Yesterday's shift was pretty much more of the same, with one interesting twist: instead of ending the shift with football injuries, that's how we started it. The night before, he was tackled and took a helmet to the chest, and had been having pain since, so he came in for an x-ray. Everything was fine, no broken bones or collapsed lungs, so we cleared him to continue playing.
That was our first case of the shift, and just like on Sunday, once they started, they didn't stop. I felt like I was several patients behind the entire day, but such is life. The attending I was working with wanted me to get some practice with procedures, so she had me starting my own IVs and such, which usually the nurses do. I also got to staple an 11-year-old kid's head, which was all sorts of fun. We gave him a little something to take the edge off first, so he was actually pretty still the entire time.
Today was a class day (ugh), which started with two hours of discussing ER cases. After that we had an hour of simulation, going over management of acute emergency patients with the clinical skills lab's computerized dummy. The first one ended up coding (respiratory arrest), because the student running the case kept asking the patient questions instead of noticing that the patient's (dummy's, whatever) vital signs were crashing. Fortunately, he had the rest of us backing him up, so we were able to do CPR and treat him and bring him back to life. I got in an argument with my fellow students, and the ER resident running the cases, when I said that we can give the patient O+ blood instead of O-, because studies have shown that while giving a woman with O- blood of childbearing age O+ blood can cause problems in any subsequent pregnancy, men obviously don't have the same problem. Well, the resident said he had never heard of that. When we went over the case afterwards, the attending said that I was right, and in times where you might have to conserve your supply of O-, men should receive O+ blood to save the O- blood for women. So, I was right, and they were wrong, and I was very proud of myself for that.
Anyway, after that I had to take my car to the VW dealership for its 5000 mile maintenance. I still can't believe I've put that many miles on it.
Showing posts with label car. Show all posts
Showing posts with label car. Show all posts
Wednesday, October 15, 2008
Wednesday, August 6, 2008
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.
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.
Thursday, July 24, 2008
The new car
As promised, here are some pictures of my brand-new Volkswagen Jetta:
Yup, that's the odometer when I picked it up... 7 miles. A little bit insane. It's the basic model, but that has pretty much everything I want/need: cloth seats (with heated seats in the front), all sorts of airbags and safety features like that, telescoping steering wheel, climate control, CD player, a port for my iPod, duel transmission (which I doubt I'll ever use but Alex had a fun time playing with), cruise control, heated windshield (that'll be nice when I wake up to an inch of snow/ice on my car in the winter), and some other stuff I can't remember right now. I'm pretty excited about it, which is good, because I'll be paying for this until I finish residency.
Yup, that's the odometer when I picked it up... 7 miles. A little bit insane. It's the basic model, but that has pretty much everything I want/need: cloth seats (with heated seats in the front), all sorts of airbags and safety features like that, telescoping steering wheel, climate control, CD player, a port for my iPod, duel transmission (which I doubt I'll ever use but Alex had a fun time playing with), cruise control, heated windshield (that'll be nice when I wake up to an inch of snow/ice on my car in the winter), and some other stuff I can't remember right now. I'm pretty excited about it, which is good, because I'll be paying for this until I finish residency.Tuesday, July 22, 2008
It's done!
After a month of whining and complaining about how much I have to study for step 2 of the boards, it's done! I left the house at 8 this morning and drove to Portland (not so far in that I had to deal with rush-hour traffic), and was seated at a computer, which became my home for the next seven and a half hours. It was a joy.
Here's pretty much what happens: I go in, check in, make sure everything is in the computer correctly, listen to the rules, and follow one of the proctors to my computer. This is just at a testing site, not specific to the USMLE, so there are people there taking other exams--for example, I saw at least four family medicine doctors there for their recertification exams. So after signing in, there's a ten minute "orientation" on the computer, pointing out what each of the buttons on the screen means. Then the test begins. There are eight blocks of 46 questions, with an hour given for each block. There's also 45 minutes of break time to use at any point between the blocks. Any time that isn't spent answering questions goes toward the break time--you don't get more time on the next section if you finish one early. I'm a fairly fast test-taker, so I had time left over after each block, so I signed out and walked around the courtyard for a bit, cleared my head, and went back in. By the end, the proctors were very used to seeing me coming up and signing in/out. I did four blocks, broke for lunch, went for a bit of a walk (since I had so much break time built up already) and came back for my last four. By the sixth block, my brain was fried and I was doing all that I could to just read the questions each time instead of clicking a random answer, but I made it through. The score for this one will come in about six weeks.
In other news, I bought a car yesterday. It really wasn't planned. When Alex and I picked up the parents at the airport, Mom suggested going in and test driving some cars so I have an idea of what I'm looking for. Well, before I knew it, I was signing the paperwork for a 2008 Volkswagen Jetta. We're picking it up tomorrow, so pictures will probably appear sometime after that.
Here's pretty much what happens: I go in, check in, make sure everything is in the computer correctly, listen to the rules, and follow one of the proctors to my computer. This is just at a testing site, not specific to the USMLE, so there are people there taking other exams--for example, I saw at least four family medicine doctors there for their recertification exams. So after signing in, there's a ten minute "orientation" on the computer, pointing out what each of the buttons on the screen means. Then the test begins. There are eight blocks of 46 questions, with an hour given for each block. There's also 45 minutes of break time to use at any point between the blocks. Any time that isn't spent answering questions goes toward the break time--you don't get more time on the next section if you finish one early. I'm a fairly fast test-taker, so I had time left over after each block, so I signed out and walked around the courtyard for a bit, cleared my head, and went back in. By the end, the proctors were very used to seeing me coming up and signing in/out. I did four blocks, broke for lunch, went for a bit of a walk (since I had so much break time built up already) and came back for my last four. By the sixth block, my brain was fried and I was doing all that I could to just read the questions each time instead of clicking a random answer, but I made it through. The score for this one will come in about six weeks.
In other news, I bought a car yesterday. It really wasn't planned. When Alex and I picked up the parents at the airport, Mom suggested going in and test driving some cars so I have an idea of what I'm looking for. Well, before I knew it, I was signing the paperwork for a 2008 Volkswagen Jetta. We're picking it up tomorrow, so pictures will probably appear sometime after that.
Sunday, July 6, 2008
Home
Okay, I am home now, and have been since Tuesday afternoon (the day, not the Moody Blues song), I've just been too busy/lazy to post anything.
After all our big plans of going hiking while on our cross-country drive, the first time we actually found somewhere to hike was Beacon Rock, which was about twenty minutes from the house. Oh, well. It was a good idea in theory.
During the drive, the fuel door on my car was getting progressively more and more difficult to open and shut, until it finally reached a point where it wouldn't close all the way. I resigned myself to the fact that I would have to put some money into fixing this, and made plans to go to a Nissan dealer after arriving back in Washington. Well, after our hike and about fifteen minutes from the house, my brakes started squealing, which just made me laugh, and I added it to the list of things that they had to look at when I took it in. So Wednesday morning, Mom and I took the car into the dealer, told them the situation, and then walked over to the mall to shop for things we didn't really need. A couple of hours later, we call the dealer and find out what the deal is. It was quite the list. 1) Some of the paneling/hinges on the fuel door were warped, and the whole assembly would have to be replaced. This is a custom job. Price: $390. 2) Leak in the oil pipe/tank (I was only half paying attention). Price: $140. 3) Leak in the power steering. Price: $160. 4) Front and rear brake pads are worn and would have to be replaced. Price: $440. Needless to say, I was a bit shocked and not all that happy about hearing that my car had over $1000 worth of necessary repairs, so I told him I needed some time to think about it, and we went back in to pick up the car and go home. Well, when we got there, he explained that most of the damage (brakes, leaky pipes, etc) were due to the excessive amounts of rust in the undercarriage due to 12 Ohio winters, where they salt the roads. So the car didn't have $1000 worth of repairs; it was actually much higher. So now I'm shopping for a new car. I'm going for a compact sedan, if anyone has any suggestions for which one I should get.
Other than the whole car debacle, not much has been going on around here. I'm actively (in theory) studying for the boards, step 2 of the USMLE (there are three steps; step 2 has two parts). I'm taking the clinical skills portion in LA on the 15th, and the clinical knowledge (multiple choice written exam) in Portland on the 21st, so most of my time these days is spent reading my cardiology textbook, my case books, and doing practice problems online. It's quite intimidating, and I don't feel ready for it at all.
After all our big plans of going hiking while on our cross-country drive, the first time we actually found somewhere to hike was Beacon Rock, which was about twenty minutes from the house. Oh, well. It was a good idea in theory.
During the drive, the fuel door on my car was getting progressively more and more difficult to open and shut, until it finally reached a point where it wouldn't close all the way. I resigned myself to the fact that I would have to put some money into fixing this, and made plans to go to a Nissan dealer after arriving back in Washington. Well, after our hike and about fifteen minutes from the house, my brakes started squealing, which just made me laugh, and I added it to the list of things that they had to look at when I took it in. So Wednesday morning, Mom and I took the car into the dealer, told them the situation, and then walked over to the mall to shop for things we didn't really need. A couple of hours later, we call the dealer and find out what the deal is. It was quite the list. 1) Some of the paneling/hinges on the fuel door were warped, and the whole assembly would have to be replaced. This is a custom job. Price: $390. 2) Leak in the oil pipe/tank (I was only half paying attention). Price: $140. 3) Leak in the power steering. Price: $160. 4) Front and rear brake pads are worn and would have to be replaced. Price: $440. Needless to say, I was a bit shocked and not all that happy about hearing that my car had over $1000 worth of necessary repairs, so I told him I needed some time to think about it, and we went back in to pick up the car and go home. Well, when we got there, he explained that most of the damage (brakes, leaky pipes, etc) were due to the excessive amounts of rust in the undercarriage due to 12 Ohio winters, where they salt the roads. So the car didn't have $1000 worth of repairs; it was actually much higher. So now I'm shopping for a new car. I'm going for a compact sedan, if anyone has any suggestions for which one I should get.
Other than the whole car debacle, not much has been going on around here. I'm actively (in theory) studying for the boards, step 2 of the USMLE (there are three steps; step 2 has two parts). I'm taking the clinical skills portion in LA on the 15th, and the clinical knowledge (multiple choice written exam) in Portland on the 21st, so most of my time these days is spent reading my cardiology textbook, my case books, and doing practice problems online. It's quite intimidating, and I don't feel ready for it at all.
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