Monday, August 19, 2013

A Phrase I Could Hear All Day, Errday

So, this may come as a shocker to you... but, I do some pretty weird things. For example, I constantly play this game in my head where I see what prime numbers a sentence can be broken down into... Ex: "I am weird" can be broken down into intervals of 2, but not 3. I also count my steps a lot. Another AWESOME game that I play is what I call the "radio-knows-all-fortune-teller" game. I get into the car and say something like "The next song that comes on is going to reflect my day/explain my day/predict my day/etc."... you get the picture.

Tonight, I blasted on the radio, declared that the next song was going to be the summary of my day, and it was good ole' Travis Tritt crooning "It's a Great Day to be Alive." Thus leading to my blog entry. 

I am currently on my OB/GYN rotation and I spent the day at a high risk obstetrics outreach clinic. The only staff members were the maternal fetal medicine doc, the ultrasound tech, and myself. We had 10 patients and were basically just doing the standard growth and anatomy ultrasound checks. I got to see a few sets of twins, some benign anomalies, and become more comfortable with reading ultrasounds. With 9/10 patients down, I went to review my notes on the last patient. I remembered being confused about her earlier in the day because the only note I could find in the chart read "Fetal heart tone." I asked the doc for some more info, and the doc told me that the patient's first trimester ultrasound revealed marked nuchal translucency and cystic hygroma. Cystic hygroma is usually an indicator of Turner Syndrome, a chromosomal abnormality where the patient only has one sex chromosome, having a karyotype of 45, XO, instead of the normal 46, XX (female) or 46, XY (male). Unfortunately, 99% of conceptions with 45, XO result in spontaneous abortion or stillbirth. The surviving 1% of patients with Turner Syndrome are actually able to lead pretty normal lives, with the exception of some cardiac defects (commonly a coarctation of the aorta) and fertility problems. 


Anyway, back to clinic. This lady was scheduled as the last patient of the day, so that we could take the time to break bad news to her. If her baby had Turner Syndrome, there was an extremely high chance that it would be dead when we looked at the ultrasound. This would be the first patient encounter for me in which we had to break this kind of bad news, and I was nervous. The doc gave a quick practice speech to me, so I knew what to expect and how we would counsel the patient, what the next steps would be, etc. I went out into the hallway and was immediately relieved that she had brought a support team with her -- her husband, mother, and other children. I brought her back into the room and we all tried to maintain a positive atmosphere, like we weren't about to drop some of the most devastating news of her lifetime. I flipped down the lights, and the ultrasound tech placed the probe, and said a phrase that I will never get tired of hearing:

"Look! Here is your baby's heartbeat." 


Yes, Travis Tritt, it is indeed a great day to be alive!


Tuesday, August 13, 2013

Psych in a Nut Shell (pun intended)

Officially done with my psych rotation! I was on inpatient pediatric psych and it was truly an incredible and eye-opening experience. 

Here are some highlights:

Scenario 1: More Wise Words from My Roomie

Lecturer: Think back to college. This was really common in college. What did someone on your dorm floor have? Or what did one of your high school friends get? 

..... a few moments of awkward thinking silence....


Lecturer: Come on, guys! Everyone knows someone in college who had this!

My Roomie: .... STDs??? 

We all nod in agreement.

Lecturer: NO!!! Bipolar Disorder!!!!


 ... Oh. That, too.


Scenario 2: Rocket Science... aka ECT

During psych, we have to do a mandatory morning in Electroconvulsive Therapy (Think One Flew Over the Cuckoo's Nest...). By the 3rd patient, the attending decided I could run the ECT session.... which basically includes being the most Bad Ass person ever



Here is how it's done: 

Patient goes under anesthesia. You hook the ECT up to patient's head, preparing to induce a short seizure. And then....... drumroll please...... you get to say this:

3...

2...

1...

Treat.

And then you push a button and it makes noise and the patient has a seizure. 


Seriously, you probably read that and think it's pretty stupid. But no! Go back! Say it. Right outloud. In a Nasa countdown kind of voice.


3...

2...

1...

Treat. 

(Push button.)




PRETTY FREAKING AWESOME! 


Scenario 3: Are you the... Nevermind.

I'm sitting at a computer and an older doctor comes up to me and says, "Are you one of the pain fellows???"

All I have to do is turn around. He glimpses the length of my white coat and immediately gives me a "Oh, you're..... nevermind." Turns around and walks away. 

Yep.  I'm the med student.