Week #6....check!

One more week of internal medicine down. It seems forever ago that I started. But, time has flown by just a little bit more these past 2 weeks, I think mostly because our residents are trusting us more and more each day and allowing us to do more and more. Unfortunately, this is our last week with this resident crew. Next week, we switch resident teams, floors, attendings and call nights. Good thing I didn't buy that $150 Pink concert ticket for October 5th. I may be on call that night :) So, here is a recap of the last week, starting with last weekend!!

Mit and Roberta came down to the city....YAY!!! Morgan, a friend from Roberta's work, flew in from Australia. He had a hotel room at the New Yorker, so Mit and Roberta came to hang out in the city on Saturday. We had brunch at Friend of the Farmer, which was excellent. We then strolled along the East River, headed to central park, sat on a bench and "people watched", headed back to the hotel room, got ready for a night out, had Mexican food at a restaurant in the lower east side, headed to the slipper room for a burlesque show. As always, the slipper room didn't disappoint me!! It was a great night, and I'm so happy that Mit and Roberta came down. And of course, it was really nice to meet Morgan.

So, on Monday started Week #6. As always we had some interesting patients. Lots of "chest pain" and "shortness of breath". I loved the patient who complained about SOB but refused to quit smoking cigarrettes or smoking crack/snorting cocaine. Her response was "how the hell does that have anything to do with my asthma?" I give our attending lots of credit for trying to explain it to her but she still didn't get it. I'm sure we will be seeing her again soon. I was on call Tuesday night and we had 1 very interesting case. A woman who just gave birth the week before came in with shortness of breath, difficulty breathing, and heart palpitations. It turns out she had these symptoms during her last month of pregnancy as well. The diagnosis: pregnancy induced dilated cardiomyopathy. Fortunately for her, it is reversible. The other interesting case was assigned to our floor on Thursday. 22 year old female with tremors, sweating, palpitations, anxiety. One look at her neck gave the diagnosis away....she had a huge thyroid. Blood samples were sent to test for antibodies but everyone is in agreement that it is probably Grave's Disease. The good thing for her is that it is completely treatable as long as she is compliant with medication. The hard part will be the next few months of trying to figure out what her medication dosage should be.

I also had 2 preceptor meeting this week. My preceptor is very good. Not only is he Director of Pulmonology at the hospital, but he is a walking textbook of everything!!! Which makes my meetings with him interesting since I never know what he will ask. The interesting thing is this, every meeting with him he makes a comment about how me and the other student there are dumb. He will make a reference to our IQs and then laugh. Or, he will flat out tell us we are dumb and laugh. I can't figure out if he is really joking or if he is really serious. I think me and the other student do very well with our presentations and answering questions. I feel like pulling in some other students from our program for our meeting and asking the doctor to talk to them. I think in a few moments he would realize that we are intelligent students. I was hopefully planning on asking for a letter of recommendation from this doctor, but not i'm not too sure. My other option was seeing if he would be my preceptor for my medicine sub I elective in 4th year....working my butt off....and hopefully getting a letter then.

Which reminds me, on Tuesday we had a meeting with a current 4th year student about next year....signing up for Step 2....scheduling electives....etc. I have been busy trying to plan my 4th year as to what I will take and when. After 12 weeks of surgery and 6 weeks of medicine, my heart still belongs to Emergency Medicine. I'm sure that won't change after peds, Obgyn, and Psych. I have decided that I want to do a rotation in Emergency at Maimo and one at Methodist. Hopefully I can get them both in before September. For the rest of my electives I am thinking about Neurology, Cardiology, Anesthesia, Peds Emercency, PICU, Family Medicine, Radiology, and Dermatology. If I have extra time available, I may also try Ortho and MICU. Of course, a 2 week course in U/S would be great also. You are probably asking why family medicine?? Well, in order to practice in California or Texas a student must do that elective. I don't want to lose any future opportunities in any state. I'm still trying to plan out my timeline and I'm just hoping everything works out. Of course I will keep you updated!!

Well, I have lots to do today in terms of studying and paper writing. Next saturday I am seeing Brandi Carlisle in concert. And, if I'm not on call 10/5, I will try to land some Pink tickets. So I have to get as much work as possible done between now and then. Take care everyone.

Weekend fun

This weekend was alot of fun!!! It started with Amanda asking me if I would like to attend a Yankee's game on saturday. She happened to have some tickets, and since I had not yet set foot inside the new Yankee stadium, I eagerly said YES!!! So, at 10am saturday morning I made my way to 161st in the bronx.


Very nice stadium!! Inside was even nicer....

Me, posing it up!!

DEREK!!!!

The game....unfortunately, they lost to the Orioles 7-2.

After the game, Amanda and Dy and the peeps they came down with (already forgot their names) had to leave to drive back. So, I hopped on the 4 train and headed down to midtown. Once there, I ran into a street festival. They sell t-shirts, and jewelry, and lots of food. I got a chicken burrito for dinner.....it was very good. Then, on a whim I decided I wanted to see the movie District 9. I have wanted to see it for the last few weeks, but just haven't had the time. I headed to Times Square to Regal. Very good movie. At first I didn't know what was going on. It was shot almost as a documentary, but then the movie picked up and surprisingly, was a little gory. But overall, I thought it was very good. Great special effects. And, an original story!!! During the movie, my tummy didn't feel too good.....damn street chicken burrito. So, after the movie, I headed back home and to bed.

I got up this morning, made some coffee and sat down at my computer to see what events were happening today. NYC.gov has this nice section entitled "events". I found out today was HarborFest.....a celebration of the Dutch settling the city. So, I decided to get ready and head on out there to see what it was about. I jumped on the Q and headed to Times Square, and then walked over to the West Side pier off of 44th St. I grabbed a brochure and headed out on the Water taxi to Battery Park...

Aren't I cute?? :) The guy on the water taxi was hounding me to take my pic......Harbor Fest was all over the city. They had events back at the Pier off of 44th st. Events off of Chistopher St. Events at Battery Park. Events on Governor's Island. Events near the Brooklyn Bride. Many of the events were free. They even offered free bicycle rentals to use on the Hudson boardwalk, but I decided to enjoy the day and walk. So, I walked around Battery Park, enjoyed some Dutch music, had some lunch and then headed back to the Pier for the Oyster and Wine fest. I didn't have any Oysters....just some wine. And, there was also a craft beer judging event there. 12 breweries from Lake Placid to NYC took part (remember, Henry Hudson sailed from NYC to Lake Champlain). They had to enter a beer that would have been brewed 400 years ago. The winner was Brooklyn Brewery with their District 2 beer. After the judging, they had a beer tasting......very good!! Other pictured highlights include:

The city.....sky looks very dark at 11:30am....but by the afternoon, it was blue skies with gorgeous sunny hotness.

This is the "Half Moon"...the ship that Henry Hudson used to sail up the Hudson river. I'm not sure if this is the real ship, or a replica.

This is some Dutch ship....I am really bad remembering people names, how the hell am I going to remember a ship's name I couldn't pronounce. Apparently this was the first ship built in New York by the Dutch in 1614.....this is not a replica...it is the original boat. Behind it is the USS Intrepid. And as I told you, the sky is blue now!!!

At 3:30pm.....after a wine and a few beers at the tasting.....I decided to head to Madison Square Garden to see the NY Liberty play their final home game of the season against the Washington Mystics. As I was standing in line waiting to buy a ticket, this woman comes up to me and the people standing beside me and says "Do you want free tickets?" Apparently she was with the Liberty and she was randomly selecting people to give tickets to. So, I thanked her and headed to my seat.......

Unlike the yankees, the Liberty won!! It was a great game and I am so glad that I decided to go....and that it was free!!! Thanks NY Liberty!!!! I will be sure to go to games next season and pay!!

On the way home, I stopped in Union Square and had Taco Bell. I was really craving a chicken taco!! I also had some nachos supreme.....hey, i walked alot today okay so I can afford the calories!!

Well, that is the end to my weekend. I had a great time.....saw alot....did alot....walked alot!!! Tomorrow starts week 5 of Internal Medicine, and I am on call. Hopefully, we get an interesting case. I hope everyone had a great weekend. Take care.

Click the box medicine

So today was the start of week #4 for Internal Medicine. I can officially say that I am bored out of my mind. I do, however, feel the utmost joy when our residents do or say something so incredibly dumb that you know the attending just wants to slap them silly. Here was last weeks funny moment:

Residents: There is no urine coming out of the foley.
Attending: So, what is your next step?
Residents: Ultrasound of the kidneys....there may be something there.
Attending: (Looking rather annoyed). Don't you want to check the foley first?
Residents: (Dumb looks on there face).
Attending: (Looking more annoyed). Don't you think there could be a blockage or maybe it is in the vagina instead of the urethra???
Residents: (Still with dumb looks on their faces....and not saying anything).
Attending: DID YOU CHECK??
Residents: Uh........................no.
Attending: Go check!!!

This is of course one of many instances where I have come to find out that some residents just lack some common sense. I can see this coming from the intern, but not the second year resident (both of which were part of the conversation above). My friend today put it rather nicely when he stated that the residents practice click the box medicine. Patient presents with this, then it must be this (check). Patient complains of this, then it must be that (check). There is no thinking involved which can lead to some disastrous consequences. The one thing I have learned in medicine is that I do not want to be a click the box doctor!!!

So, this past weekend I decided to travel home to visit. It was my sister's birthday and she wanted to go to the State Fair. I hadn't been to the state fair in 3 years so I was excited. It only took about 1 hour to realize nothing had changed. All the vendors.....all the food....all the rides....all the games....all exactly the same. Even with that, I had a great time. I got chocolate milk for $0.25/each.....I rode the ferris wheel....I saw the horse pull....I had some wine....I ate corn on the cob, a hot dog, a hamburger, a twist with chocolate spinkles, 6 chocolate covered strawberries, a root beer float, a few of my brother's fries, a bite of my mom's roasted prime rib sandwich, a few cubes of NY cheese, a couple of nachos, and lots of water!!! And of course, I walked around all day long and I was exhausted when I got home....passed right out!!! So, going home for the labor day weekend was a great idea.....that, and if I had stayed here in Brooklyn, I would have been in the heart of the weekend long Caribbean festival...and I have already experienced that once!!!! Happy Birthday Randi!!! Everyone have a great night!