Exactly

"Do you know where you are?" - nurse to patient
"I know EXACTLY where I am" - indignant patient
"Where are you?"
"Well I don't know exactly ... "

Alvesco

Morning doctor: "What can you tell me about Alvesco?"
Me: "sounds very familiar, is he on the cardiac ward?"
Morning doctor: "Alvesco is a medication"

Haunted

Nurse, "room 405 is haunted ... ... that's your office"
Me, "my office is 404"
Nurse, "that's what I meant"

I totally laughed her off, but I'm keeping the lights on.

Dreams

I had to wake up a sweet old lady for her blood test this morning. It's pretty much the worst, waking someone up to jab them with a needle.

She was especially upset though, because in her dream a gorgeous man was just abut to jump into bed with her.

I left her with a passing comment that I'd let her get back to her gorgeous man. She just gave me a withering look and said "dreams don't work that way, dear".

Muffins

This is an actual page I got in the wee hours of this morning ...

"Hello Dr, I'm calling from the cardiac ward. We have a couple of jobs waiting for you but more importantly we have muffins. Some are chocolate with choc chips, and some are just choc chip. Whenever you're ready."

Best ever!

Night shift

I started another term of medical nights this week. For the next three months I will work seven 12 1/2 hour night shifts in a row, followed by seven days off.

I've done it before over winter, and chose to do it again because of the valuable experience you can only get on nights. Haha ... actually the pay is really good and I like having every second week off.

I used to think the first night was always the hardest, but I've just remembered otherwise. It's the night after your first proper daytime sleep. I'm struggling right now!

Delete

It turns out you can accidentally delete a patient's file from the emergency department simply by leaning your elbows on the keyboard.

As far as we can tell, there is no actual key sequence that does this - you have to use your elbows. I am not the only one to have done this, by the way.

Aggressive-aggressive notes

Got that?

Pagers

I do wonder how many times this happened before they made a sign ...

Short calls

Asked to see patient: needs pain relief

Patient admitted with shortness of breath, treated for exacerbation of COPD.

Currently denies any pain.

Patient states he is thirsty - "all I want is a drink of water".

Plan: patient may drink water

Signed, Dr S (medical RMO)

Grumpy RMO

Night shifts make me grumpy.

I have updated our handover board accordingly.

Holistic

Tonight on night shift I refused to give two people Temazepam, and prescribed a heat pack as an adjunct to somebody's pain relief.

Oh God.

I'm becoming some kind of hippie.

Simplify

Speak slowly, use small words.

Preferably diagrams.

Happy Workday

I'm in the middle of a three-month term of medical nights. Seven 12-hour night shifts in a row, followed by a week off. Rinse, re-adjust body clock and repeat. It's not so bad.

But today is my birthday. At midnight I had a celebratory cupcake (thanks to my little sister) and the nurses all said happy birthday. And after I've slept the day away today, I'll come back for another 12 hour shift and it will still be my birthday. The prospect of working twice on my birthday does not excite me.

There had better be more cake.

Sputum

I hate sputum. It is definitely in my top 5 least favourite bodily fluids. Somehow though, patients are especially proud of their sputum. They will endeavour to produce a sample right in front of you, showing it off like a new baby. They will dig through their rubbish bag to find you a particularly interesting sample from last night.

I even had a patient who apparently collected it at home. "I fill up *that* much of a coffee can in a week", he told me.

That's a lot of commitment to sputum.

Catching fire

"Was it last year we had someone catch fire? That was in the foyer here"

- senior medical consultant on why we can't give home oxygen to smokers

Pillow talk

This almost broke my heart today.

Poor, helpless folder.

Lady Godiva

My uncle's horse was part of the Fringe parade, but I don't think anybody saw it.

More on love

"Ok Mrs P, looks like you're ok to go home today"

Mrs P: "Really?? Oh, you're so good! I love you very much"

Me: "Oh! ... ... Thank you"

O?

I don't know what I was thinking. 

There's not even a 0th of February.

Man of mystery

We have a patient at the moment who I am really struggling to get my head around. I think he came in with diabetic ketoacidosis because of sepsis, but I'm not sure where the sepsis came from.

It doesn't help when ward round conversations go something like this ...

Registrar: "do you have pain in your chest?"
Patient, "sometimes but then we bought a special bed"
"Does it feel like someone sitting on your chest?"
"No its a special orthopaedic bed"
"So ... No chest pain recently?"
"If you ask my wife she'll tell you what sort of bed it is"

Yup, he's a real mystery.

Medicine and Love

Last year, my boss busted an elderly female patient reading this trashy hospital romance novel on the ward.

At first he thought it was terrific because this book featured a handsome physician rather than the brutish surgeons our patient usually read about (my boss was a cardiologist). He even photocopied the cover, hence the black and white pic above.

Then he discovered some sage advice on the cover. From that day forth, whenever we came across an attractive fellow medic (it might have happened twice), he would stop and wisely remind me, "medicine and love do not mix".

Wouldn't find that in a textbook.

To Mr S

You came from home, a fit old man who had lived on his own for three years after his wife went into a nursing home.

You were as deaf as post, even with your hearing aids in. Deaf, but not silly. You had loved your school days, although they were cut short because you needed to work to support your family. You told me what you knew about the heart, how it pumps blood to the body, how it pumps blood to the lungs to collect oxygen. You weren't silly.

I could almost pronounce your name right - you corrected me until I could do it, and you liked that I tried.

You came to us because you had trouble breathing. The X-ray showed the fluid in your lung space, and before we could drain it your old heart gave out. By the time we discovered your cancer the next day, you were gone.

Gone too soon perhaps, or gone on time to save yourself from more pain. Either way, may you rest in peace. I liked you.

My student

I love having a student on the ward.

For the first week, I used him as a tour guide because I was new to the hospital and he'd already been there a week.

And I appreciate his presence on ward rounds because the consultant always bombards him with medical questions, which leaves me to act very busy because usually I don't know the answer.

And, like many of my colleagues, I love teaching. It's not entirely altruistic. It makes me feel smart.

Like today.

He'd never taken blood before, so after going through the theory I let him practice on me before setting him loose on a patient. Ego-boosting success all round, and he barely left a mark.

I also took him with me for the solemn task of verifying a patient's death. I told him my most important tip (turn on the lights), and let him see for himself how hard it is to say for certain that a patient has absent breath sounds.

As I drove home from work, I thought about how good I'd been,  taking this young student under my wing.

And that's when I got his text message: "I reckon I might go home now if that's cool. Anything for me to do before I leave?"

Oops.

Dog Tears

Tetley the teacup chihuahua loves our Mum.

In fact, Tetley loves Mum even more than it loves my sister, its rightful owner, which of course breaks my sister's heart.

Yesterday Mum came to visit and after she left, Tetley sat by the door waiting for her to return. Sat there for hours as the sun went down, in an ever-growing puddle of dog tears and sadness.

Rejection all round.

Lost: one female doctor

Day 3 of my new job today. I've gone from "intern" to the far more responsible-sounding "RMO", and from a small country hospital to a much larger hospital in the northern suburbs.

The job is going well so far ... except I keep getting lost.


I feel like a mouse in a maze, but not a mouse that's good at mazes. I'm the mouse that gets lost every single time and spends half its time back-tracking and turning around on the spot, trying to figure out where it is.

I can imagine the posters ...

Lost: one female doctor.

Last seen on ward 2B wearing pink stethoscope, said she was going to staff cafeteria. Not answering pager; possibly unable to locate phone. Approach with caution a may become more disorientated if alarmed.

Kindly return to medical team.

Cencent

I really wanted it to be "concert", but no ... it's just a bunch of consent forms.

New Stethoscope

I've had my trademark pink stethoscope since my first week of medical school, when my Mum took me shopping for supplies. I've carried it through clinical skills tutorials, ward placements, OSCEs and overseas electives, and it had seen me through the first half of intern year.

Still, with a rotation in general medicine approaching, I felt that the old pink Spirit Classic wasn't going to cut it anymore.

Choosing a replacement was not easy ... I needed a quality steth, without compromising and choosing a boring colour.

My solution, the Spirit Cardiology, has been great - and comes in bright pink. It works, too - my supervising physician was impressed with my ability to hear and differentiate murmurs.

Still, if he ever found himself in need of a stethoscope, he would hastily bypass mine in favour of a lesser model from a student or worse, the obs trolley.

Pink is not for everyone.

Moving Vehicles

No I don't regret buying a sports car before moving house, why do you ask? 

Moving Lies

I recently moved 500 km to start a new job, which of course involved completely moving out of my old house and cleaning it for inspection. I hate moving. Hate, hate, hate it. I also tell myself a lot of lies in the process. For example:


"This will all fit in my car"

"The pet hair will vacuum out"

"The next tenant will appreciate this half box of cocoa and leftover olive oil"

"I won't need this until I reach my new house"

"I'll remember which box this is in"

"I'm glad I didn't waste my money on a professional cleaner"

"It was like that when I moved in"

Plans

My sister and I have made the dubious decision to share a house this year. We get along pretty well, for sisters, but of course we argue from time to time.

 We're going to try very hard not to fight too much this year. It's going to be difficult, and we both know it ... communication will be important.

Lucky we found a house with a blackboard!

Adverse reaction

I really value the "allergies" section of a patient's records. Patients often aren't sure what adverse reactions they've had, or to what medications, so it's nice to have an official record. A record that's accurate, and professional, and ... Wait. Bunged up eyes?

Trandolapril

Almost forgot the "D"! That would have been embarrassing.

Dog breath

Sprite has the worst dog-breath of any dog on this planet. I took her to the vet this week and after establishing that removing teeth wasn't going to fix the problem, he started offering me a number of interesting and expensive cures (algae-extract food supplements for dog-breath? Beef flavoured dog-toothpaste?). After struggling to scientifically account for most of them, he eventually gave me a free sample of some special dental dry food which will scrape tartar off the teeth with brute force.

He warned me to introduce it slowly, mixing it in with her other dry food. Dogs can get suspicious of new food ... apparently. Ever since I introduced these dental dog nuts, Sprite won't eat anything else.

Maybe she knows about her dog-breath.

Naturopath

"I went to the naturopath who said I'm gluten intolerant, lactose intolerant, anaemic and I've got parasites in my digestive system. He said the blood tests were very expensive so I thought you could do them".

Me: "Well you had a blood test last week and your haemoglobin was 141, so you're definitely not anaemic"

"Ok, well what about the gene test for Coeliac?"

Me: "We don't usually do a gene test for Coeliac's disease, but the antibody tests you had last year were all negative, and your symptoms are not typical, so you probably don't have it"

"What blood test do you do to test for intestinal parasites? The naturopath said he could do a blood test for $300 to tell me which parasites I have"

"No he can't. But here's a stool pot - scoop up some poo using this scoopy bit and we'll sent it off to check for parasites"

"I'm taking these two very expensive vials of magical natural goodness, will they affect the tests?"

"Shouldn't do, see you in a few weeks"

"Oh, can you bulk bill me for today? I already spent several hundred dollars at the naturopath"

WHY??? Why is the naturopath worth paying but the doctor is not? This guy just told you a whole bunch of lies, charged you an extortionate amount for the privelage of being told you're allergic to bread, and now I have to clean up the mess.

I'm not doing it for free.

Communication

He had been calling out "errrrrh" all day, every day since admission.

Today he needed blood taken.

"Errrrrh, errrrrh" as the nurse held his arm and I tightened the torniquet.

Then, as I poked him with the needle, "F-cking awful bastards!"