to joke that one day I'll damage my kneecaps with my nose. My kneecaps seem to be ok.

The guy we hit prudently pulled over 100 feet down the road - in case we blow up? -and a good samaritan stopped and called the police as we worked on catching our breath.

The statey arrived. Here, I'd like to take a short aside and raise the question of why do people in a position of power feel that it's acceptable to express derision and be rude in general to people in distress? This statey must have been a bully in high school or something... "you want the ambulance?" I'm palpating my own neck.... "I don't know... it kind of hurts... I don't know..." Blank stare. Husband says, "she's a doctor, but she doesn't know..." A poorly concealed roll of the eyes: "Yes or no?" and a facial expression that quite clearly says: "I don't care about what or who you are, you want the effin ambulance or not?"

Yes! Since I can't quite look all the way to the left... or the right.... please do. Do us the favor of calling the ambulance like it's your job.

I didn't deal with the statey thereafter, but hubby did, since to add insult to injury, and a kick to the fuck, it turned out that his driver's license was about 4 months expired. The likely triumphant statey gleefully made out a detailed citation notice and handed it to the guy with the totaled car and the concussed wife and rugburn on his baldspot (from hitting the car ceiling). Strong work. Criminals like this must be punished. And under no circumstances should they be humored and aided in finding the phone number of the dealership where they have just dropped their other car, so as to be able to call the dealership, pick up the other car, and have a manner of getting to the nearby hospital where the aforementioned concussed wife will be undergoing medical evaluation. No way.

And may I just digress for a second. Yes, I forgot my keys in the door the night before the accident, and yes, I left the camera plugged in on the desk, giving Blueberry easy access to lick the LCD and eventually flick the $1000 camera to the floor with his powerful tail... and ironically, yes, those examples of my lacking sense of responsibility were what we were discussing in the seconds before the crash... but, ahem, my driver's license is in good standing. My honey IS human after all. And I am so glad!

What followed next was a surreal sequence of events that started with me getting decorated with a collar, placed onto a rigid board and getting my head taped down, and ended with me contemplating life and love atop a bedpan in the ER. [don't read this next part if you're squeamish about peeing] I'm not kidding. "But I'm a healthy 30 year old!" I pleaded. "But you can't get up until your C spine is cleared!" "But I have performance anxiety! I can't get it up for this bedpan!" "But if you don't, you'll have to wait until after your xrays!" "But I had a large coffee and my cup runneth over!" "But you might twist your neck, and sue us later!" "But what if I promise not to turn my head or sue anyone later?" Even with husband hissing outside, waterfall-like, to encourage micturition, I still couldn't do it. It's all about mind over matter. Peeing lying down on purpose past a certain age, and before some other certain age, just ain't right.

All in all, we're quite happy with our accident experience. For one thing, we're here making jokes about it to you, and not to that saint who guards the Pearly Gates. Plus, we scored 15 soon-to-be extinct percocets. Which, by the way, was a hilarious trip to the pharmacy. The pharmacist, after refusing to fill prescription number 1 secondary to failure to find the sticker with the date and doctor's name (it was on the back), kept having to "check with her manager" to see if the percocets from prescription number 2 could be dispensed to the suspicious bald character with the same last name as the prescribee and an expired driver's license. How does anyone ever overdose accidentally on percocets if buying them requires bargaining skills akin to what you might need when getting a deal on a used car? But like I said, we're happy overall, because we did score percocets, and we are alive, albeit whiplashed, and that's what matters.*

And back to taking xrays, what better way to find out that you're not pregnant? "Any chance you could be pregnant?" is fairly standardin the ER, and most people will emphatically shake their head no, but I requested a blood test, since I was actually supposed to have official end of cycle labs done today anyway.

"We'll have to do that before your xray," they warned. "babies, gonads, radiation... bla bla"

What better way to find out the results than when they take you to xray without saying a word 30 minutes later?

"Well. I guess I'm not pregnant?"
"Huh?"

Fabulous.




* I jest. Percocet is a physician prescribed medication that I wouldn't dream of scoring in any way, and would only dream of using it as directed. I'm a responsible patient.

Strong women

I have not posted links and funny things in a while because I've been trying to give more "meaning" to this silly writing project. But this is too good.

It has nothing to do with fertility or doctoring....

Wait....

It probably has everything to do with fertility.

I feel vindicated. Enjoy!

http://www.mosnews.com/weird/2009/07/07/strongvagina/

The prison doctor will see you now

I write a lot about surreal happenings in and around the hospital because I feel like if I don't get them down on paper, maybe, they didn't happen, and in my head, I know that they did, so I must create some solid proof of this fact. I have said this before, and I'll say it again, the only thing that makes this job survivable is the surreal unrealism that surrounds us on a daily basis.

When I was a third year resident, I rotated through a certain infamous state institution as the "medical senior," which sounds really fancy, but is secret code for "the bitch." Said state institution is one of those places that stands isolated atop a scenic hill, amidst beautiful greenery, and has murky urban legendry and old wives' tales floating in the moat that surrounds it.

It's block shaped, and made of solid red brick, the walls lined with beady barred windows. Inside, it's clean, but decorated very a la 1950s. Puke green dotted epoxy festively adorns the floors, and the walls a covered by a sensible washable matching tile - in case someone does, indeed, puke. I imagine.

The place had 8 different kinds of psychiatric units. You'd never know there were that many, but once you start listing them, it makes all the sense in the world, for all the different flavors of crazy out there: regular lock down psych; geri psych; med-psych (when they have a medical problem too); behavioral psych; addiction psych... these are some of them.

The crown jewel of the place, though, was the prison ward.

A tiny window with a push-out pull-in drawer marked the spot right next to the steel door with one of those wheels on them. You'd hand in your ID - why? Oh, so that in case there was a hostage situation, the police would know who's in there - and your phones before going in. Once that was done, the door would open, and you'd step into a tween room. The door behind you would close, and the metal bars in front would then open. Then, the guards would lead you down the hallway halfway, with a second set of guards taking over at the halfway point to take you to the end.

The guards were special. As a relatively cute girl, I wasn't sure whether to be more afraid of the guards or the prisoners, but I generally wore my best pajamas and buttoned my white coat from toes to nose. Just in case.

Once, there was a female prisoner. She didn't look much like a female, but she came from a ladies' prison, so I know it has to be true. She needed a special convoy, and bathroom accompaniment for her activities of daily living. I guess that makes total sense, but it's bizarre in the moment.

Another time, there was a young man, not a prisoner, who'd sneak out to the corner, or rather, to the bottom of the scenic driveway, where there was a known druggie pit stop, and sell off hoarded percs to the folks getting out of the methadone clinic.

Another young prisoner would lick and spit into his IV thereby inducing horrendous life-threatening bacteremias, which ended up in him developing a severe case of endocarditis, but at least it kept him out of jail. We figured this out after the third episode of shaking chills and profound sweats, and MRSA in the blood, directly temporally related to placement of a central line catheter. Lo and behold, IM antibiotics put an end to the problem.

My favorite case of me not being able to keep my mouth shut was when a prisoner arrived with epididymitis (testicle infection), which is basically an STD. So, you've yourself an STD, I told him. His response? How'm I gonna have that, I been incarcerated for 2 years. I think I said, Well, stop having sex in prison.... I may have said, "ass sex," I'm not sure. Sexual harrassment doesn't apply in the prison hospital.

The prisoners were pretty funny, but so were the nurses. The most common answer to any question in that place was, "yes, I think I remember somebody said something..." in a distinct tropical accent.

One day, we all got to talking. As the "medical senior," I lead a crack team of 4 random interns collected from indentured hospitals in the area, 1 PA student and several pharmacists around, and technically answered to an attending, most of whom were questionable at best, and therefore best avoided. But this one day, we all got to talking; we were discussing tatooage. The prisoners' tattooage. The subject of that omni-present tear tattoo came up, and I said that it means they've killed someone. The attending just would not believe me. She just couldn't. You see, because our delicate medical sensibilities must be protected, we weren't really allowed to know what our patients did, lest we allow personal feelings affect our clinical sense.

(This worked most of the time, except when you'd be taking care of the sweetest little old man and his cancerous prostate, and then suddenly find out that he's been incarcerated for the past 40 years, and has 40 more to go. What does one think in those circumstances?)

But the tear tattoo really got under this attending's skin, so she went as far as to ask of the patients. The one she picked happened to be a young kid, who was in after having been caught "partying" by the cops, and while at the pound, or the holding cell or whatever they call it, he was discovered to have an IV line from a previous hospital stay somewhere else, unclear exactly what happened there, but we can only assume that the "partying" took place directly via the conveniently placed IV access.

The kid was a punk. I gotta say. Skinny weasly little punk, whose main problem and crime probably WAS his punkedness; I can't imagine that his ass killed anyone, but there it was, a distinct tear tattoo. So, when she asked him if it's true that it meant he's killed, he acted mostly embarrassed and refused to talk. Then, we googled it, and much to her chagrin, yes, it was true. The punk kid, though, I'd bet he was a poser.

This story has not point other than the fact that if a whole place can be one giant iceberg of surreality, maybe there is still hope for survival.