Tuesday, May 11, 2010

The Life and Times of an Intellectual

So I've been pretty busy with rotations...even though I haven't made posts or comments, I of course have been reading the blog. I was working in the ER for the past month working from 11 AM to 11 PM, which needless to say sucked because all I did was work and sleep. Being the small town that it is, I didnt see anything too interesting, although there was a little bit of excitement. Got to stitch plenty of people up which is kinda fun, other than that there was one code which was also kinda fun. Basically an 86 year old lady was brought into the ER feeling weak. We put her on a bed and while asking her questions she went unconscious. She stopped breathing and had no pulse, but she still had a rhythm on the heart monitor. This is called pulseless electrical activity, where the heart is beating but not in a way to pump blood through the body, so it requires CPR. The thing is the doctor working that night is kind of an idiot and was arguing the fact that the person was not in PEA, because the heart rhythm looked normal. By definition PEA can be any rhythm, there just isnt a pulse. Long story short this guy waits like 10 minutes and the lady eventually decompensates into a heart rhythm that requires shocking (get the paddles, "clear" etc.). So after that I start CPR and immediately feel multiple cracks as I break a few of her ribs, "if you dont break ribs you arent doing it right." Anyway, the lady ended up dying after doing cpr and stuff for about 45 minutes. I honestly think if I were in charge she may have lived, oh well.

On a different note, one day I was buying dinner with my debit card and it was declined. I knew I had money in my account so I was confused. I came home and found that my account had been hacked and google ads had spent like $1500 from my account. My bank was able to reimburse the money eventually, but still it was a hassle. I havent really watched porn since I started dating my girlfriend about 6 months ago, so I dont think that is the culprit. I think I probably got some kind of keylogger virus from one of the sites I download movies from. Just to be safe I reformatted with a downloaded copy of windows 7 ultimate. Ironic? Hope not.

As far as my current situation, I'm finally out of the small town of Petersburg that I'd been living in for almost a year. I'm in Wheeling, WV for a month doing an anesthesia rotation. Its far better but still this will hopefully be the last time I'll have to work in WV. Next month I'll be back in Va beach for 6 weeks working with boski's doctor. Thanks bosk. Been living with my girlfriend for like 3 months as well. Trying to set things up so we work in the same area.

A couple of things about the healthcare system that I thought were pertinent and kinda funny that I read on a medical blog I frequent at times (http://thehappyhospitalist.blogspot.com/):
Neighbor: These allergies are killing me
Happy: That's terrible. I hope you feel better
Neighbor: I tried Zyrtec but it wasn't doing anything for me. So my doctor prescribed xxxxxx (in audible drug name )
Happy: Does it start with an X
the drugs name is Xyzal
Neighbor: Yes it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec that the company slightly changed the formula and now they get to sell it as a patented medication at ten times the price for the next ten years
Neighbor: Oh, I didn't know that. But you're right. It was $110.
Happy: Did it help you with your allergies?
Neighbor: Nope.
Happy: I guess you just wasted $100
Neighbor. I didn't waste anything. My insurance company paid for it
Happy: Actually, we all paid for it with higher premiums
Neighbor: walks away.

You see it all the time. With Obama's healthcare plan, medicaid will be one of the primary ways that doctors get paid, as those who cant afford private healthcare get it paid for by the government. Of course the government doesnt compensate as well, and therefore doctors have little incentive to accept these patients other than out of the kindness of their heart.
" I make $1 on every Medicaid patient I see in the clinic. If I see four Medicaid patients an hour, I make $4 an hour. I don't work for $4 an hour."


term said...

How tight is the chain of command in the medical world? In other words, how taboo would it have been to just spoken completely out of place on that lady's condition and just taken the action you thought was correct?

Prime said...

while it would have benfitted the lady in pex's example, i would think there would have to be no tolerance for students/interns/residents (not sure proper term) to take action against the doctor's orders. i would hope that examples like this would be few and far between and the doctor is usually right, but who knows

pex said...

Voicing my opinion would have been ok, but obviously I wouldn't have been able to supersede the doctor's orders. The head nurse was already telling the doctor that she thought it was PEA, and I agreed. The doc disagreed though, so who knows what may have happened if we woulda started CPR 10 minutes earlier instead of waiting so long.

The terms you used were right prime. In ascending order it goes 3rd year med student, 4th year med student, intern (your 1st year as a doctor, a more specific term for a 1st year resident), resident (2nd year of residency on), and attendings (docs who have completed their residencies).

Staboski said...

So when Pex gets here I am going to schedule a appointment for a physical and request that Pex personally check out my prostate.

nyphon said...

Good to hear from you Pex.

Sorry to highjack the thread, but I have another question for Term (or anyone really). Should BP be responsible to pay everything to fix the damage they caused in the Gulf, even if it means them going out of business?

term said...


Prime said...


Staboski said...

Yep, thats the price of doing business. You fuck up royally you get screwed royally. Two guys own a moving company with one truck. Guys are driving truck and have been driving 17 hours straight. Guy falls asleep and hits family in mini van killing the mom and 2 out of the 3 kids in the van. Whats gonna happen? Dad will sue him for more than he is insured, probably get it, guy will be uninsurable and will go out of business. And thats the way it should be.

We've already started heading down this path where companies can fuck up (cough Freddie Mac) due to poor financial management and be bailed out by the goverment. Now you can have a total disregard for safety and still be bailed out?