My First Code Blue Experience

My first code blue of 3rd year that I was in and got to see from start to finish was on my neurology rotation. It was a friday night and I was on call, which means I had to stay till about 8:00pm. I was dreading staying, but started studying to use the time wisely. All was quiet until about 6pm the over head system said Code blue 12th floor, Code blue 12th floor. I knew that was us and I  ran to the code blue with my team, my heart pumping. We got there before everyone and got to see the start to end of the code. The process was awesome.

The controlled chaos of 20 people in one room working smoothly to get this guy revived. He had a brain bleed initially for his reason at the hospital. He also had kidney failure and had to get dialysis every day, and he became unresponsive during the procedure. It was cool to see the doctor standing at head of bed coordinationg everyone, telling the nurse to push epi, and to push magnesium, and to push bicarb. They stopped every 2 minutes or so to check for a pulse and a shockable rythm and would do CPR. I almost did chest compressions, but I stepped back and just watched the process. Next time I will do compressions. The guy made it. It was super cool to see the process. It made me realize i really want to do ER. I love Codes!

-MD in 14 

First post of 2013 (3rd Year Impressions)

It has been literally months since I last wrote. My main excuses are I am too tired or I need to study. This is a major lol, since I still find time to play Call of Duty and watch TV for a little every night. Ha ha! Anyways, I am at home today, it is January 2nd 2013. I am cleaning up my papers from my last rotation and getting organized, and opened my "Internal Medicine" notebook to find something I wrote on the first day of the rotation of Internal Medicine. This was my last rotation of 2012. I have done 3 rotations thus far, they are in order, Surgery  (July 2012- Sept 1 2012), Pediatrics (Sept 2012-October 10th 2012 or so)  and then my last rotation was Internal Medicine which lasted until Christmas break.  Anyways, my note I found was:

First Day patient rounds at cook county-
-1 patient with crack/cocaine abuse
-1 heroin user
-1 women just out of jail 1 month ago
-1 man who is currently a prisoner and has possible TB
-2 patients who do not speak a lick of english

I'll never forget that. It was the 2nd half of my internal medicine rotation. I had completed 4 weeks at Rush, and just started Cook County. I had heard it was different and eye opening, but that was far from what I imagined. I have never seen any of those at Rush, besides some non english speaking patients. But, this was crazy. Cook County was eye opening. It was foreign, it was scary that first week.

Then, I got used to the system, but not entirely.  It's mainly poor people who cannot afford healthcare, and many, many prisoners. It was sad because many of the people were in really bad shape by the time they got to the hospital because they let the diseases go for a long time since they cannot afford to pay for anything. The patient that left the biggest impression on me, and it is hard to type this without some tears in my eyes, was a young women, I would say she is more of a girl, she was close to me in age, if I remember right, around 24 or 25. She had blood cancer called leukemia. She had it treated several years ago, but it had come back, and much stronger this time.My team told me that she was not going to make it.

She was going to die, and they said they said it was because no one would treat her, and the treatment available at cook county could not help. She needed a bone marrow transplant, and cook county does not do that operation. I remember the moment I had to go draw her blood one day, and her arms were black and blue from the constant blood draws. They were checking her antibiotic levels since she had something called neutropenic fever. I was the one that went and drew the blood for these levels every day. One day, her mother just broke down in a stream of tears as I was telling A, the patient,  (cant say her real name, so A will have to be it) that I was drawing her blood. So, I put my supplies down and walked over to her, and hugged her. She cried some more, even more heavily. She was spent.

 Her mother had been at A's side every day, almost every hour of the day. I had never seen a time she was not in the room.  I'll never forget that hug. It took all my might not to cry. That hug had an impact on her, and a major impact on me. This woman's daughter was dying in front of her. Every time I went in there she struggled to eat because the cancer had messed up her esophagus. She was also constantly in sweats and always looked  uncomfortable. I am crying as I write this. She's 24 years old and dying. The few times she smiled really made me realized how precious life is.  That is the most profound memory I have at county hospital. It makes me realize how small my problems I have are. This profession really humbles you. I complain about having to study or long hours at the hospital. It is nothing compared to the people we take care of. 

Anyways, rotations have been going well. It's hard, but very cool at the same time. I start neurology next Monday. It will last for one month. I only have 3 rotations left this year, and then I am done in April. It has gone FAST. so fast. I cannot believe I am almost a 4th year. I have really enjoyed it.

-MD in 14

M3 Rotations Wake Up Call

Ok, so I havent written for a while, wow. Its the end of september today, and Iowa plays Minnesota at home for homecoming game, minnesota is 4-0 going into this game, we are 2-2 after losing to central michigan last week. This game is going to be huge!

So up to this point in 3rd year Ive done one whole rotation, surgery, and half done with my 2nd rotation, pediatrics. So, I got my evaluations back yesterday for surgery and also back for some pediatrics. And I am worried and kind of shocked.  Worried about whether the couple of bad evaluations will affect my residency. A couple of the doctors didnt say good things about me, well at least it will get me to pay more attention and shape up for the future rotations! Here are the nice kind words that I am talking about!!

Keep in mind, for this 1st one, I was late ONCE and I didnt know what JP was at the end of the 1st week, or didnt know she had it because I thought it was taken out, I don't know, it was a small thing, or at least what I thought was a small thing, that this DOC thought was a MAJOR deal. WOW.
Doctor 1:

“Keep reading -You need to understand a few things. First, there is a heirarchy in medicine and as a med student you should respect that. This applies to the 4th year students. They know much more than you about everything, so taking their advice would be a great idea. -No one is perfect. Respond more openly to feedback/criticism. Everyone makes mistakes, but it's how you repsond to this criticism that will determine how you do throughout your career. -you need to pay more attention on rounds and throughout the day about what's going on with our patients. Perfect example: we had a pt who had a JP in that we had been seeing for 5 days. When we discussed it, you claimed to not know she had a JP in place. This is unacceptable. To be a successful doctor you're going to need to pay much more attention to what's happening on rounds and less attention to your iPad. -The more interest you show, the more people will want to help you and teahc you. No one wants to take time out of their day to teach someone who isn't paying attention or doesn't care. However, if you show understanding and appreciation for their teahcing, you'll find that everyone (nurses, residents, attendings, etc) will take as much time as is needed to teach you and help you with things -Punctuality is an extremely important part of medicine. It's disrespectful to be late for anything, especially as the med student. -Try to be a better team player. Medicine, and especially surgery, is all about teamwork. If people can't trust you to do your job, the team falls apart. -None of this is a criticism on you as a person. This is just some feedback very early in your career that hopefully will help you to improve significantly as you go on. You're a good person. You just have to work on some of these things.”

The other two DOCS are below in what they said, and keep in mind I would "dissapear" when they told us nothing was going on, and we could go read, etc. I would go to the library, and so this is what came of that:

1  has not quite made switch from being a 2nd year medical student working on academic aspect of medicine to a 3rd year medical student on the wards. Max would disappear at times without informing or checking in with team. Work on being more of a team member within the health care team and with other 3rd year medical students.

Needs to work on being a team player. Is enthusiastic and enjoys being a part of team but at times did not take direction or suggestion well.  Anyways, I guess thats just life, I am going to work hard to learn from this and be better! Its just so crazy seeing how a little thing can become such a big thing. Anyways, I am going to go study a little now before the hawkeye game

 

The Quiz that Destroyed the Class

So I love med school because going into a quiz I know that I don't know everything and it's usually going to be just trying to survive. Yesterday we had a blood disorders quiz, anemia and blood cancer and clotting disorders was the main subjects.

My goal was to get a 50% because this unit is insane! I got in there and got a 68%. I am stoked. Thats a GOOD grade. In fact, average was 67% (before this quiz our average was 88% on all quizes). 


It is important for aspiring medical students to realize you cannot always be perfect. Now, time to get back at it.

-MD in 14 

Don't Mess Up On a Woman's Age

So, we have these program for M2 year called APD. Stands for Applied physical diagnosis. it's cool, we go to a hospital 4 times throughout the year, 2x in fall, 2x in spring semester and interview and do a physical exam on a real live patient in the ER of either rush or cook county hosptial.

 Anyway, I got assigned to Cook County, the busy County hospital. So last week I had one of these sessions. It's in a small group, 4 of us and an attending ER physician, they mimic 3rd year stuff, so it feels like real rounds. After we interview the patients, we have to present the pt just like a real round during 3rd year.

Well, I muffed up 2x in my presentation. After I had a 5 minute conversation with my pt about how I need to ask her her age and not just date of birth because my mental math skills aren't great, we laughed about her still being young and under 30. Well, as I presented to the doctor during our rounds, which i forgot to mention are at the bedside of the patient, and yes mine was aware that we were there, some aren't, but mine was. I said "miss blah, blah is a 30 year old female who presents with kidney stones. Well I messed up, the pt cut me off mid sentence and yelled "Hey, I'm NOT 30!!" ahh, hell naw, I rounded, I'm an idiot I immediately thought to myself.

Then later I said aloud that she smoked 2 packs every day, when it was 1 pack every two days. I felt real bad. It was real embarrassing messing up the age of a WOMAN right in front of her! I laughed real hard after, and so did the doc and my classmates. Anyways, the practice history and physicals in the ER are great. We have all the tools, a stethoscope, the blood pressure cuff, ear and eye instruments, the hammer, all the stuff we need for a complete physical exam. its crazy. we get to be doctor, its definetly my favorite part of this year. Also, I'm going to try and shadow my ER doctor within the next week or two! PEACE

 -MD in 14 

2012 First Post- It's Been to Long

It's already two weeks in, today is January 15th 2012! I had to write today because of the poem to the left. Ive been meaning to blog for a while, my last one hasn't been since I think maybe October, which seem like a YEAR ago, for real. Why? Because we have learned so FREAKING much! We ve covered GI, kidney, various cancers, and heart diseases. That was all in the fall semester so far. We also covered tons of BACTERIA and how they cause disease, mostly in November.

 On top of all that we have learned close to I am guessing near 300 or so different drugs, which I have forgotten over half of those at least, if not more like 90% of them. The drugs we learned last semester (last year! its wierd saying last year already, AHHH, time slow down a little please) dealt with Cancer drugs, Nervous system drugs, and Heart Drugs.

Wow, so much. Then we got 2 weeks for christmas. It was awesome, and literally the fastest 2 week break of my entire school career. I had Jennie visit me in Chicago for the first few days (we went on a helicopter ride, it was SICK!) relaxed at home with family, went to Iowa city for a couple days, and then celebrated New Years Eve with the dwgs in Chicago at a hotel and a club. It was such a good break, loved every second of it because I knew it was ALL WORK once back in Chicago. And its true, all work. My method lately has been skipping class and relying on the recorded lectures called "Camtasia" for my learning. Its so efficeint for me. I can stop and pause and take notes without being MAD confused all the time in lecture. Also my schedule is SO screwed up. Its crazy, I've been waking up at like anywhere from noon to 3pm, even as late as 5pm and then working out quick, eating dinner and then getting to the library/ study rooms at school by 9pm at the latest.

 Then, I stay up untill ALL NIGHT, usually till 7am or later studying. Its EFFECTIVE. Sometimes I get distracted and watch youtube. Like tonight I did that, Ive been at the school all night. I watched a supercross race before I came over. Then studied hard, but then got distracted by what we are studying on youtube. We are learning about WORMS, and so I youtube searched them, and got caught up into a talk show called "Tyra", where they had tapeworm diets. it was disgusting. What we are learning right now is absolutely disgusting. We ve started out the new year by learning about fungus infections, parasites, and worms. GROSS.

The poem on the left sums up EXACTLY how I feel. After listening to hours of lectures of this stuff, you don't wanna eat meat, go outside barefoot, walk on the beach, eat fish, be around kids, or travel abroad, especially to Africa! This shit SCARES the hell outta you. On top of that, as I'm studying, every time I itch, I think I have a worm infesting me! While I was studyn tonight, my stomach cramped a little, I was thinking I had a worm since every worm infection goes into the GI tract. So ye, this stuff affects you, it really funny though! and makes u def scared of the world thoe lol.

The poem is dedicated to Dr. Lint, our microbiology professor. Its the M2 course where we learn about all this stuff. Dr. Lint is a funny professor, he tells the best stories to the class and shows all the crazy pictures of disease. He precludes each picture before he shows it by saying "are you ready for this one? This one is Nasty" (its funny in his peculiar accent). Then, he shows the picture to a collective gasp of the class. Dr. Lint is outright my favorite professor that we have had at Rush. I wish he taught all our classes. He actually keeps stuff interesting. and he is hilarious.

Now, we are learning about the various lung diseases right now. When I was told how medical school would be it was no lie. year 2 is learning PATHOLOGY and PHARMOCOLOGY, which in simple terms is learning a particular disease, how it works, important findings (in med terms, its called HALLMARK findings) who is at risk, and then a few key drugs to treat it. Now pathology and pharmocology are separate classes, but at RUSH they keep the topics of the two very similar which incredbily nice. So now we just learned about different lung diseases in pathology class. In pharmacy we are learning the drugs that treat these diseases. So, summary of year two if you asked me? DISEASE and DRUGS. Now, the cool part about 2nd year is you feel like your learning some cool stuff and you can actually feel smart on the floor instead of wanting to curl up in a corner and hiding under a blanket.

What have I gained this year? I ve gained some confidence in talking about disease when I see it. It s a cool feeling, a feeling of legitamcy and a little feeling of maybe what it feels like to have that sweet MD (mmm cant wait!) Now, we also do clinical practice here, and my next post I will do now before I forget addresses that! Overall, 2nd yr is CRAZY as HELL, much harder than last year, and I am constantly reviewing last years material to understand this year's material. so my advice to someone about to enter medical school? TAKE COPIUS NOTES, ha I sound smart huh?

 I mean really, take good notes and SAVE them. I take all mine in notebooks my each subject and make sure their are well written, yea it takes effing forever, but I can reference them quickly for background info about this years stuff. Example: I forgot entirely how the lung works, ( I remembered it was a balloon for air lol), and I looked up exactly how it all worked in my notes. anways, next post, then its off to help my buddy move his stuff to a new apartment, sleep for a few hours, get my ass up, do a workout, and then its same old song and dance! STUDYING LIKE A BOSSS!

-MD in 14 

Future Summer Project Idea (When I'm a Doc)

So, midterm week was last week, it was hard but I am happy! I got 80% on all three tests, pharmacy, pathology, and physcianship. I am STOKED!! The average was like 84% for each thoe! Crazy huh?!! Med students are CRAZY SMART!! Anyways, we have a preceptor program we do every other week. 

We follow a doctor and slowly learn the HPI (history of present illness) and physical exam skills. I really like it alot! Well, I want to expand on this preceptor program. When I get my own job and start practice, here is my idea:

 Its called summer immersement with an MD. It's only for 1st year medical students after they are done and they have that summer in between M1 and M2 year. I have say 10 students for the summer, they come in 1-3 times a week. 

They become PART of the team. I would schedule less patients on the days students are to come in and then that way they can be taught and I can quiz and teach them about the essentials to the important things. 

Anyways, I wanted to write it down before I forgot about it!! Back to studying!