Thursday, September 30, 2004

And One More

So, my intern year schedule started out with an easy month and then three consecutive months of overnight call. Two of those three are now gone. I'm still unsure what this coming month in a town of 8,000 in the middle of eastern Kentucky is going to be like. Yesterday I heard a version that made it sound like a pretty good time, all things considered, other than being away from home.

I haven't had any clever or interesting stories from the medical world lately. The ICU and CCU aren't necessarily clever and happy. However, the other day we were admitting a guy and we asked him who his usual cardiologist was. He replied with the phrase "Who shot Lincoln?". Normally at the VA, that means that the patient is crazy and everything they say after that should be ignored. However, after a split second, I realized that we had an attending somewhere at UK named Booth.

And finally, please follow this link to the Glasgow Gomer Scale, a takeoff from the Glasgoq Coma Scale. This list is so incredibly wrong, but dead on. I've seen many of these things for real.

Thursday, September 23, 2004

The Most Wonderful Time of the Year

College football is going strong now. Of course, this weekend there are no games of note. I think that the most entertaining game of all might be Alabama-Arkansas, and I don't even like either team. Alas, I will have more time for the important things in life.

I am no beginning my last week in the ICU's at the VA. Finally. Actually, the second half of the month on Cardiology and CCU has not been bad at all. Patients with problems that can be addressed and fixed. Much nicer situation than the hopeless patients in the other unit.

Oct 1 I begin my month-long rotation at a small-town hospital in eastern Kentucky. I'm really not sure what to expect from it. Supposedly I will have weekends off, which I have not had since July. That will make almost any level of work/abuse during the week worth it.

October 8-30 also coincides with the fall racing meet at Keeneland. It's an awesome atmosphere. The weather's just right and limiting live racing to two 3-week periods a year makes everyone get that much more into it. I've been trying to learn a little more about horse racing, both the actual racing aspects as well as the wagering aspects, so that I'm picking horses based on more than just "Wow, I like that name. That's clever". Unfortunately, we probably won't make it to Founders Day, where everyone comes to the track wearing 1930's garb. It really does look like Seabiscuit.

I'm also looking forward to the leaves changing color soon, although that will herald colder temperatures of course. I haven't lived somewhere that the leaves change color in fall in 11 years. And Heather has never lived where leaves truly change color. I mean, we saw the leaves last fall, but this year, they are our leaves on our trees in our yard.

Sunday, September 19, 2004

OK, I don't mean to dwell on this, but it is officially freaky now. At the grocery store today, I saw exactly one UK tee shirt and one Auburn cap. That is a 1:1 ratio. Bizarre, but comforting.
What a day for football

Not only did Auburn come back and defeat LSU, but UT and Florida gave a heck of a game as well. After Auburn's win over the faux-tigers (notice it rhymes with geaux) we went out to our favorite beer and pizza joint on the edge of UK's campus, Pazzo's. If anyone reading this is familiar with Mellow Mushroom, which is a pizza/beer chain located in almost every SEC city (except Arkansas and the Mississippi's), Pazzo's is similar. Rumor had it that the former manager of the Auburn location of Mell packed up and came to Lexington about 6 years ago. We've noticed that the style of pizza is very similar. Last night we walked in and the manager and some of the staff were all wearing Auburn tee-shirts. Keep in mind, that this was during UK's home opener being played about a mile away. Not only that, but while we were looking up at the Tennessee game, our waitress asked us if had watched that good Auburn game on earlier. Didn't even mention the opponent.

This was cool, maybe someone has had this before. I tried a "Smoothie" last night. It's a blend, along the idea of a Black and Tan, but it is Guinness and Woodchuck. Yummy indeed.

Also interesting is that in the morning we had gone to the farmer's market and saw someone there wearing an Auburn sweatshirt. I'm not sure why there is such a presence here. One must realize, it's not like we were seeing shirts from schools all over. No Ohio State. No Tennessee. No West Virginia. All UK and an occasional Auburn shirt. Very bizarre. I think after that game a few years ago though, UK tries not to think about LSU too much.

Oh and by the way, UK beat Indiana 51-32. Go Kats.

Saturday, September 18, 2004

WAR EAGLE!!!

Why do they call them special teams? Because they're special! That's why.

LSU has lived by the missed extra point and now has come full circle and died by it.
10-9. Auburn has finished what Oregon State started. I know LSU fans with their TiVo's will show replays of the missed (Auburn's that is) extra point and scream that there was no personal foul. Well, that is from that camera distance and that camera angle. So shut the hell up.

Happy 50th Tuberville!

Friday, September 10, 2004

Kill 'em All
from Heather

Brian told me I had to share about my newborn experience, so here it goes.
I was on newborn nursery call last Sunday. My job there was to show up to any deliveries that were scary for the ob/gyns and take care of the infants. While I was there a poor pregnant woman who was carrying triplets walked into triage. She was in labor. This would be normal except instead of the usual 40 weeks she was only 22 weeks along. At UK we do not attempt to save below 24 weeks and the infant also has to be at least one pound or so (500 grams). Triplets are not going to be that big. I did what any frightened intern would do and discussed these fetuses (it is easier for me to call them that) with my attending. He then told me to wrap them up, keep them warm so they would use up all of their energy reserves and die faster. He then said if they appeared to be in any kind of respiratory distress to get the nurses to place an IV and load them with morphine until they are gone.
Yes, people, I was told to kill babies. I know that the outcome for these little ones are not great. They have a 50% mortality and a 100% chance of significant morbidity at 24 weeks, which they are no where near. I am having big issues with this because it was the first time I got to play God. If this mother were to drive one hour to the west (Louisville) or one and a half hours to the north (Cincinnati) she would have had children in the NICU. Why am I the one who gets to hold these babies until they die? Actually, it would be the mom, not me, but I am the one who tells her.
As a postscript, as of yesterday the mother had not delivered. Her infants are now twenty-three weeks along, and are therefore "viable". I have to look and see where she is. I hope all will be well with this mother.

Congratulations Troy

Four years after entering Division I-A play, Troy has hosted a ranked team from a major conference and won on its home field. Way to go. Big 12 really not impressive.

Conjugate, roving eye movements = "the hosed sign"

Five IV poles decked out with 4 bags each of fluids and medicines = bad and is actually predictive of death within 24 hours.


Monday, September 06, 2004

And so it begins

College football season opened for real this weekend, sort of. The only game between Top 25 teams got postponed for obvious reasons. Most of the SEC teams looked decent with Kentucky, Ole Miss, and LSU being the notable exceptions. Kentucky's excuse? Probation and most of their attention cast to an indoor sport. Ole Miss? Their team plays on Sundays now, that is, EliMae. LSU? I don't think LSU is bad this year or anything, they quite simply didn't appear to have their shit together. As I was on call on Saturday, I didn't get to absorb myself into the spirit as much as usual (and limited to network TV offerings), so I didn't pay much attention to non-SEC goings-on.

The thing that excites me the most about Auburn's victory over token opponent Louisiana-Monroe had nothing to do with defeating a Sun Belt Conference opponent. It had more to do with the fact that someone besides Jason Campbell can play QB. The guy that was destined to replace him two years ago, but had serious health problems, played some in Saturday's game and did alright. At least he's an alternative now, since one never knows which Jason Campbell might show up for any particular game.

What's the difference between a bullet and a VA nurse? A bullet only kills one patient at a time and you can only fire a bullet once.