Wow! October already! Here's a great sky scene I saw on the way back from Austin last week... or was it on the way to Austin? This was right before I saw a rainbow! This month has been pretty cool, give or take a few rough spots. I haven't cried yet on my new floor rotation, we have three of these that are supposed to be the roughest of our intern year. I am slowly suspecting something... we pedi residents are freakin lucky. I'm so glad I'm not a surgeon.
But I have gotten yelled at by more patients in the last week than I've been in my entire (short) clinical experience. Apparently the private patient population of Houston has less patience for new interns getting to know the system. Some yelling has been justified (I'll write those orders faster!) but some yelling... has just been strange! I had to explain to a mom today that just giving a kid (no fevers, not in pain, but recovering from pnemonia and dehydration) Tylenol didn't do anything for her tantrum-throwing... she was, in fact, displaying totally normal two-year old behavior. With a sneaky smile the whole time. This actually meant she was getting better, which the mom had a hard time grasping. She just kept saying "I don't care what you think, there's a gift store downstairs, I'll go buy Tyelenol myself!" To her credit, I think she calmed down in the end (the kid, not the mom.)
The craziest instance so far I've had getting yelled at was two months ago in LBJ. This event should go down in some kind of book. I'm going to call this chapter "Worst Luck in History" This little patient was a baby transferred over from Hermann because of insurance reasons, and he was getting IV penicillin for an infection through a PICC line (I forgot where the infection was, he was a patient I was cross-covering for... Di, if you're reading this you know this story!) and had a PICC line. Anyway, this mom didn't trust the cleanliness of the county hospital (understandable actually) to the point where she brought along her own cleaning supplies. Now, LBJ is a different world, a world where patients DO get better, but it's far from the hotel-like atmosphere of the private hospital where she was coming from. Anyway she also demanded that the nurses wear gloves (I thought they did!) and wanted her own room instead of sharing it with four other patients (probably a HIPPA violation, but c'mon! county hospital!)
The team who was caring for her daughter moved her to one of the isolation rooms. (normally used for patients admitted with contagious illnesses.) So the team checked out to me, and soon I get this page from a nurse... "um, Doctor? you better come quick..." I got back to the floor, and there were three nurses going into her room, and a rather official looking person walking towards us. I walked into her room, and she's shaking and in tears. She mentioned something about pubic hair on the toilet (ew!) and bugs in the shower, and kept crying, and then just couldnt talk anymore. So I look in the bathroom, and the toilet looks fine (she said she cleaned it off, I wondered if her cleaning supplies were cleaner than the hospitals. I shoulda borrowed it for the call rooms.) and then I looked in the shower. There were BUGS! like... LITTLE ROACHES! About twenty of em!! Or more! It was really gross, and ridiculously ironic. But mostly gross. :-)
Needless to say, it took a miracle talking her into staying the night, so at least her own doctors could find another solution for her kid's treatment. But then two things happened, one, the wipey board fell off the wall in her room (causing even more tears) and two, the baby's PICC line clogged up. This is where I'm not sure where the story led to, I signed off on this point after being on the phone with Interventional Radiology all night trying to figure out how to fix a clogged PICC line in a hospital which doesn't have tPA (the clotbuster!) or attendings in house at night trained how to reinsert them. So, I think I switched to Intramuscular Penicillin, so she wouldnt miss any doses, I think the mom yelled at me some more for making her baby take more shots, but she needed 5 more days of therapy and that was the best I could do! Of course if this were House, Pediatric interns could just put in new PICC lines... sigh. Maybe on my call tomorrow...
But man. Everytime I think I have a bad day I'll just have to remember that mom's day. I'd like to think there's very little in the world out there that can top that.
