Update

I'm finally back. Somehow this blog got lost with everything life required of me. Where shall I begin? Well, I updated the heading. I'm no longer a wide-eyed 1st year medical student naive in wanting to "restore" health and practice the "art" of medicine. Medicine is not pretty. Nor do we make patients "brand-new." It is messy, at times unorganized, bloody, and tiring. Working with residents who hate their lives doesn't help either. Occasionally, I will have a moment where I know it is all worth it.

The other day -as all my stories begin -I had a young girl come in to the hospital for a rule out appendicitis. My residents, easily seeing the Surgeon written all over my face, thought it cute to have me take care of this patient. I was immediately put on the spot. I went in to see her. I performed the best history & physical I had ever done; presented the patient to my attending; wrote orders. I consulted Surgery and spoke to the on-call surgeon over the phone. I then saw the patient with him.

The surgery resident didn't believe the girl had appendicitis. I agreed based on his history. But from my detailed history, this girl had a classic case of appendicitis, which later ruptured, and now has peri-appendiceal inflammation or perhaps an abscess. He somewhat dismissed it when I told him this, but suggested we get an abdominal CT if we really thought she might have an abscess. He wasn't too convinced that this girl had anything more than "constipation" and walked off.

My patient's labs started to trickle back. It became apparent that this was NOT "constipation." I called the surgery resident right then and there. He now seemed to agree with me and suggested I call radiology to rush the CT scan. I ran everywhere just to get a radiology number that worked. Even the number the operator gave me went unanswered. After finally reaching someone in Radiology, I met the technician and took the p.o. contrast off her hands. I then found myself walking down the halls back to my patient with a super-sized cup of Gastroview mixed with orange juice.

After my patient had slowly finished it all, my part was done. Radiology would call her in 60-90 minutes to image her. The night team would handle it from there. I explained everything to her and her mom. I acknowledged that her feeling scared was natural, told her the rest of the doctors would take care of her, and said goodbye. I could see both were very gracious to have had me manage their care, especially my patient's mother.

As I made my goodbyes to everyone at clinic, I received strong compliments from the nursing staff, residents, and attendings. I had really only done what I was supposed to. Perhaps they were just amazed with the speed at which my patient was already on her way to getting a CT scan. In any case, it was getting late. Next problem - what to eat for dinner?

Some time last August, I was in line at the John Wooden Center to sign up for Taekwondo.  Behind me, this kid asked me if he was in the right place to sign up for Brazilian Jujitsu.  He was.  I had done a little Brazilian Jujitsu back at Stanford so we started talking about that.  I learned he was a freshman and was unsure/anxious about what to expect now that he would doing Brazilian Jujitsu at UCLA.  I mentioned I was in medical school and answered a couple questions about that.  A little bit later, I was done signing up for Taekwondo and went about my other business.  Occasionally, I would see this guy around campus but never spoke to him.  I had no clue if he remembered me, and I certainly didn't remember his name.

Tonight, Brazilian Jujitsu ran a little late as usual.  Taekwondo usually waits until they finish so we can use the room.  As I walked into the room, the students from Jujitsu weren't getting off the mat.  Surely they knew Taekwondo reserved the room for practice.  3 or 4 Jujitsu students were leaning over this one kid who apparently hurt himself.  I walked over to help out and immediately recognized the guy.  It was the guy who I met back in August when I first signed up for Taekwondo.  I elevated his leg, looked for any swelling, palpated for pain, all the while getting the story of how it happened.  The Jujitsu instructor comes up to me and says, "Hey, are you CPR certified or something?"  I reply very non-chalantly that, "I'm a medical student."  Immediately, he starts apologizing that he was wary of someone coming in and moving around the hurt guy's leg.  Of course he was doing the right thing.  I had not introduced myself.  The kid hurt on the ground thought nothing about me just coming over.  He answered all of my questions.  I even did a rough neurological exam and determined his vasculature and nerves were intact.  I got the impression that he remembered who I was and that I was in medical school.

After examination, I really had no definitive answer as to what was the cause.  The guy slightly dislocated his tibia.  It wasn't that obvious because of the ligaments of the knee typically prevent dislocation.  In the process, the guy partially tore a ligament or two.  He described a "throbbing" pain deep to his patella indicative of an ACL tear.  Because of the way the tibia had partially dislocated itself, it could have been an ACL or PCL tear.  I chose not to tell him this.  In this type of situation, if a person/doctor doesn't know the diagnosis, he shouldn't throw out the entire differential.  It'll just make the patient worry more...."I COULD HAVE CANCER????"....not cool.  After an unreasonable amount of time, he was taken away by EMT.  He'll have an x-ray done that will show his tibia partially dislocated.  All of this is rather minor and the guy will be back to normal in a month or two.

Next time I see him, I will definitely ask him about it.  There's no doubt in my mind that he'll remember who I am.

I just got done watching the Hermanos video for Club Caliente.  It was a good laugh.  From the video, I would guess Club Caliente would the place to be this Friday.  Unfortunately, I know exactly what is going to happen.  People are going to chill outside of Tresidder Union.  There will, of course, be a group of students upstairs that are studying on a Friday night.  But that's normal.  There are really just two things to do at Stanford: eat and study.  There actually are some other things to do, but they're either illegal or few and far between.  After Club Caliente is over, those kids studying will move elsewhere to study.  Hermanos will clean up and complain as usual.  During this complaining, the pre-conversation about food will begin.  Plans will be made.  It's time to eat!  Then the actual conversation about food will start.  Vegetarians will be made fun of.  Please don't mention that you like Gnutella.  In fact,  just say, "What is Gnutella? I've never heard of it."  If you say this, happy times will be had.  The conversation about food will continue.  This will persist for hours until the conversation about studying will begin.  This conversation is the low point of the night.  It won't last for hours like the food conversation.  It'll be done in less than 30 minutes.  At least 3 people will look depressed.  2 will be asleep.  1 person will be missing, and the question will be brought up, "Where is (Insert either Jeff or Herba)?".....good times.

Last post before I turn 22 and I am exhausted.  I almost didn't make it back tonight from the Wooden Center.  Taekwondo class lasted for 2 hours!  In addition to our warm-up and high intensity class, we had to do 6 sets of 20 burpees with crunches in between sets AFTER class was over.  I had no idea what burpees were before, but this is what they are.  After doing 120 burpees with crunches in between, I almost died.   I laid on the floor for 5 minutes and barely got up.   I managed to shuffle to the bathroom in case my nausea materialized.   And what did my instructor Sean say while we were dying??...."c'mon guys, summer's coming."  What is that supposed to mean???.....I work with Special Olympics on the weekend.  I'm not exactly trying to impress anyone here....though I could.

Somehow I was able to make it back to my apartment.  What a way to end being 21.....this is probably what I would feel like if I made to 81...

Today was again another beautiful day--translation: I didn't do any work.  Of course I tried to; I always do.  I went to the gym in the morning to start my day off right with a plan to get work done afterwards.  Needless to say, after I got back and showered, I was making plans to go to Santa Monica Beach.

The beach was packed beyond belief.  I could've used my long arms to reach into some guy's cooler next to me.  That might've happened if I had been lying on the ground that way.  Of course I was laid out so I could see the ocean, a regatta, and these girls from Mexico (given away by their TB scars and Mexico City-like spanish).  This random old guy stopped by and started talking to them.  He was very bizarre-looking and started drawing stuff in the sand----"very interesting," I thought.  That became my entertainment for awhile.

At the urgence of friends, I put on sunscreen.  I had just learned Friday that sunscreen damages the ocean.  Source:  my preceptor's middle school daughter......sounds reasonable.  So, I only put a little on and then didn't get into the ocean.

Now that the sun has gone down, I'm headed to a Persian restaurant with more friends...