whoops, no time to blog yesterday! was in 6a-7p, got home, had dinner, and fell asleep while Mike was showing me the photobook of us that he's been working on at about 8:30!
Today was a better day, a well rested mind makes the morning a lot easier to get through! Was in from 6a-6p. 12 hours, holy cow, only 12 hours today! Saw two interesting cases:
A man came in with a femur fracture and nasal fracture from a fall out of bed...he has Osteogenesis Imperfecta. This is a relatively rare disease, so I was more than excited to meet him! Osteogenesis Imperfecta (OI) is also commonly known as "Brittle Bone Disease". The cause is a genetic defect in the Type 1 Collagen fibers that make up parts of our body that include most notably bones, but also sclera, skin, and endothelial tissue. The partnership with OI is Blue Sclera; That is to say, often a patient with OI has a bluish tint to the "whites" of his/her eye. Due to the collagen defect, patients suffer from repeated fractures throughout their life. This patient said he has had over 150 fractures so far. He is a lucky one, though; many OI patients die in childhood. That of course depends on the specific genetic cause of the disease, and there are 4 differing types of OI, with different prognoses and disease progressions (In case you want to learn more, this man probably had Type 3). He also happens to have a very impressive goiter. He was definitely the patient of the day for me! :)
A woman came into the ER as a Level I Trauma, found in cardiac arrest at the scene and was undergoing CPR by the paramedics at arrival. We continued CPR (it's more of a workout than you might imagine!), adjudicated her therapy with medications (Epinephrine, Bicarbonate, ), and attempted cardioversion, but after about an hour of our best efforts, it proved to be unsuccessful. That was hard to see...I have seen so many patients pull through traumatic injuries and poor health in the SICU/MICU, this was the first time I saw our efforts to be completely ineffective.
Tomorrow is another day...I am nearing the end of my trauma service on surgery, but I have had a really great time in this rotation. I would definitely recommend it, good exposure to patient care and management, as well as difficult management of very sick patients, with minimal time spent in the operating room - my ideal surgical service!haha
Quote of the day: The head of our Surgery Department rounded with us today. We have spent some time with him in the last two weeks, and he is a really great teacher and a great role model physician. Today, he said to my trauma service partner and me: "I have been in this business a very long time, and I know when I see students who will make excellent physicians, and you are very bright students. You are well on your way to becoming very successful physicians, keep doing what you're doing, keep working hard, and I promise you that it will pay off."
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