Monday, November 24, 2014

Fun with Pharmacy

I haven't done "fun with pharmacy" in a while, but this is one I had to do. The order was:

Zoloft 50 mg PO qAM

Guess what time the pharmacy scheduled the medication for.

Saturday, November 22, 2014

Weekly Whine: McDonald's Shaming

I am seriously sick of all the shaming that goes on around eating at McDonald's. If you don't like McDonald's and don't think they taste good, then don't eat there. But don't act like you're better than everyone else because you don't eat there or other fast food restaurants.

Someone recently made a comment on this blog that they could tell I was stressed out because I take my kids to McDonald's a lot. First of all, I don't know how a complete stranger who mostly just reads blog entries that I largely wrote before I even had kids knows how often i take my children to a particular restaurant. I probably take them there once or twice a week on average. I try to limit the number of times I take them there, not because I think they are so unhealthy, but because it's a pain in the neck to wait for the drive through and it's more expensive than making something at home. Plus then when we go to McDonald's, it's a special treat that everyone gets excited about.

Is McDonald unhealthy for children? Seriously, I don't think so. Maybe McDonald's is more healthy than some gourmet cook making special organic meals for her child every day or something. But I am willing to bet that the average woman does not give her children food that is healthier than McDonald's.

Most children love the following foods: chicken nuggets, fish sticks, pizza, etc. my kids demand chicken nuggets almost daily. I looked up the nutritional value of the "healthy" frozen chicken nuggets that I buy at the grocery store. And guess what? They have the exact same number of calories and fat as the nuggets at McDonald's. So if I get them a side of apple slices and a yogurt with the nuggets, am I really subjecting my children to something so horrible? And I think the little burger they get there is probably healthier than most red meat dishes I might make for the kids.

Probably the main reason I limit McDonald's is because the stuff that I get there is much worse than the stuff that I make for myself at home. And the temptation to get myself something is too strong if I do the drive-by.

I just think there's too much McDonald's judging going on when it comes to children. In small children, I don't think McDonald's is contributing to obesity. At least not based on the caloric and fat content of their food for kids.

Thursday, November 20, 2014

Yummy lunch

Some patient on our unit had an epic bowel movement yesterday. It was one of those poops where the smell permeated the entire hallway and traveled down several adjacent hallways.

The smell even went into the back room where I usually do my charting. I heated up my lunch, with the intention of closing the door to the room and opening up a window, so that I could eat without the smell of feces in my face. Before I could do that, somebody in the room with me crinkled up their nose and said to me, "Your lunch smells awful!"

I don't know, maybe I sometimes bring weird stuff for lunch. But I'm pretty sure I've never brought feces.

Wednesday, November 19, 2014

Contribute!

A while ago, I informed the readers of this blog that I was building an anthology of humorous medical stories of 1000 words or more. Some of you were kind enough to have contributed stories. Well, it turns out we have enough to go ahead with the anthology, thanks especially to the generous contributions of Dr. Grumpy. Here is the cover:



I am still collecting story submissions, so if you have anything appropriate, email it to me at Fizzziatrist@gmail.com. Remember, all profits in the book will be donated to Red Cross.

Tuesday, November 18, 2014

Dr. Orthochick: Neverending

Circulating nurse: Schools are closed again tomorrow [because of snow]
Me: Wow, I really do not miss being in school
Dr. Orthoking Jr: Why's that?
Me: First off, I don't have to do homework.
Dr. Orthoking Jr: Yeah Orthochick, you don't have homework.
Me: Well--
Dr. Orthoking Jr: What did you do last night?
Me: I did some reading on proximal hamstring injuries, then I wrote out my operative plan for this case and the next case, then I reviewed my article for journal club and worked on my presentation for Tuesday on minimally invasive sacroiliac joint fusion.

Damn.

It never ends around here.

Monday, November 17, 2014

Scribble

I was just doing a CME activity and the lecturer had the most unintentionally hilarious slides that I had ever seen. He had clearly drawn on some of the slides, but it all just looked like freehand scribbles. Basically, it look like something my preschooler would have done, except maybe not quite as good.

Here is a sample of a slide, just so you don't think I am exaggerating:



What do those scribbles signify, exactly?

Saturday, November 15, 2014

Weekly Whine: Charity

A few days ago, I was at Barnes & Noble. I don't go to bookstores much anymore, but my mother was visiting and she wanted to buy some books for the kids, so we went.

We bought a few books, and while my mother was paying, the cashier mentioned a book drive for the poor that Barnes & Noble is doing. "Oh, that's great," I said. "So I can bring in books to donate?"

Apparently not. Apparently, you actually have to buy the book from Barnes & Noble, then the book is passed on to an underprivileged child.

I have seen supermarkets do similar things. They have a bunch of items that you can buy from them, then the items are donated to charity. Except I don't understand how this is not the store exploiting poor people to make money. Because I would've been buying the Barnes & Noble book at full price. Then they just pass the book on to charity. I could just as easily donate an old book to charity myself.

Tuesday, November 11, 2014

Dr. Orthochick: Respect

On Friday I was walking from Point A to a rather remote Point B and I ran into one of the peds ICU docs so we walked together. (side note: I have no idea how I know the peds ICU docs because I try to stay out of that place, but for whatever reason, I've always been the type of person who knows everyone. This happened to me in med school too)

Me: Hey, is everything OK? You seem sort of...bummed.
PICU Doc: I pronounced a kiddo this morning.
Me: Oh wow. I'm sorry.
PICU Doc: His father is probably going to go to jail.

I'll spare you the details, but it was probably one of the most sickening child abuse cases I've ever heard. (And if you're in ortho, you see child abuse. And domestic violence. And elder abuse. I don't talk about it much, but I see a fair amount of it.) Not to get too graphic, but the six month old baby had multiple skull fractures and had been shaken so hard that the gray matter of the brain couldn't be differentiated from the white matter of the brain. And that was just the injuries he had to his head.*** I wound up talking down the PICU doc for a while which was a little strange since I don't really know him, but he kind of seemed like he wanted to talk.

I've also been to some really sad places lately. The other day I was doing something in the ER and one of the general trauma docs (Dr. MarineBerg) asked if I could help him for a little while because he didn't have a resident and a Tier 1 trauma was coming in. So I followed him into Trauma Room B, gowned and gloved up...and the medics brought in a dead 13 year old. Gunshot wound to the chest. Dr. MarineBerg pronounced, I left the room.

The reason I bring all this up is because I was involved in a (different) upsetting case the other week where a 20 year old guy tried to kill himself by jumping out of a building. He broke his neck, his back, both legs, both feet, one arm, and lacerated his liver and his lung. One of his ankle fractures was open so we had to go to the OR to wash it out and do what's known as "damage control orthopaedics." (DCO for short) He was hemodynamically stable, intubated, and appropriately packaged by about 22:00 so we headed up to the OR then.

I really try to not get holier than thou, but I was disgusted by the behavior of most of the OR staff. The anesthesiologist said repeatedly he wished the kid had succeeded in killing himself so we wouldn't have to operate on him now, the circulating nurse said it pissed him off that our tax dollars would likely go toward the guy's medical bills, the scrub nurse said we should just finish the job and kill him in the OR, and my attending said he couldn't understand why we were bothering to save him since he was a suicide.

I'm sorry, I'm better than that. I was raised better than to make comments about how people should kill themselves and I"m not even going to make a comment about finishing the job as a joke. That's disgusting. I know it's late at night, but that's the sacrifice you make when you go into medicine. Sometimes problems don't happen between 9 and 5. Yes, it's inconvenient, but here's someone who really, really, really needs help. Let's do this. No, it's not what i was planning on doing with my Saturday night, but it's my job and I will do it to the best of my abilities. So I wanted to tell everyone to please refrain from making comments like that, but I didn't want to come off as holier than thou. So I didn't, but I wish I had.

I am very sensitive and I worry that since this stuff upsets me to the level it does, maybe I'm not cut out for trauma. But if the peds intensive care doc can still get upset when kids die and be a damn good doctor, then it's OK for me to get upset when people get hurt.

And quite frankly, I wouldn't want it any other way.

***If it is any consolation to anyone, all of his organs were harvested. Heart, lungs, kidneys, intestines, pancreas...everything. I think there were three transplant teams working at the time.

Monday, November 10, 2014

Fist Bump

When I started my residency, I was one of only four girls in the entire program. The hospital where I was rotating most of my first year had only male residents.

There were two male residents Nick and Rick in the program who I often ate lunch with and they were constantly fist bumping each other. I honestly can't give you an example of a fist bumping situation. It probably involved mentioning some girls booty.

I started to become intensely jealous of the fist bumping. As a woman, I felt really excluded from it. I used to talk to my husband about it, and whine about the fact that I never got a fist bump. granted, there were other guys who ate lunch with us who didn't get fist bumped either. Mostly, Rick and Nick would just fist bump each other.

Anyway, one day I said something (can't remember what, possibly involving some girls booty) and to my delight, Rick held out his fist to me. I happily bumped it. I was so proud.

Fast forward to nearly a decade later. I did something at work recently that my boss really liked. Instead of complimenting me, he held out his fist and I bumped it. I was only slightly more happy than when I get a raise.

I don't know what it is about having my fist bumped. I just really like it.