Are you a really really sound sleeper? Please tell your doctor/paranoid 3rd year medical student!

Today was a semi-stressful day in the hospital. I had a patient with lots of fairly serious chronic medical issues who was in the hospital to treat some infections and acute medical problems. All-in-all he was a pretty sick guy the day before his blood pressure kept fluctuating sending flurries of anxiety through our medical team. However, today he induced new levels of stress in my slightly-paranoid 3rd year medical student-ness when I went in to check on him this morning and he was unarousable. I kid you not - this man was dead to the world, in fact he seemed to be in some sort of coma-like state. I tried shouting, shaking his shoulders, a sternal rub (a maneuver to cause somnolent individuals to wake up by painfully rubbing their chest bone), but my patient would not wake out of his slumber. He had not received any sleep or pain medications that could make him more sleepy, and he seemed to be working harder to breath. When we rounded on my patient later, my anxiety over my patient's sleepy state seemed to infect the rest of the team and my attending doctor told me to call the patient's decision maker for health care to clarify whether or not the patient would want to be placed on a respirator if he became more ill. I made the call and put in some more orders. I kept checking on my patient throughout the morning and was disturbed to find him as unresponsive as ever. As I left for a teaching conference I passed by his bed and gave him another anxious look and several "Please don't die" wishes/prayers/jujus/brain waves. After my conference I went straight to his room to check on him. From the hallway I was surprised to hear cheerful voices and laughing coming from his room. Upon entering I found my patient sitting up, breathing normally and chatting happily with a nurse who had come to visit him. He looked as healthy as ever cracking jokes and he and the nurse were laughing up a storm. I was about to cry foul and ask just what was going on - had someone injected my patient with superman juice while I was gone???!?!?? Just then, his family members come in, worried because I had called earlier asking about the respirator, and told me that he is a really, really, really sound sleeper and that once he goes to sleep they can never wake him up at home either. So word to the wise - if you are a very sound sleeper and ever end up in the hospital, tell the paranoid 3rd year medical student taking care of you and save him/her from getting a few more white hairs and stress wrinkles.


Yup, the picture pretty much says it all.

Rock Climbing and hiking

They have been keeping me pretty busy at the hospital. On my last call shift (where you stay overnight at the hospital) I didn't sleep at all. It has been very fun/educational though and I am learning a lot. Some times I wish I could be more help to my team, but I such is life. I guess the more I learn the more help I can be.

I still have some time for fun (occasionally). Today I went rock climbing for the first time. It was harder than it looks! On the plus side, I had a very good and patient teacher to guide me through my first rock climbing attempts. Despite being surprised by the difficulty, I had a really good time and look forward to trying my hand at climbing again.



View of Twin Falls during a recent hike.


Taking off my tight (and remarkably uncomfortable) climbing shoes after my very first climb.

I am sure this is exactly what you all wanted to see while reading my blog on your lunch break - a delightful shot of my hind-end. Whatever. The important thing is that I manged to very slowly climb and have a positive experience!

Wait, figure 8 knot?
Shoes... off... feet... resting... (happy sigh)

Very demented old man in the hospital: "Your beauty took my pain away."

Earlier this week I was assigned a patient in the hospital with very severe dementia. When he first came in he was pretty sick and could only give one word answers to questions. However, as he started feeling better he also started speaking in more complete sentences and the extent of his dementia became more apparent. He would point to objects not present, etc. A few days ago I went in to check on this patient before rounding with my team. I started asking him about the various kinds of pain he had been complaining about the day before and whether or not the pain was any better. He responded by saying that before I had come into the room he had been in some pain, but that I was so beautiful that his pain went away as soon as he saw me. It was quite the humorous comment, particularly since this patient was older than my grandfather. I decided to focus on trying get information from him about his symptoms, but he kept insisting that he had no pain and seemed to be making attempts to ask me out on a date which I politely ignored. Frustrated, I went to look up some lab values before rounds. During rounds, I gave my presentation and informed the team that the patient seemed to be feeling better this morning. However, after my presentation the patient started going on and on about all the pain he was experiencing, including a new pain that had not been present the day before. I thought about sending the patient a nasty look - I would much rather have been called ugly and been able to present my team with accurate information, but it was clear that my patient no longer remembered our previous conversation. Apparently my stunning looks only function as a temporary analgesic!