So a few things have recently happened... I finished Cardiology with the most kick-ass last day of a rotation EVER, I went on a vacation road-trip with a girlfriend to visit my med school peeps in NJ/NYC (it's true...we DO vacation at times!), I've started nightfloat (I shake my fist at thee, nightfloat), and I've started reading The House of God. These are all things (minus my roadtrip) that deserve their own post (don't get me wrong - roadtrip was awesome), so I'm going to start with Cardiology....
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Cardiology...wow! I had a great month overall, getting to meet and work with one of the groups of Cardiologists in town. They were all really cool docs who were really great teachers, and fun to be around - this (no matter what the hours) makes for a great rotation. I spent the majority of my month working with this brilliant guy who was just the kind of doc everyone wants to be one day; he loves his job, he loves his patients (and they love him), he loves his family (and they love him), and he is really good at what he does. He is an incredibly smart man, and I wanted to be like a sponge around him....I was truly baffled at the amount of stuff he knows (and remembers - the man was drawing out biochemistry pathways that barely look familiar to me, and I took biochem twice!!)! The thing I really love about the way he practices, is that he is really knowledgeable about the use of herbal and vitamin supplementation in medicine. Now this is a topic I am interested in - I try to be a minimalist with meds, and I like to use herbals and vitamins where I can.....patients like it, cause it doesn't feel as 'mediciney' as being on prescriptions, and it's usually cheaper, and there are a lot of things out there that have evidence to work with certain conditions (this is a topic for another day, I'm sure).
So anyways, my month with Dr. McSuperstar was great....we did rounding then consults, with procedures (TEE - an ultrasound down the esophagus to look at the heart; TTE - an ultrasound on the chest to look at the heart; central lines - putting a big line (kinda like an IV) into one of the larger vessels; Caths - where a tube is inserted in a big vein artery in the groin, then moved up backwards to the heart so that dye can be sprayed in to look at the heart vessels (for blockages, etc)....very cool; stress tests - having the patient on the treadmill, or having a medication given to them to see if their heart gets worked to see if it gets 'stressed' (chest pain = not enough oxygen, ie. potential blockages). It was great because we'd be bounding all over the hospital doing random things all day, which was perfect for my attention 'issues.' Most of the month was pretty routine though....not a whole lot of craziness going on, no really critical patients....mellow. Then my last day, I was with a younger guy, really nice (they were all really nice...refreshing after working with lots of the docs I encountered during med school.)
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My last day started at 8, and I met my doc in the ED; his 'rounding nurses' (the nurse practitioners who worked with the group, and did all the consults) welcomed me and said that one of the other docs (who was assigned to do the TEEs) wasn't there, so we'd be running two services today....busy, but manageable. So my doc came, we started rounding, then did a TEE, ran a code, did another TEE, and it was there that I had my
'Awesomist Moment Yet.'
The patient was an older gentleman who had afib (an abnormal heart rhythm that you can shock back to normal, but we need to be sure there's no clot in the heart first). So this guy was good - no clot, so they had the sticky pads set on his chest and tried to shock him. Nothing, twice. So my doc said
"We'll have to use the paddles."
I looked at him with a look that I'm sure resembled the one that kids have on christmas, and I said "Can I shock him?"
The doc smiled at me, chuckled and said "Sure."
I was so excited! To this doc, and all the techs and nurses there, this was something routine for them....but for me, this was something I had wanted to do, dating back to the days when Dr. Green was shocking people on ER. It isn't used as much since the sticky pads are around, and I am itching to do anything that makes me live out these little fantasies I've had for so long. Like a kid at Christmas...
So they handed me the paddles, lubed them up, then I put the paddles on this patient and said
"Clear!"
Then I backed away from the bed (more like arched as much as possible since this guy was pretty big), and shocked him. Not even one bit anticlimactic. I can't help but giggle at myself right now as I think to just how excited I was right after. I think my smile was probably breaking my face, cause everyone seemed really amused by the whole situation. Really though, it was one of those 'make-me-REALLY-feel-like-a-doctor' moments.
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From there we went to place a central line on an ICU patient, did a couple stress tests, saw a couple more consults, read a few EKGs and Echos, watched a carotid cath, and then to the ED for the first of THREE MIs (heart attacks) we would have that afternoon! It was organized chaos, and it was fantastic.
Cardiology, I heart you :-)
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