signout | July 20, 2006This is why people who don't know science shouldn't write about it as if they do. I don't care how much she's "mulled it over"-the author of the recent New York Times opinion piece about compulsory vaccination of girls with the vaccine against HPV makes some dangerous assertions here based on totally unscientific thinking and some seriously lame perspective.
And if this lady is SERIOUSLY going to suggest that in the face of other preventive options, we choose to rely on the often-imperfectly-used condom for prevention of STD's, especially among adolescents whose access to them is determined…
signout | July 17, 2006As part of our resident education program, there is an hourlong noontime conference at the hospital five days a week. The subject is usually something medical, like "Diagnosis and treatment of urinary tract infection in the elderly." Although you might expect us to resent these conferences, we usually don't: for some of us, it's the only didactic teaching we get during busy rotations, and when it's good teaching, it's really useful.
The other day, however, the subject was "Surviving Medical Residency." Apparently, it featured some guy nattering about how in residency, you have to make time…
signout | July 10, 2006You'll hear residents everywhere refer to "codes" as both the most terrifying and the most exhilarating experiences they have during training. "Code" is short for "code blue," or "code red," or whatever term each hospital applies to situations wherein help is needed in resuscitating a patient. It's used as a noun ("I wet my pants during the code today") and a verb, both transitive ("Rounds were so boring today, I nearly had to code my attending") and intransitive ("Your patient probably coded because of the Tylenol you wrote for"). Codes are often chaotic, and, I won't hesitate to tell you,…
signout | July 8, 2006When I was a little kid, we had a yearly raffle at my elementary school that I won every year with such weird regularity that I started to think of myself as lucky. It's been a long, downhill slide ever since, but when I started residency a couple of weeks ago, it seemed I might have gotten my game back: against all odds, I was a white cloud.
In hospital slang, white clouds are people who, through good luck alone, have fewer difficult patients on their services and fewer unpleasant call nights. As one of them, my call nights had been easy. I'd been getting more sleep than any person…
signout | July 1, 2006My parents call me every few days and ask to hear stories. Sometimes I'm contrary about it, and just rattle off a list of diagnoses and interventions. But I know that's not what they want. They want a heroic ideal. They want a dramatic arc. They want a story.
To get to the ICU, you have to be unable to either breathe or maintain a blood pressure on your own. Most of our patients are mechanically ventilated and quite heavily sedated, and all require careful attention to the tiniest minutiae of their conditions. We rarely know what our patients were like before getting, as one of my residents…
signout | June 25, 2006I'm recovering from my first full call day in the medical intensive care unit, the MICU. Call in our MICU is a morning-to-morning shift, which means being awake all night, unless you can justify sleeping. It was a relatively quiet night for us, so we got about 5 hours of sleep-a full night's worth, more or less.
I made my first death pronouncement at 10:35 p.m. last night after a family withdrew care from a woman who was only 48 years old. I hadn't taken care of the patient at all; I just pronounced her as practice.
In the middle of the night, I mentioned to my residents that I was going to…
signout | June 23, 2006Today was my first day of residency. In the large, academic medical center where I work, the wards were filled with people like me: kids fresh out of medical school, creases still not washed out of our long white coats, playing with the buttons on our beepers, looking for the bathrooms. For the next year, we will be the interns, and on this first day, we tried to like it. It wasn't that hard, right? There was a free lunch, and the nurses were really nice to us. Plus, now we have real responsibility. We love responsibility.
It gets easier to be an intern with every year that passes. A few…