Anything

A young girl who will never be the same
Clumsy cars too much to drink
youth quickly lost in a night
frozen in time
never to return
our beauty is fleeting
she can’t move her legs

the naked

The naked body can be seen in such different context. When that striped down body comes in post traumatic injury, it is no longer a 2 page swimsuit center fold. It is the sudoku on pg 85.

Precordial Thump

I was a year away and things sorta fell apart. I think it’s appropriate to start this up again. I just gotta cook more. Also, the monster breakfast burrito gave me the worst shit of my life. The breakfast burritos were my togo breakfast the next day. I remember walking down California and then feeling like I had to pee out of my butt. I eventually got into the testing building early and was proud that I had left my self some time to use the bathroom. The security guard rang me in and had me sit down in the lobby with the other MCATters. Nazi style. He said we had to sit in specific seats and even kicked out a boyfriend of one of the girl MCATters. He practically yelled at him. So I waited for the go ahead to proceed upstairs where the test center should accommodate us better. I had to squeeze real hard to keep my shit together. Literally. I was making diamonds. After 15 minutes I said fuck this. I went up to the booth and kindly explained to the security guard that I had to use the bathroom. He asked me if it can wait. I leaned in about 2 feet to his face, and in front of all the MCATters I was going to MCAT with, I said flatly, “no.” His eyes widened and he jumbled for his keys as he scuttle around the booth. Follow me! He said in a panic. He evolved from a midget Hitler to the white rabbit late for his date. All in all it ended well. I did not feel I tested well, but I don’t think anyone is confident coming out of the test.

Update: So apparently I did very well. My only advice to future pre-meds now is this: eat at a 7 dollar korean chinese buffet the night before the test and stuff yourself. Then right before the test take some epsom salt. Works like a charm.

MCAT breakfast hot link burrito

We got some ingredients pictured underneath. These are Louisiana Hot Links. Makes a fire in my tummy that burns through the morning into the afternoon. I made some for tomorrow.

I rarely have dreams. Last night I had a dream that jolted me awake from a most uncomfortable situation. The dream started as I left my house to go over to my neighbors to help him with some chores. My neighbor is a friendly elderly gentleman topped with a tush of white-hair. He was beginning to explain to me his day when he suddenly collapses to the floor. After a few seconds he gets up and presented with stroke-like symptoms. We both agreed that he was having a stroke. I told him I would take him to the hospital and to wait for me to get my jacket from my house. I went back to my house to get a jacket and on the way back I was met by an EMT at my neighbor’s front porch wondering who I was and if I knew the guy inside the house. I explain I was helping him. I go inside my neighbor’s house and find him dead.

I do not like this.

Brick Wall

A responsibility I have at work is to perform an EKG when a doctor orders one for a patient. The test requires that electrodes and leads be placed across the patients chest. Something that is interesting about health care is that as a provider of health care, you are allowed access to certain parts of the body that you would not otherwise have access to. So professionalism is of the UTMOST importance. This is for ethical reasons, legal reasons and just being a good person reasons. When I am performing an EKG on a female, I always make sure to never use my palms or finger tips when palpating the chest. I never ask them to be fully unclothed. The routine is always that the gown is pulled up above the abdomen and but still covering the breasts with only a 1-2 inch area around the sternum being uncovered. A blanket is used to cover everything from the lower abdomen and everything distal. I verbalize all of my procedures in order to keep the patient informed at all times of the process. I also always make sure to ask if it’s okay for me to perform the procedure before I do anything.

The other night I ran into a problem for the first time. A 40 year old female consented for me to perform the EKG, but I could sense a little bit of hesitation. After asking if she would prefer a female nurse perform it, she declined my offer and urged me to continue the test. After pulling the gown up to the abdomen, the patient exposed her chest to me and remarked that she’s no longer shy because she’s had an EKG all week. This did make me slightly uncomfortable because I never need to expose that much of the chest to perform an accurate EKG. The next thing she said got me.

“One of them is purple, I know it’s purple. And I don’t care.” She was referring to her nipple. To be honest I tried not to look at her nipple, so I took her word for it. I was thrown off guard and did not quite know how to respond to reassure her that, I’ve really seen it all. Purple nipple or not, it was not something that bothered me or disgusted me. I ended up retorting with, “I don’t know” and “it’s okay.” Today I am still wondering what I could have said to keep that professionalism intact. She then laughed about it and said, “Yeah I guess it doesn’t matter. It can be turquoise for all I care!”

I do not care about the physical aesthetics of my patients. I care about the physical health of my patients in terms of survival and well-being. I will assess for wounds, abnormalities, foreign objects, marks and other medical signs of poor health. Purple nipples are not a high priority in this case. What I do care about peripheral to physical assessment of health is personalities. I find it very interesting to notice personalities of my patients. I don’t know why.

I wanted to tell this female that, your purple nipple is fine. I do not notice it. It does not disgust me. I wanted to tell her that: you’re so pretty on the inside because you are strong, because on the inside, for a brief moment, you let go of what society has dictated to you what is pleasing to the eye and you loved yourself, for yourself in a way only you can love. I believed she truly didn’t care, for that brief moment, that her nipple was purple. Or turquoise. I wanted to tell her, if you can see that you’re beautiful, then I can too. And you are.

But that wouldn’t be professional. That would be dramatic. There has to be a way to shorten all that down to a sentence or a phrase. I’ll think on it.

Night Shift with the Peeps

Night shift is interesting because there’s a lot of down time and you really get to know the team you’re working with. This night, we had a motorcycle accident patient. He was going 90mph, intoxicated and with headphones. Other than having poor judgement in regards to personal safety, he was a nice guy. He had a lot of dirty abrasions and got scrubbed up pretty good. I like retelling people that what we scrub with is something that’s similar to what you would clean a bath tub with. There are long plastic teeth that really take off flesh. I felt bad doing it. Gotta get that asphalt out!

There was also a 50 year old female who had been out drinking and got kicked in the head. She was being very uncooperative. Asking what can be done about her bleeding head and then refusing treatment. She kept accusing us of treating her different because she was Mexican. Then she played the race card. Even though our staff had a lot of ethnic variety, she still played the race card. It was ridiculous to say the least, but very entertaining. Instead of getting medical treatment, she got a ride with the police.

There was also a elderly gentleman who had a fall. He was very respectful of our help and was really one of those great patients you’ll remember for a long time. He was having pain all over his arms and was found to have a C-6 fracture. He didn’t make a fuss, nor did he ask for much, but you could tell he was in a lot of pain. What really got me was that his daughter was there at 4am in the morning and was with him the whole time. The devotion she had for her father moved me tremendously. He kept telling her to go home to get some sleep and she kept telling him no. “Too bad Dad. I’m staying here. You’re stuck with me. You’ve always been stuck with me.” It’s easy seeing your father in the emergency room.

Half Shift

Sometimes I’ll get half shifts and they’re great because you’re there for a lot of good work and leave before you get tired. I wish I could have half shifts all the time. My half shift was pretty heavy. 3 traumas came in within 5 minutes of each other. Also 2 chest pains. I got to see a chest tube placement and somebody got intubated.

Chest tube placement. A suction is palced within the pleural cavity in order to alleviate pneumothroax symptoms. The trauma surgeon locally anesthetisizes the lateral thorax around the 5th intercostal space, or wherever the pneumothorax is. Then he makes an incision about an inch wide in order to go in and break into the pleurum. I did not expect to hear the sound of air rush out of this guy’s chest, but it happened. It was like a basketball deflating. Then they shove a thick tube into the incisions and hook it up to suction. This creates negative pressure in the pleural space. I think I got that all right. I’m sure my physiology teacher won’t read this. Anyways. Knife goes into your chest. Tube goes in. Air comes out. Fun.

I got to see some pretty nasty avulsions on an older gentleman. They were about the size of envelopes on top of his head and on his right shin. Pretty Gnarly. He bled a lot. Nice guy.

Work is work

I did a few things last night at work that I never did before. Kinda refreshing.

A young male about 12 years old came in with a cast to get removed. The preferred method for cast removal is to use a vibrating disc saw with vacuum attachment. This thing looks incredibly menacing, but it isn’t. It looks like a 4 inch diameter rotary saw, but the thing is it only vibrates back and forth, it doesn’t spin. This allows the cutter to only cut casts without cutting through clothes or skin. The problem with this machine is that it makes the nastiest noise when it turns on. It scared the kid really bad. I was being nice and stopped a lot because the kid kept screaming and telling me to stop. I think the doctor got mad at me for taking so long. Next time I’m just going to turn that thing on full spin and slice it off.

I helped a elderly gentleman pull down his diaper so he could pull out his penis to pee in a urinal. Afterwards he screamed at me to call his son. When asked what the number was, he responded with 411 in San Francisco. I told him I couldn’t call him with only that information. He then yelled at me some more.

Later in the evening a combative and drunk 25 year old male came in to visit the ER. He had gotten drunk and fought a bouncer. He had a laceration above the left eye upon initial examination. It sure livened up the mood in there. He began calling all the nurses bitches and to let him off the backboard and restraints. He promised he would be good and just wanted to go home. Then he tried to get up and punch at people. 2 security guards and I held him down as the nurses provided treatment. He called me a “bitch ass cocksucking faggot that can’t get any pussy because you suck cock you cock sucker.” Then he started crying and said he was sorry. I was glad I was working with the team of nurses, doctors, security personnel and law enforcement officers. Everyone was safe and treatment was provided in an orderly fashion. So guys, when you go get drunk next weekend just remember, if you’re going to hit the bouncer and then get your butt laid out, don’t wake up in the ER and try to swipe at the people trying to help you.

Funniest moment was when he was asking us not to transport him to the hospital because he didn’t want to pay for the ambulance ride. He said he didn’t want to go to the ER because it would be really expensive and he’d get in a lot of trouble. We told him he was already in the ER. He said “Nuh uh, you guys are liars.”

That pretty much took me to the end of my shift. I washed my hands and headed home.

Salsa Salsa!

3 large hothouse tomatoes (diced)
1 small red onion (diced)
2 limes (squeeeeeeeeeezed)
1/2 cup of chopped cilantro
5 cloves of garlic
tbsp of salt
tbsp of sugar

ALL FRESHHHHHHHHHH wooo.

It was okay. Burned my tounge a bit.