Island Med Student

This week is going to be a stressful one. I have exactly one week off from the hospital, and during this week, I have to move the rest of my belongings from an apartment in Baltimore, Maryland to my parents’ farm in Virginia for storage. I have a few very heavy pieces of furniture and a bunch of other random belongings. It was 90 degrees yesterday when I started packing, and it’s supposed to get up to 90 degrees again today. I have no air conditioning in my apartment, nor in my car. So, let’s get to my point here.

Yesterday I began the packing process by placing all of my books into cardboard boxes. My books (not counting the ones I have in New York) filled up 13 boxes (see photo below). Now I have to get these 13 boxes loaded onto a Uhaul truck, along with the rest of my belongings. You could say that I’m not looking forward to this task.

So, why on earth do I even have 13 boxes worth of books, you might ask. Well, to answer that question, I have to go back to my childhood. My parents’ farmhouse was literally overflowing with books. We had two dedicated “libraries,” and pretty much every other room in the house was packed, wall-to-wall with books. My parents are book junkies. I was surrounded by all these books while growing up as a child. I have many fond memories of randomly picking a book off the shelf, and reading the whole thing in one day. When I would complain to my parents that I was bored because there was no television, my dad would suggest that I read the encyclopedias. I would get a little mad at him for a moment, but then I would pick a letter and start reading.

Now that I am older and looking back on my childhood, I realize the powerful effect all these books had on my life. I became a very fast reader. I became addicted to books. It made me a curious person. Having the wide variety of books made me question authority. I don’t like to accept anything at face value. I enjoy researching and investigating. Reading eventually gave way to writing. Now I can barely go an entire day without writing something. I enjoy communicating. I value people who are effective communicators. Books have undoubtedly had a huge influence on the person I’ve become.

Now, back to my 13 boxes of books. I’ve kept almost every textbook and book that I’ve ever read. Many times, I think about getting rid of them, which would definitely save me a lot of headache. But then I think about my own kids. Someday I would like to have children. I realize that by the time my kids are old enough to read, paper books might be obsolete. Perhaps there will be no more libraries. Maybe everyone will only read information electronically. But I can’t help but think we’ll be losing something. I love the feeling of picking up a book, cracking it open to a random page, and just reading whatever happens to pop up. I love the smell of old and new books. I love the feeling of the paper in my hands, and the crinkling sound it makes as I turn the pages.

My kids might call me old fashioned. They might laugh at their mother who has medical textbooks from 20 years ago on the shelves in her kitchen. But they will have them. If they ever get past how old fashioned the paper books are, they might one day randomly pick a book off the shelf and crack it open. And they might just actually learn something. And they might just actually like it.

Click Here To View the Original Post on Medscape

• Language Barriers Complicate Immigrants' Medical Problems – washingtonpost.com
  (tags: news)
• Doctor and Patient – When the Patient Gets Lost in Translation – NYTimes.com
  (tags: news)

I just signed out for family medicine. Finally, this week is over! It’s currently 65 degrees outside and sunny. There is a soft wind blowing. I’m reclining in a chair, feet up. Scope and Molly are lounging on my bed. I’m drinking a Corona with a lime slice and listening to awesome music. I don’t have to go back to the hospital for a week. I’m meeting up with some family medicine peeps for beers and pool in a few hours. Saying that I’m relaxed and happy would be an understatement. I have achieved nirvana!

Tonight I went on a spending spree ($7) at a local 99¢ store in Bushwick. I seriously have an addiction. My fave part about the stores might just be the poorly translated captions on various items. That, and the great bargains, of course!

I’m pooped right now. Like seriously tired.

Here is an example day for the past 2 weeks:

5:30 a.m. – Wake up/Coffee/Shower
6:00 a.m. – Take dogs for 1.5 mile walk
6:30 a.m. – Walk 1 mile to hospital
7:00 a.m. – Check up on patients/Eat breakfast if I’m lucky
9:00 a.m. – Rounds
11:00 a.m. – Writing SOAP notes, orders, etc.
12:00 p.m. – Round again
1:00 p.m. – Eat, if I’m lucky
1:30 p.m. – More running around the hospital, getting stuff done, chasing down nurses
4:00 p.m. – Round again
5:00 p.m. – Admit patients from the emergency room
7:00 p.m. – More rounds
7:30 p.m. – Walk 1 mile home
8:00 p.m. – Take doggies for 1.5 mile walk
8:30 p.m. – Eat dinner (usually soup from a can because I’m too tired to cook)
9:00 p.m. – Do my sit-ups/push-ups/take shower/review material learned and read up on assigned cases
10:00 p.m. – Pass the hell out

Honestly, I barely sit down all day. I spend a good portion of the day on my feet. I do a butt-load of walking. I’m tired.

I’m not complaining, though. I actually do like my life. As tired as I am, I am happy. I enjoy the hospital for the most part. I love my patients. I learn a lot. It’s just that I barely have a life outside of the hospital. My inbox is way overloaded. I don’t have time to study anything beyond the cases that I encounter during the day. I have zero time for extra-curricular activities. But it’s good. However, I am really, really looking forward to next week, which I have off. Even if I will be spending the week moving crap from Baltimore to who knows where. This is the life I signed up for. And I have no regrets. Dinner time!

• Doctor and Patient – Life and Death on the Operating Table – Question – NYTimes.com
  (tags: news)
• Compassion: Easier For A Broken Leg Than Heart : NPR
  (tags: interesting)
• Dr. Sherwin Nuland Finds 'The Soul Of Medicine' : NPR
  (tags: news)
• Budget Chief: For Health Care, More Is Not Better : NPR
  (tags: news)

I apologize for the lack of posts recently. I have been working fairly long hours at the hospital all week long. Today, I got up early and took the train to a YMCA on Jamaica Avenue, in Brooklyn. They were having a health fair, and all kinds of other cool activities. I volunteered to take blood pressures and counsel people. I had a blast! Meeting people in the community and taking part in group activities is totally up my alley. I met a bunch of wonderful people, donated my blood, got my face painted, and had so much fun!

I forgot to take my camera, but I did snap a few pics with my iPhone. A few other people were also taking photos, and I will post them as soon as I get them. For now, enjoy the ones I have.

Today is absolutely gorgeous! It’s sunny and 74 degrees outside right now. I helped out a friend, cleaned my apartment, started some laundry, and am getting ready to take my doggies for a long walk at the park.

I can’t wait for more summer time activities!

Click Here to View the Pics

• Schizophrenic Brains Not Fooled by Optical Illusion | Wired Science from Wired.com
  (tags: interesting)

Seen in Bushwick….

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I want to find out how a patient of mine at the hospital is doing. After seeing her quickly in her room, I want to check out her most recent lab results, have a look at her recent CT exam, and see what the various doctors on her case are writing. I go to find her chart, but it’s nowhere to be found. I search for almost 30 minutes, and eventually find it hidden under a pile of papers at the nursing station. I open up the chart to read her recent consult. But all I see is scribble. The doctor’s handwriting is illegible. I’d like to read her lab results, but the lab hasn’t brought them up yet. I go down to radiology to view the CT, but everyone is on their lunch break. Does this story sound familiar to you?

The frustrations I just described are merely the tip of the iceberg. I could go on for many pages listing the problems I’ve had with obtaining patient information. I’ve worked in quite a few different hospitals beginning around the year 2000, and I can attest that the handling of patient information, and the management of the workflow of the hospital can be as important a component of quality patient care as are the doctors and nurses.

The hospitals I’ve experienced have spanned the whole spectrum of so-called electronic medical records (EMR) implementation. Some have barely even had a single computer, while others have had completely integrated systems for accessing and storing patient information. And I can attest that I have been able to save immeasurable amounts of time and stress because of the ability to easily access the information I needed.

EMR systems have been in the news recently, as Obama included a portion of his economic stimulus plan to include the implementation of EMR systems in hospitals and private practices. Some people are very excited about moving towards a higher-tech way of handling medical information, while others are immensely concerned about the possible negative consequences.

To provide full disclosure, I must admit that my opinion is probably a bit biased by my previous experience. I’ve worked in the IT industry, and have more than a working knowledge of computers. Also, based on my age, I am a part of the “Facebook” generation.

It’s interesting to watch the interaction between us “younger” med students, and some of the older residents and attendings. When the attending can’t seem to figure out how to pull up something on the computer, one of us students always help out. If I need to find some information on a drug or dosage, I whip out my iPhone, while the older resident or attending might pull out a book. I’m not saying that one or the other is necessarily better, but I know that I generally feel much more comfortable using technology.

There are many issues that people have brought up regarding the implementation of EMR systems. The biggest criticism is that it makes protecting privacy incredibly difficult. How can we ensure that doctors and other healthcare providers don’t go digging around unnecessarily in everyone’s records?

Although there are many potential drawbacks to implementing EMR, I will come right out and say that I am a huge proponent of them. I have seen first-hand how patient care can be improved, and a doctor’s workload lessoned by utilizing EMR, and other types of electronic systems. But perhaps this is because of the fact that I am a part of the “computer generation.” I wonder what older people in the healthcare industry think. And I wonder if there are any younger folks out there who just don’t think that we’re going in the right direction. I encourage you all to share your thoughts!

Click Here To View the Original Post on Medscape