...And Other Such Tales of Adventure!

Showing posts with label patient stories. Show all posts
Showing posts with label patient stories. Show all posts

Sunday, August 15, 2010

“XII If the radiology resident and the BMS [Best Medical School Student] both see a lesion on the chest X ray, there can be no lesion there”

I was reluctant to read the novel, House of God by Samuel Shem (Dr. Steve Bergman) mostly because one day during medical school I opened the cover and read the words “Except for her sunglasses, Berry was naked.” Uh… I’m all for art and free expression but I figured the book held the words of a male chauvinist-surgeon type and I was already annoyed with half of the male population in my medical school class. But as fate would have it, I ended up with a copy a few weeks ago and just finished it today.

It was written in the 70’s, before the ACGME insisted upon humane treatment of residents, when residents took q3 or q2 call without going home at noon post-call. Good Lord, I cannot imagine what that must have been like. It’s bad enough as it is. After having completed an emotionally draining adult neurology year, I can relate. I think everyone can. The calls alone put my pediatrics intern year to shame. And I can’t complain because I know my surgeon friends work even more.

I’m so grateful to all my sane medical and non-medical friends who kept me somewhat normal. Because after reading this book, I saw how easily I could've fallen off the deep end taking care of Neuro ICU patients. I’m already worried that I know residents who have. I mentioned once to a non-medical friend about a recent call I had, when the ER paged me on two patients who arrived with large brain bleeds. I had to tell their families about the imaging results, likely poor outcomes and consoled one of the families with a Spanish translator at 3am which felt wrong somehow. When I told my friend this, maybe I didn't realize how easily I laughed off the coincidence of having not one, but two horribly critical patients roll in the ER, my comment ‘man that really makes you feel helpless every time.' or how quickly I changed the subject afterwards. I don’t think I’ll forget the next question he asked, after a long pause: “Um, did you ever think of therapy?”

We probably all need therapy as residents, and The House of God highlights that. It’s an amazingly honest book about internship year that demanded change from the medical system. And it worked! In fact, there’s a rumor floating around that the 80 hour workweek limit will be shortened to 60 hours and interns will no longer do 24 hour shifts in the hospital. Hallelujah!

For me, my therapy was the ocean, friends and family who remind me that there IS life outside the hospital and it is wonderful. And my patients- those really sweet old ladies who'd tell me stories every morning when I’d check on them. And one ridiculously cute old gentleman with a fisherman’s cap who’d always ask me about Texas and talk about dancing. He wanted to learn how to incorporate his new cane into his dance moves. :)

It's nice to finally get all those House of God references people throw around. I’m also grateful to be a pediatrician again. It’s so much happier here. :)

Wednesday, June 3, 2009

PICU Playa'

I was a little surprised at the pain meds neurosurgery ordered for a kid they admitted to the PICU last night. He had just had his skull opened and grids placed to help figure out the location of his seizures. Our ICU team was consulted to help with pain management overnight. I figured it was probably just me not being used to adult doses—he was 16—so I thought I’d try it out and follow their plan. It was this combination of frequently scheduled Toredol and Valium… and if he still had pain he could have 5mg of Morphine (big adult dose!) or Tylenol with Codeine. Neurosurgery does not mess around!

Turns out, they worked a little too well… I woke him up before examining him and saw him looking at me kind of funny while I was introducing myself. I asked him to follow my light… but instead, he just said “Woah… doc! You’re beautiful!” His mom started laughing pretty hard while I just went on with my exam, but he was like “no really—you’re really beautiful!” Nice. I had to cut back on his meds a bit. The best part was watching the reactions of any female nurse or resident who came out of his room… they all had smiles on their faces!

Countdown to California… 25 days!

Saturday, April 11, 2009

"Thanks for makin me feel like a real [idiot], doctor..."

No more explaining things that already should have been explained to semi-confrontational angry dads while leaving the ER especially when I've already stayed 30 minutes past my shift. The funny thing was that I actually was starting to question his mental competence... at least he didn't punch me. I owe another resident for digging me out of that hole. It was a deep, deep hole. (I woulda punched me.)

I met my new little hero today! He was a three year old who was wandering around an appliance store, when someone opened a refrigerator door in his face. He had a pretty deep laceration on his forehead that needed stitches. If I knew enough Spanish, I woulda said to him, "Aw, buddy I know exactly how you feel! I get accidentally whacked in the face all the time!" But no need- he looked so happy to be getting all this attention. Can you believe it- he sat through lidocaine shots AND three stitches. Those parents should give classes... the whole family helped keep him calm but had to keep switching off because they'd get lightheaded.

I love being in the Pedi ER! Things seem to come in themes. Today was head vs. hard object day. Yesterday was appendicitis day. Looking forward to swallowed foreign body day (those have fun X-Rays.) And things don't "come in three's" here, more like fives or sixes in a row... all at once. Unfortunately we also seem to be having sexual assault week. I hate that theme.

But here's something super awesome- we're giving away stuffed bunnies now in honor of the holiday! We've also been having an easter egg hunt every morning for the staff. The hunt isn't the fairest of hunts since when I have trouble finding normal things like tongue depressors, how am I supposed to find eggs? Luckily, my confusion seems to be winning me some jelly bean donations. Mmm! Just like FAT BUNNIES! ;-)

Sunday, January 25, 2009

Resolutions, Version 27.0

After a year of being knocked out by sleep deprivation (did I even have resolutions last year?) I thought I’d try this resolution business again. This time I’ve had more sleep, and more time to soak in the world around me. So much, that even though my call this month in the NICU is every five nights instead of the standard four, I still feel like I’m being run to the ground.

But, as self-improvement is an adventure in itself, I have some great ideas brewing. Some of my resident friends here may join me in my most ingenious idea. If it works, I shall blog about it in a year, if it ends disastrously (Wikepedia says I have an 88% chance of failure) it will still be worth writing about, as it will surely be an ingenious disaster. :-)

Here are a few other ones I came up with: (Hold me accountable!)

1. Take time to read more often. For example, for the past year our clinic has had a shortage of the Hib (Haemophilus influenza B) vaccine. This vaccine was a breakthrough in preventing one of the most common potentially deadly illnesses and reason for hospital admission in children. Never really questioned the shortage, but after reading this, I know that Merck made a mistake, kids ARE getting sick again, and if anything this may help parents understand the importance of childhood vaccinations.

2. Get the flu vaccine. (I hope my chief residents aren't reading this... I'm gonna get it soon!)

3. Try not to suck so badly at Kareoke again. The uncomfortable silence and nervous laughter after my version of "Mr. Jones" during my friend's new year's party comes to mind...

4. Do something kid-like at least once a week. Yesterday I played basketball for the first time in years. It was with a group of men and women with an average height of like, 5’3". I know... I know... but man it felt good. ;-)

5. Stay updated on current events. Despite the instability surrounding us now, I’ve never felt so patriotic or proud of our country before for the version of leadership we’ve chosen. In the past it’s usually been an apathetic detachment, or disappointment that issues I supported (or cared enough to form opinions for) were in the minority. It’s a humbling, wonderful thing, this witnessing of who we are slowly becoming.

The NICU is a crazy place. Crazy, but always interesting. A baby with a sacrococcygeal teratoma was born today, there's a giant mass coming out of her lower back/rectal area. I wonder if there's teeth in it. Extra eyeball? :-) Ew... ok subject change... another resolution maybe?




6. Celebrate Bunnies more often! AWWWWWWW!! :-)

Saturday, August 30, 2008

Turkey? Provolone?

I think my subconscious wanted to be a doctor more than I did. For the past several weeks, the medical world keeps finding a way to creep into my dreams. Two days ago I dreamt vividly of a four month old baby on the wards with feeding issues and that I happened to have a friend who specialized in feeding problems. (Is there really such a sub-specialty? At four months?) I decided I immediately needed to transfer care to my friend. This meant I should pick up the phone at once and call her… which I did… until I realized it was 3am and the friend that I was calling was the last person who had text paged me. Thankfully I realized this after hearing it ring on her end, so I hung up quickly. She’s actually an internal medicine resident so my dream-mind was WAY off. Does this happen when I’m on call too??

Today, in dreamland I had to undergo special training for resident leadership skills. This meant running a sandwich shop. (I think I may have been a little hungry too while dreaming this.) The nurses from the ER were my coaches. They told me that my job was to “be their friend” but to put on my “sandwich gloves” and be stern when I need to direct them to do something. So, they had me behind the counter and I had to direct the sandwich-making. One female elderly doctor had approached the table, and she had an easy request, but before we could get to it (there was a more experienced sandwich maker at the counter too since in my dream I could not make sandwiches) two older male doctors came and demanded sandwiches. They said they had to go to the OR. What did I do? I told them to go back in line! And they did. My supervisors told me I did a great job. And then… then I woke up before I got my sandwich reward!! Blast.

My floor supervisor month in July rocked. The interns are all so nice... and smart! ER has been awesome too. Foreign bodies were pulled from all kinds of orifices (my favorite… sponge up nose! that one was a surprise), friendships were maintained despite consulting pediatric surgery every five minutes, violence was avoided from angry parents (but one nurse got hit!) On the downside, babies were beaten at home, twelve year olds found out they were pregnant, and I went through two other pagers after my beloved/hated electronic companion of a year broke. But I learned more this month than I think I’ve learned in a long time, simply from the volume and diversity of patients we saw. Next month I have to do some ER shifts at the county hospital (shudder!) and work as floor supervisor at night for a week. More stories I'm sure, I may have to try and stay awake more so my real stories outnumber my dream stories! Next month will also bring two vacations, my birthday, and a possible hurricane evacuation.

Stop Gustav!

Friday, May 2, 2008

Rocket-Science ;-)

Watching the Rockets play is like watching little kids playing with art supplies… sometimes they figure it out and it’s brilliant, but sometimes they try to get creative and end up with a giant mess…

That said, I’m a new Rockets fan! Secondary to the Spurs of course, I can’t help being an NBA fan after living in SA for 4 years. The Spurs make the city so happy! And I want to hug Tim Duncan everytime I see him play. Since they always win games and usually play great it's always fun to cheer them on (except for one loss to the Rockets earlier this season which I’m still a little bitter about, but have chosen to overlook for now.) The Rockets, however are another story. No one is really sure how they made it to the playoffs, but they’re sticking in there! I’m watching game 6 now… Utah has a big lead and I think the Rockets are starting to get nervous. C’mon Rockets! Ummm they can come back from Utah’s 26 point lead right?

I’d also like to celebrate my new footwear addition—new running shoes again! These are light blue Nike’s which have really nice padding in the front… never really appreciated how great sprinting can feel when your toes have something to bounce off of! Not that I’m a sprinter, but if I were ever to flee an attacker, I know I’m well equipped. These are the bounciest shoes ever, and if you look closely you can see little hearts and stick runner figures on the laces. Wooo! I heart you Nikes! (don’t tell my Adidas shoes…)

Holy goodness!! The Rockets have tightened it up…. pretty freakin incredible! So I’m going to get back to the game. But here are my pretty shoes!

Next time I'll try and add some more hospital stories. I'm at MD Anderson in the Oncology ward, after a month of Infectious Diseases. After last month, I probably know more than I ever wanted to know about diarrhea, just short of experiencing it myself (thankfully!) Moral of ID month: Don't play with live crawfish, and wash your hands. This month will be good, especially from a pedi neuro perspective... though emotionally it will be quite the test with the terminally ill patients. Cancer sucks.

Hmm... and speaking of sucking the Rockets are doing that thing again when they're getting outscored... I think they need my full attention now. Since this might not end so well tonight (unless they surprise us...) here's a happy pic!


This was from StL (home of the lovely April daffodils)... reunionizing was awesome and I really miss the ones who couldn't make it... so here is a daffodil for you! :-)

Sunday, March 2, 2008

Surviving the Petri Dish

Yay! My ER month is over. It was really cool and inspired many a' ponderings:

1. It's impossible to work more than two 12-hour shifts in a row without getting sick! I bet I'm colonized with a nice variety of bugs now... luckily they're the "upper" kind and not the "lower" kind.

2. Completely well children in the ER are really fun to see, despite the trees killed to meet their paperwork requirements.

3. Completely well children who listen to people's bottoms with stethoscopes cause they're not tall enough to reach your lungs are even more fun!

4. Teaching med students how to suture is AWESOME. I feel so useful now! Want me to suture you??

5. When you pick up a chart, and it says "vaginal bleeder" it's ok to put the chart back and walk away slowly. You can even use the speculums in self defense!

6. Working nights is kind of strange, because halfway through at midnight you have to switch the dates. So, when I'm there during days I start switching the date at noon which stirs up all kinds of trouble. Although, it makes time move twice as fast. :-)

7. Splinting is totally cool and fuels the part of me that always wanted to do Ortho. (I think it's a small part. Can we splint and cast brains?)

8. All ER attendings are crazy. I think you really kind of have to be, and admittedly some are crazy in more endearing ways than others. My favorite is the attending who writes "Stop using Drugs or You'll DIE!!!"on her discharge papers for kids who come in with drug overdoses. She'll underline the "DIE!!" too, and write it really big. And under the 'home meds' section she'll put "None-- you have already had too much!"

9. This same attending did a throat swab on me after I asked her how to do one. Good thing I didn't ask for a refresher on a Gonococcal/ Chlamydia probe...

10. Mia Bella's (off Lexington and Shepard) has half priced drinks and appetizers all day Wednesday and free dessert coupons on Citysearch.com. AND the food is delish! This doesn't have so much to do with the ER, but it's my new favorite restaurant in Houston! MMM!

I'd like to thank my asthmatic patients on the Hermann floors for once again allowing me to update my blog. I can't really sleep since I have to check on two of them every hour or so, so this is great. I will miss not having call, but it's nice being back here... these kids are so cute! One patient who looked like the girl from little miss sunshine kept making pooping noises at me. (She really wanted to poop because she hadn't in a while.) And another toddler who had two butt abscesses drained was still running around her room laughing.

Bye bye pregnant teenagers! :-)

Friday, January 18, 2008

Ode to Spaces (and babies!)

This month will end in 12 days! I'm in the newborn nursery and don't get me wrong, I love babies... and love the fact I have no call this month. But the PAPERWORK! There's got to be a better way. We have to collect information from everywhere (three different sources not counting the babies themselves) and fill out these papers. It's quite repetitive. So much of my time is spent doing this, I'm starting to have bad handwriting! I thought I was immune, but alas. Residency takes what wasn't already sucked out of us in Med school. :-)

Strangly enough, being around newborns is triggering maternal urges I never knew I had. Lucky for the babies, they all have security devices which go off if they get too close to the elevators or if someone illegally takes off with one. I'm trying to become more responsible in caring for other life forms. Over Christmas and New Years, I took care of my neighbor's plants... and they survived! One day I will have my own plant... then I shall work upward from there. (and steal cute babies.)

More thoughts: I am getting to know the nurses on the floors better, and they rock! One of them, I'll call 'Mama G' (she's so wonderful!) was telling me about her husband... and how for the past 38 or so years she wakes up to "oh honey, you're so beautiful!" and hears "I'm such a lucky man for marrying such a kind and generous lady" on a fairly regular basis. She said at first she thought it strange and it took a while to get used to, but now she thinks it's great! He even notices her haircuts. :-) Mama G told this story much better, and she definitely raises the bar for the menfolk in this world: Men everywhere- take note! Verbalize!

I just got back from a friend's place-- her apartment complex had a pizza-movie night (Transformers!) and along with the group, there were 5 or6 toddlers there. They were from 3 different families... each maybe 2 or 3 years old, and I had as much fun watching them socialize as actually watching the movie. One little girl was trying to join a group of three kids--two boys and one girl--sitting on a couch in front of the TV. The boys were all about including her in their Transformers talk-- I think she was asking them in Spanish too. The girl however seemed a bit protective of her friend circle and just kept saying "NO! NO!"The boys didn't care, and one even moved over so the newcomer could sit next to him. The other girl however, came over and smacked her!! That girls' dad and mom ran over alarmed and pulled her away... then later she comes back and says "I'm sorry" to the girl she just hit. As if that weren't cute enough, the girl who got hit (who may or may not have understood the English) hugged her. It was like... real life hallmark!!!

Also, I need to fix my space bar. Here's how it looks like, I've trained my thumb to hit the little white rubber thing in the middle. Only it came off too! I put it back on, but it pops off. Poorspacebar! As youcansee, I also am missing a white plastic part on the right... I hope my vacuum cleaner didn't eat it up! Anyone have a spare spacebar (or glue?) lying around?

Monday, December 24, 2007

Santa's big helpers!

I really should sleep now (since I'm on call) but I feel a little guilty. There are only two of us interns covering the entire pedi service tonight on Christmas eve/morn, one of us admits (not me) and the other one is available for questions/concerns/emergencies the other patients in the hospital might have. Right now I've gotten called on a few easy things (tylenol for fever!) a few confusing things (why IS this patient in the hospital, really?) and one sad thing (boooo yeast line infections in kids!) The admitting intern, Jaime, is hard at work seeing kids, saving lives... and then here I am blogging! well, I could be sleeping. I'm already caught up on my discharge summaries!!

So I've kind of been bad keeping up with these hospital stories... I had this whole "ode to pumkins" theme I was going to use for my little NICU babies. but alas, that was a month ago. My pumpkins are doing well from what I hear, I heard one little baby (who was really fat too! AWWW!) was recently extubated and feeding well! and my other one who started looking like a glow-worm when I met him might actually be gaining weight. He was cute. If I could describe my entire NICU experience by one patient, that would be little baby A. He'd just be rocking in his little chair like a bobble head... with his big eyes wide open, tounge sticking out of his mouth and a serious look on his face (sometimes he'd smile though!) Soooo cute.

Last month (december... gasp!) I was in a chronic care facilty for kids who needed rehab, long term med therapy or kids too sick to go home but not sick enough to be in the hospital. That was pretty fun, only one kid I got really attached to (as did everyone since she'd been in and out of hospitals for the past few years) decide she had enough of her war against Pompe's disease (and the experimental enzyme replacement therapy she was getting for it) and left for a better world. Poor kiddo. She will be missed... with her cute little smiles, head bobbing and arm waving... but I'm sure she won't miss the crazy amount of meds and breathing devices keeping her alive. The room was so quiet though, it was eerie. If I were a braver intern, I woulda held her while they withdrew care, but I think I'm not quite ready yet. I have so much admiration for hospice workers and people in general who are at peace with the idea of death, and being with people as they go. I, on the other hand, have a severe fight-or-flight response. So I flew... out the door. Meh.

Whew. Now this holiday schedule is so confusing. let me expain. there are four teams of interns at our hospital, we've combined two of the teams so that Team A is former Teams B and D, and Team B is former Teams A and C. There are three interns on each team, and two supers on one team, we admit tonight and tomorrow, and the other team admits the day after Christmas. I'm taking call tonight for Team B, but I'm really on Team A. Or something like that. Anyway we have the original Team A pager (since it says team A on it) but the real team A patients are on Team B... so you can see what kind of fun we've had today. :-) But the nurses are feeding me goodies tonight and digging my Santa hat, so I can't get annoyed. It's almost Christmas!

Speaking of which, I wish you all a merry one! I'm going to have a fantastic one tomorrow... in my bed all snug and warm... with my pager OFF! :-) Good night to all!

Thursday, November 8, 2007

Awesome.

This woman is my hero!

That's all for now... I slept 13 hours straight after my NICU (neonatal intensive care unit) call the other day. And... I think I'm going to sleep some more now.

But first a story. I intubated today!! It sort of counted, the NICU fellow had to hold the blade in place to expose the chords after my own failed attempt. So all I really had to do was put the tube in between the chords, and wooooo! It was in! You remember how when we were kids we put blocks through holes and thought we were geniouses? It was sort of like that. Maybe next time, I can do the whole thing myself!

I should write more about my babies. They're all champs, they're so cute and are starting to fix themselves. Its amazing how many babies are born broken, and even more amazing how they can sometimes self-correct. I'll leave that to my next post. I already have a fun title in my mind. (wouldn't you like to know!) :-)

Mmmm I need a run. Tomorrow. OK I'm out!

Tuesday, October 9, 2007

October


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.

Tuesday, August 21, 2007

Bunnies!

So this is the most belated post of all time (Sorry Scott!) A few weeks ago, a fellow friend from med school and I journeyed to the Houston Zoo... and here are some pics! I really should have taken more, but my camara was broken. Luckily my phone has super phone powers. You can click on the pics to make them bigger (I think). Since this zoo visit, I've figured out how to bike there from my apartment, and it only takes about 30 minutes! it's a really nice trail by the big bayou flood collection thingie by my apartment. Here are the pics!


First... BUNNY! And... tiger getting in the water... Hop bunny, hop away!




You can kind of see the bunny standing in front of the Giraffe. SO MANY BUNNIES!






This might be a better view of the bunny. It's the little spot under the pole that kind of runs into the Giraffe's neck... does that make sense? This bunny has no danger of tigers, since Giraffes have tiger eating abilities. Or fences around them. :-)


And finally: MONKEY!! I've decided that if one day I aquire superhuman abilities (superior to my phone's photo taking abilities of course) I shall free the monkeys. Hopefully the monkey poo won't take too much of a toll on the city's cleanliness, but I'm sure we'll all benifit from a little coinhabitation.

And speaking of camaras.. I FIXED mine! It turns out that if your camara's lens is jammed so that when you turn the phone on the lens doesn't come out (or it makes a funny noise and turns off as in my case) all you have to do is take it apart and jiggle it around! then when you put it back together, jam the lens all the way in. And voila! FIXED!

I can take real pictures now. Watch out, world!

Hmm... what else of note... things are fun at the hospital. Although, I find myself laughing at really horrible things now. My co-intern was presenting a 2 year old patient that he admitted for an asthma exacerbation overnight, and the story kept getting more ridiculous. Mom didn't believe in giving the kid corticosteroids, and he had eight ER visits in the last year. Mom was bipolar, Dad was a sex offender. Dad complained mom hit the baby. Baby presented with a black eye. Mom admitted to calling dad saying that she bit her baby. I kind of lost it there and thus began an embarrasingly unstoppable fit of giggles. To my credit at least, the attending joined in.

And what was the result of all this? CPS said "sure the kid can go home with the mom." WHAT?! Legally perhaps the kid was in no danger, but dude! the kid is only 2. TAKE HIM AWAY FROM THOSE CRAZIES!! He won't remember when he's older.

Whew. That's all. I've come to really appreciate good parents in light of all these people who have children. I've come to appreciate my own parents most of all I think.

Only two more weeks left at LBJ... think I might take Step 3 next month during my development and behavior (aka child psych) rotation. I probably should just enjoy slacking off for yet another month, but something tells me I should actually try to become smarter... :-)