Bad car! Bad med student!

Hmm... I don't know which story to start with. I guess I'll go chronologically.

I managed to wake up on time this morning, so I went running for about an hour, then showered and changed at the gym before going to work. The morning was pretty low-key, with a giant conference of all sorts of preventive med people (PM, public health nursing, occupational medicine, industrial hygiene, health physics, and others I'm probably forgetting). After that there wasn't much going on, so I finished the online smallpox vaccine course and did some work on my scoliosis project before latent TB clinic in the afternoon.

And here's where the "bad med student" part comes in. So I'm interviewing the patient, who had a skin test of 13 mm after returning from Iraq. Unlike most that we get, he's never had a completely negative skin test, so he wasn't quite sure why he was referred to the TB clinic this time. Well, after finishing the history, I present the case to the attending to determine whether or not he's in a risk category that would make 13 a positive test (low risk is only positive if it's over 15 mm; medium risk is 10-15). Then we went back in together to get more history to figure out his risk factors. Yeah. Apparently, in addition to being deployed in a country with TB (which we sometimes consider a risk factor), he used to work in a chiropractor's office (patient care is a risk factor), lived in large cities in Texas (where there was possible contact to Mexican immigrants with TB), and spent a weekend in jail (another risk factor). So if I had bothered to take a complete history, I would have realized without a doubt that he was medium risk and 13 was a positive result and he should get treated. Oh, well. I'll do better next time.

Now for the "bad car" part. After our day was over, I got in my car, and the key did not turn. At all. I tried jiggling the steering wheel, pressing the brake, arming and disarming the alarm... nothing. So I called Volkswagen roadside assistant, and they called for a tow truck (it was very interesting to try to describe where I was parked, but that's another story). Fortunately, Bubba the tow truck driver showed up fairly quickly. Yes, his name was Bubba. I couldn't make that up if I tried. Well, he couldn't get it to turn, either, so onto the tow truck the car goes. Then we got it to the Volkswagen dealership here in Tacoma, at which point it starts up on the first try. So now my brand-new car seems to like making me look like an idiot. Hopefully it's done playing games now.