I'm sitting in the MICU fishbowl, (thats the resident work area in the MICU, so called because it has windows the nurses use to watch us), waiting for code bongs to go off, and it dawns on me - tomorrow is June 1st! Important because that means only 21 more days of 'tern life for me! Woohoo! Thats either really awesome or really scary, depending on whether you're my patient or not :).
Due to such the occasion, it has me nostalgic for the craziness of intern year and more specifically the multitude of interesting patients I've cared for thus far. The one I'll never forget no matter what I do, where I go, or how senile I become (I would've said bald, but sadly I'm dangerously close to this already)... Mr. O. What makes him so special? Oh only because I've had the distinct pleasure of taking care of him twice and, oh by the way, have I mentioned he's my neighbor! Yeah that kinda takes the fun out of casually passing each other on the steps every other day.
Our first encounter. First month of internship, the doublemint twins and the rest of the team are heading down to the ED to meet the new overnight admit. We're standing in the patients room and I'm thinking to myself, "this guy looks awfully familar." Didn't take him as long to recognize me, as he belts out a heafty, "Howdy neighbor!" with the entire team standing around. Awesome.
Second encounter. I'm on one of my ICU months and is early AM during rounds. Code bongs reverberate the building and direct us to a room down the hall. I rush in the room with about 5 other people and wouldn't you know its my old buddy. Thankfully, it was just a narc overdose, but about 45 minutes later, there was a "Howdy neighbor!" directed at me from across the ICU. Great times.
21 days. Get it done.
Saturday, May 31, 2008
Thursday, May 29, 2008
The Original I Am Legend
For those of you who saw the recent film adaptation of I Am Legend and walked away saying, "What the hell?" This is for you. I came across the original ending to the movie, which mirrors more closely to the book and I have to say, what were the producers thinking? The original is TONS better. Watch yourself:
This ending - as opposed to the one used - actually gives philosophical weight to the movie. Legend (Will Smith) realizes in this sequence that HE is the monster, not the zombies. For they are attacking only to retrieve one of their own and in fact shows Legend is a ruthless killer, not a saviour! The title even makes sense, Smith is the legend of their (the creatures) nightmares. Furthermore, this ending depicts the creatures in a rational and evolving manner, adding to what we saw in previous scenes of leadership and trap-setting. Quite the revelation!
Some might prefer the non-thinking, slash-and-gore approach, I don't. Rumor has it, the original ending was shot and screened for a focus group, who preferred the alternate ending (the one published). What does this tell us? One, Hollywood does in fact ruin good books and second, the public is filled with idiots (incidentally which I already knew).
This ending - as opposed to the one used - actually gives philosophical weight to the movie. Legend (Will Smith) realizes in this sequence that HE is the monster, not the zombies. For they are attacking only to retrieve one of their own and in fact shows Legend is a ruthless killer, not a saviour! The title even makes sense, Smith is the legend of their (the creatures) nightmares. Furthermore, this ending depicts the creatures in a rational and evolving manner, adding to what we saw in previous scenes of leadership and trap-setting. Quite the revelation!
Some might prefer the non-thinking, slash-and-gore approach, I don't. Rumor has it, the original ending was shot and screened for a focus group, who preferred the alternate ending (the one published). What does this tell us? One, Hollywood does in fact ruin good books and second, the public is filled with idiots (incidentally which I already knew).
Thursday, May 22, 2008
A Magical Experience
Last weekend I went to see the second movie in the Chronicles of Narnia series, Prince Caspian, with Laurie. She was quite excited to see the film as she loves the book series and as it takes her back to childhood memories. Me on the other hand, was less excited and secretly wanted to see Iron Man instead.
There is a ton I could say about the movie, but really, I'm not in the mood to write much. What struck me the most while watching it was the similarities to a recently popular series, Harry Potter. I'm sure there are many ways to draw similarities and differences between these books, but what I realized was the centrality of magic in the stories. As an admission, I've never read a single Harry Potter book, but I do remember when it first came out and the scores Christian organizations and Christians themselves who blasted it's wizardry for teaching children evil things. Even more interesting was the amount of media coverage it received. In contrast, now that C.S. Lewis' series is in the mainstream, where is the opposition? Is not a potion that restores life, talking animals, and rituals to call powerful spirits magical?
I'm not trashing the Narnia series, but rather desire Christians (and everyone for that matter) to cast the same critical eye on all literature. Lets not play favorites. My fear is that Harry Potter received so much opposition is because it was written by an author who denies a sovereign God, whereas Narnia by an affirmed Christian. How can a secular world take what we say seriously if we are hypocritical in our judgments?
There is a ton I could say about the movie, but really, I'm not in the mood to write much. What struck me the most while watching it was the similarities to a recently popular series, Harry Potter. I'm sure there are many ways to draw similarities and differences between these books, but what I realized was the centrality of magic in the stories. As an admission, I've never read a single Harry Potter book, but I do remember when it first came out and the scores Christian organizations and Christians themselves who blasted it's wizardry for teaching children evil things. Even more interesting was the amount of media coverage it received. In contrast, now that C.S. Lewis' series is in the mainstream, where is the opposition? Is not a potion that restores life, talking animals, and rituals to call powerful spirits magical?
I'm not trashing the Narnia series, but rather desire Christians (and everyone for that matter) to cast the same critical eye on all literature. Lets not play favorites. My fear is that Harry Potter received so much opposition is because it was written by an author who denies a sovereign God, whereas Narnia by an affirmed Christian. How can a secular world take what we say seriously if we are hypocritical in our judgments?
Friday, May 16, 2008
Jack Bauer Who?!
I found this post that I wrote back in October, but never published. ahhh memories...
The last 8 hours in the CCU...
10pm: get sign-out from the other team
11pm: first admission arrives (pt#1) heads straight to the cath lab for inferior STEMI
1215am: pt#1 hits the floor, begin to write up h&p
1230am: pt#1 is in Vtach, has BP 70/50, and is vomiting repeatedly
1245am: discover pt#1 is actively infarcting his right ventricle
115am: 3L of fluid later BP still 80/60 --> start Dopamine gtt
2am: second admission arrives (pt#2)... Atrial fibrillation with complete heart block (ie HR is 30)
4am: third admission arrives (pt#3)... 88yo F in cardiogenic shock, no pulse --> code ensues
445am: pt#4 codes four flours up
5am: pt#3 codes again after being stabilized!
515am: pt#4 is pronounced
530am: pt#3 is pronounced
6am: pt#5 HR is 170
630am: sign-out to the primary teams and get the heck out of the CCU!
The last 8 hours in the CCU...
10pm: get sign-out from the other team
11pm: first admission arrives (pt#1) heads straight to the cath lab for inferior STEMI
1215am: pt#1 hits the floor, begin to write up h&p
1230am: pt#1 is in Vtach, has BP 70/50, and is vomiting repeatedly
1245am: discover pt#1 is actively infarcting his right ventricle
115am: 3L of fluid later BP still 80/60 --> start Dopamine gtt
2am: second admission arrives (pt#2)... Atrial fibrillation with complete heart block (ie HR is 30)
4am: third admission arrives (pt#3)... 88yo F in cardiogenic shock, no pulse --> code ensues
445am: pt#4 codes four flours up
5am: pt#3 codes again after being stabilized!
515am: pt#4 is pronounced
530am: pt#3 is pronounced
6am: pt#5 HR is 170
630am: sign-out to the primary teams and get the heck out of the CCU!
Tuesday, May 13, 2008
Book of Crap
I just finished watching the second National Treasure movie, coyly named Book of Secrets. I don't know if I can I adequately express how uninspiring it is (of course I will try though). Obviously the first question one should ask, "Why even see the movie given the first was so bland?" Great point. However, I respond by noting that the first was partially filmed in Philly and Philly rocks. Truthfully though, I have a soft spot for movies that afford me the opportunity to turn off my brain and just be entertained. I say this with a caveat, that the movie doesn't irritate me with its shear stupidity first. So with that expectation I watched Book of Secrets - and was still disappointed!
First, don't treat me (the moviegoer) like a 5-year old child. Both movies present themselves as 'puzzles,' which is almost laughable. I understand the average U.S. citizen reads below a 9th grade level, but that is no reason to create a movie where the actors proclaim truths that are insanely obvious to anyone with a brain. For instance when 4 of the main characters are trapped underground on what amounts to a large seesaw. Nic Cage exclaims, "We need to balance ourselves like counterweights!" No flippin kidding... you don't say. What gave you that impression? Possibly when you almost fell off because it was tipping?! I realize saying big words like 'counterweight' makes a sentence sound intelligent, but still no excuse. How about when 'Abigail Chase' shouts, "The water makes the rocks darker!" Holy crap, she should win the Nobel Prize for that one! Another example? When Jon Voight miraculously remembers his grandfathers dying words, "the debt that all men pay," when they were trying to solve the cypher. So all the years before, when he undoubtedly repeated this story ad nauseam, he simply forgot to share this crucial bit of information? Riiiight.
Secondly, get a better villain. Don't get me wrong, I enjoy Ed Harris and it doesn't get any better than Francis X. Hummel reciting Thomas Jefferson, "The tree of liberty must be refreshed from time to time with the blood of patriots!". It gets me every time. But, in this case, to have a villain whose sole motivation for masterminding a world-wide search for treasure be his slighted family name is frankly stupid. If his family is so bad off where'd he get all his money to travel the world? Heck, the dude trashed his Range Rover, doesn't seem like the Wilkinson's are doing that bad to me.
Thirdly, the 'don't kill my baby' bull expressed by movie-mothers time and again is played out. Seriously. We are led to believe the main characters mother has no contact with her son whatsoever, yet somehow she is brought to debilitating tears over his safety?! If you cared that much, why didn't you pick up a phone? I'm tired of women being portrayed in such a stupid emotional state. Not because it's sexist, but because its so flippin annoying!
First, don't treat me (the moviegoer) like a 5-year old child. Both movies present themselves as 'puzzles,' which is almost laughable. I understand the average U.S. citizen reads below a 9th grade level, but that is no reason to create a movie where the actors proclaim truths that are insanely obvious to anyone with a brain. For instance when 4 of the main characters are trapped underground on what amounts to a large seesaw. Nic Cage exclaims, "We need to balance ourselves like counterweights!" No flippin kidding... you don't say. What gave you that impression? Possibly when you almost fell off because it was tipping?! I realize saying big words like 'counterweight' makes a sentence sound intelligent, but still no excuse. How about when 'Abigail Chase' shouts, "The water makes the rocks darker!" Holy crap, she should win the Nobel Prize for that one! Another example? When Jon Voight miraculously remembers his grandfathers dying words, "the debt that all men pay," when they were trying to solve the cypher. So all the years before, when he undoubtedly repeated this story ad nauseam, he simply forgot to share this crucial bit of information? Riiiight.
Secondly, get a better villain. Don't get me wrong, I enjoy Ed Harris and it doesn't get any better than Francis X. Hummel reciting Thomas Jefferson, "The tree of liberty must be refreshed from time to time with the blood of patriots!". It gets me every time. But, in this case, to have a villain whose sole motivation for masterminding a world-wide search for treasure be his slighted family name is frankly stupid. If his family is so bad off where'd he get all his money to travel the world? Heck, the dude trashed his Range Rover, doesn't seem like the Wilkinson's are doing that bad to me.
Thirdly, the 'don't kill my baby' bull expressed by movie-mothers time and again is played out. Seriously. We are led to believe the main characters mother has no contact with her son whatsoever, yet somehow she is brought to debilitating tears over his safety?! If you cared that much, why didn't you pick up a phone? I'm tired of women being portrayed in such a stupid emotional state. Not because it's sexist, but because its so flippin annoying!
Sunday, May 11, 2008
Mother Earth
Yesterday I drove home after a 30-hour shift, sat in bumper-to-bumper traffic (who knew we had that in C-ville), and for some inexplicable reason - likely my mental stupor - became fixated on the person in front of me who was throwing trash out their window. "What compels someone to do that?," I asked myself. Better yet, what produces such a nonchalant attitude towards pollution?
I'm not a tree-hugger. I've littered myself; many times. But on this dreary afternoon coupled with a monotonous drive home, all precipitated by a coma of my mental prowess lead to this time of introspection turned philosophical daydream. What leads people to throw trash out their windows? On a more global level, why do we trash our planet? Like everything, it is certainly multi-factorial, though I can't help but wonder if being so removed from the idea of this planet providing for our basic needs (ie shelter, food, etc) enables us to disrespect it. For example, we no longer 'hunt and gather' in so much as we go grocery shopping. The earth no longer provides us with shelter, Toll Brothers does. So, if the perceived value (therefore not it's true value) of something is in what it provides, then by stripping those provisions from the source, has that commodity then been devalued? Probably.
In our world today, the cause and effect of pollution have been inherently separated. The further we alienate ourselves from 'nature,' the more we will continue to disrespect what it provides for us.
On a brighter note. Happy Mothers Day Esther, Dianne, Stacey, and Jodi.
If you haven't yet, call your mother and tell her you love her... she deserves it.
I'm not a tree-hugger. I've littered myself; many times. But on this dreary afternoon coupled with a monotonous drive home, all precipitated by a coma of my mental prowess lead to this time of introspection turned philosophical daydream. What leads people to throw trash out their windows? On a more global level, why do we trash our planet? Like everything, it is certainly multi-factorial, though I can't help but wonder if being so removed from the idea of this planet providing for our basic needs (ie shelter, food, etc) enables us to disrespect it. For example, we no longer 'hunt and gather' in so much as we go grocery shopping. The earth no longer provides us with shelter, Toll Brothers does. So, if the perceived value (therefore not it's true value) of something is in what it provides, then by stripping those provisions from the source, has that commodity then been devalued? Probably.
In our world today, the cause and effect of pollution have been inherently separated. The further we alienate ourselves from 'nature,' the more we will continue to disrespect what it provides for us.
On a brighter note. Happy Mothers Day Esther, Dianne, Stacey, and Jodi.
If you haven't yet, call your mother and tell her you love her... she deserves it.
Monday, May 5, 2008
would YOU live through a pandemic?
Haven't you ever been the least bit curious what living through a pandemic would be like? I don't wish harm on anyone, but there's just something in me that is just a bit curious. Maybe its just my medical background, fascination with the unknown, or simply my desire to see 'what I'm made of.' Whatever it is though, its nice to know - as a doctor - who to treat.
What do I mean? Well, in this weeks CHEST, an official list of 'recommendations' has been published that outlines proposed guidelines, designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when a pandemic hits, ie who not to treat. They include:
-People older than 85.
-Those with severe trauma, which could include critical injuries from car crashes and shootings.
-Severely burned patients older than 60.
-Those with severe mental impairment, which could include advanced Alzheimer's disease.
-Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
The idea (whether bad or good) is intended to better utilize resources at a time when those resources are certain to be scare.
If you listen closely, it almost sounds a bit socialist. Interesting.
What do I mean? Well, in this weeks CHEST, an official list of 'recommendations' has been published that outlines proposed guidelines, designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when a pandemic hits, ie who not to treat. They include:
-People older than 85.
-Those with severe trauma, which could include critical injuries from car crashes and shootings.
-Severely burned patients older than 60.
-Those with severe mental impairment, which could include advanced Alzheimer's disease.
-Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
The idea (whether bad or good) is intended to better utilize resources at a time when those resources are certain to be scare.
If you listen closely, it almost sounds a bit socialist. Interesting.
Saturday, May 3, 2008
So... funny story
I'm in the hospital at the moment, fearing every page I get is another admission waiting in the ED. In the meantime, I sit in the housestaff lounge watching the Kentucky Derby on the brand new 61" DLP TV we have and remembered a funny patient story.
I don't remember all the details, but the short version goes like this. On a previous call day, I was admitting a particularly contentious and unruly alcoholic for what we thought was acute alcoholic hepatitis. Being the thorough 'tern I am in seeing that his hemoglobin was low, I prepared to do a rectal exam (yes, yes... GH; funny I know). I go into the room, where the patient sits with his daughter, explain everything that is going on and subsequently that I need to do a quick rectal exam to determine if he is bleeding. What happens next even I can't make up.
Patient: you gotta do what?
Me: a rectal exam. It's just a quick procedure to make sure your not bleeding from your bottom.
Patient: HELL NO! My daughter may take it up the ass, but not me!
Needless to say, I couldn't hold back the laughter. Its the only time this year I've laughed in front of a patient (I usually just laugh at them behind their back). Glorious times.
I don't remember all the details, but the short version goes like this. On a previous call day, I was admitting a particularly contentious and unruly alcoholic for what we thought was acute alcoholic hepatitis. Being the thorough 'tern I am in seeing that his hemoglobin was low, I prepared to do a rectal exam (yes, yes... GH; funny I know). I go into the room, where the patient sits with his daughter, explain everything that is going on and subsequently that I need to do a quick rectal exam to determine if he is bleeding. What happens next even I can't make up.
Patient: you gotta do what?
Me: a rectal exam. It's just a quick procedure to make sure your not bleeding from your bottom.
Patient: HELL NO! My daughter may take it up the ass, but not me!
Needless to say, I couldn't hold back the laughter. Its the only time this year I've laughed in front of a patient (I usually just laugh at them behind their back). Glorious times.
Subscribe to:
Posts (Atom)
